Family Name:
Father:
Mother:
Street Address:
City:
State:
Zip Code:
Phone:
Email:
We are interested for:	Summer 2009 Summer 2010
How did you hear about Camp Starlight:
Child 1
Name:
Age:
Birthdate:
Grade (Sept 2008):
Interests/Needs:
Previous Camping Experience:
Child 2
Name:
Age:
Birthdate:
Grade (Sept 2008):
Interests/Needs:
Previous Camping Experience: