Lilburn

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Who We Are
- Our Mission and Values
Giving Back
Contact

Camp Lilburn (July 23-27)

Child's name:

Child's age:

Child's grade next year:

Child's school next year:

Child's gender:

Address:

Primary guardian's name:

Primary guardian's cell phone:

Primary guardian's email:

Primary guardian's occupation/ place of work:

Secondary guardian's name:

Secondary guardian's cell phone:

Secondary guardian's occupation/ place of work:

Additional emergency contact (name, relationship, number):

Child's allergies:

Child's medical conditions:

How you discovered this camp:

Describe your child's personality:

Friend attending you'd like grouped with your child (if possible):

May we use a photo of your child for promotional purposes (yes or no):

Thank you for registering! Don't forget to pay (payment not made one week prior to camp will forfeit your child's spot). Please check your email closer to the date for important updates and reminders!

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All Rights Reserved | Map to HOPE, LLC

Contact Us:

We are an Atlanta-area Social Enterprise

Phone: (608) 856-HOPE

Email: info@maptohope.org

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