2017 I.C.O.O. Karl E Kelley Memorial Camp Application

Thank you for expressing interest in having your child attend this year's ICOO Karl E. Kelley Memorial Youth Camp! Please completely fill out the folllowing form and take not to the required fields!

You will be required print a confirmation at the conclusion of this process, so please make sure you have access to a printer!

Eligibility: Open to children who have completed the fifth or sixth grade in the previous school year and who have not attended this camp previously.
Camp Dates: June 18 - 24, 2016
Location: Ross Camp, Tippecanoe County
Cost: $350.00 Make checks payable to ICOO

Camper Information:

First Name:
Middle Int.:
Last Name:

Address:
City:
State:
Zip Code:

Date of Birth: (mm/dd/yyyy)
Sex:
Current Grade:
T-Shirt Size (Adult Sizes):
Weight:

Parent or Guardian Information

First Name:
Last Name:

Address Same As Camper?
Address:
City:
State:
Zip Code:

Primary Phone:
Secondary Phone:
Email Address:

Emergency Contact Information (other than parent)

First Name:
Last Name:
Telephone:

Buddy Choice

Each camper may select one camper to be a buddy who will be assigned to the same group, if buddy choice is selected as a camper. All other buddy assignments will be randomly selected. Buddy choices will not be changed after group assignments have been made.

Buddy Name:

Make Sure All Information is Correct Before Submitting!