Watershed Adventures Program Registration Form

Program Choice

Please Note: Our sessions of the full week Multi-Sport camps are full as of 2/15/19. Please email Sonya as sonya@rivannarivercompany.com to be added to a waitlist. Thank you.*

SESSION FULL: Multi-Sport Camp, 8-10 yrs old, June 24th-28th, 2019
SESSION FULL: Multi-Sport Camp, 8-10 yrs old, July 8th-12th, 2019
SESSION FULL: Multi-Sport Camp, 11-14 yrs old, July 22nd-26th, 2019
SESSION FULL: Multi-Sport Camp, 11-14 yrs old, July 29th-August 2nd, 2019
Multi-Sport Camp (3 DAY @ B.R.S.), 6-11 yrs old, June 19th-21st
3 day 2 night Backpacking Trip, August 13th-15th, 2019
7 day 6 night Backpacking Trip, August 5th-11th, 2019

Basic Information for Camper

Camper's Name*

First Last

Gender*

Female
Male

Date of Birth*

Age of Participant at time of Camp/Trip:*

Current School Attended*

Height*

Weight*

T-Shirt Size*

Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large

Contact Information

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Primary Contact*

First Last

Relationship to Camper*

Cell Phone for Primary Contact*

Email Address for Primary Contact*

Emergency Contact in addition to Primary Contact

First Last

Cell Phone for Additional Emergency Contact

Camper's Detailed Information

Thank you for completing this section, which will help our staff in taking care of each camper.

Medical Conditions and Allergies*

Information kept strictly confidential. Please list any allergies, medications previously taken or currently taking, and previous medical history (i.e. history of asthma, diabetes, cardiac issues, epilepsy, EpiPen)

Dietary Restrictions*

Please provide as much detail as possible about the camper's dietary restrictions, if any.

Previous Outdoor Experience*

Please include any information that might be relevant to our instructors and guides.

Additional Information

Use this section to let us know anything important that you haven't had a chance to yet. Thanks!