RAD 2011 On-line Registration

First and Last Name Required

First

Last

Are you a boy or a girl? Required

Email Address Required

Address Required

Street Address

City

State

Zip Code

Phone Number Required

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Cell Phone Number

Can you receive text messages on your phone?

Age Required

Birth Date (month, day, year) Required

Which grade will you be in after camp?

Are you on facebook? Required

If so, what is your facebook ID?

Name of parents or guardins while at camp Required

Name of person we should contact on the campground in an emergency: Required

Which building or cottage are you living in at camp? Required

What date will you be arriving at camp?

How long will you be at camp?