Camp Registration Printable School Tour Request Form Please Specify The Name And Date Of The Camp/Event You Are Registering For(Required) Student's Name(Required) First Last Grade completed(Required) Parent's Name(Required) First Last Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Major Phone(Required)Other PhoneEmail(Required) Would You Like To Be Added To Our E-newsletter mailing list, To Stay Up To Date on Up Coming Events?(Required) Please let us know of any health problems your child may have including allergiesPlease list:Is there someone besides yourself, if you cannot be reached, with authorization for your child to be treated in the case of a medical emergency?(Required) Yes No Emergency Contact Info(Required)First NameLast NamePhone Number Add RemoveIf there is more than 1 emergency contact, click the + (plus) symbol to add more. Please check and sign for permission to use your child’s picture for publicity or other BAHM publications.(Required) Yes No Signature