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Billing Address *

First name *

Last name *

Company name (optional)

Country / Region *

Street address *

Apartment, suite, unit, etc. (optional)

Town / City *

State *

ZIP Code *

Phone *

Username Required

Email address Required

Password Required

Parent/Guardian Details *

P/G First Name *

P/G Last Name *

P/G Phone Number *

P/G Relationship To Camper

Parent/Guardian 2 Details

P/G 2 First Name

P/G 2 Last Name

P/G 2 Phone Number

P/G 2 Relationship To Camper

Trusted Adult

These individuals must be of legal age (18), reliable, and responsible adults. By listing the person(s) above, you provide us with permission to receive/release your camper(s) from/into their custody.

Two individuals are allowed on our online form. All parties must be authorized for pick-up/drop-off via the fields above or a note signed by the legal guardian of the camper(s). The signed note must be provided to the Lead Scientist(s) at Sign-In.

TA First Name

TA Last Name

TA Phone Number

TA Relationship To Camper