Student Name *

First Name

Last Name

Student Date of Birth *

MM

DD

YYYY

Parent(s) Name *

First Name

Last Name

Parent 1 Cell *

(###)

###

####

Parent 2 Cell

(###)

###

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I understand that the price of camp is $450, with the possibility of successful fundraisers lowering this cost. *

Yes

I understand my final balance is due June 6, 2025 *

Yes

I understand my spot is not reserved until I have paid my $75 non-refundable deposit. *

Yes

I will pay my deposit:

Online ---- Youth Events - Non-Charitable in the Funds dropdown menu

Cash or Check in offering box with RSM Camp in memo