Please register below for Explorers - 2-5 grades - June 30-July 5, 2019. If you have questions please contact us at 906-542-3529 or email@example.com.
Please Note: This camp ends on Friday, July 5, 2019. The closing parent/camper closing program begins at 3 pm.
If registering by May 1, 2019 you qualify for the Early Bird Discount. The coupon code is MAY1ST
* Denotes a required field to fill in
First Time Camper?
Clear My Answer
Where did you hear about Lake Ellen?
Other Social Media
Camper's First Name
Camper's Last Name
(including area code)
Emergency Contact Name
Emergency Contact Phone
Grade in fall?
Father's Name & Occupation
Mother's Name & Occupation
I would like to room with:
Pony Express - 2-3 grades - $50
Rough Riders - 4-5 grades - $80
Show Basics - 2-5 grades - $20
Vaulting - 2-5 grades - $20
Person who will pick up camper at the end of camp
Camper's FULL name
Name of Physician
Precautions to be observed
Known Communicable Diseases
(Must be brought in original containers)
Special Housing/Disability Needs
Are Immunizations up to date?
Date of last Tetanus Booster
Known Diseases or Conditions
Special Dietarty Needs
Waiver Acceptance Required
Please read and sign the below waiver.
I, the undersigned, hereby give my permission to Lake Ellen Camp to call a doctor or emergency medical service and for the doctor, hospital or medical service to provide emergency and/or surgical care and to provide routine medical care for the above named child should the need arise.I give my permission for the applicant to participate in all activities as they pertain to his/her program, for the applicant to be transported in camp-owned vehicles to and from off-campus activities, and to use digital or print photos of the applicant for camp promotional purposes.Parent/Guardian Signature: (Please type your FULL name). By typing your full name you consent to the above disclosure.*
I have read and accept this waiver