Parent Information

Parent First Name – (Parent one) *

Parent Last Name – (Parent one) *

Primary Email Address (Please enter same as Parent Login E-Mail) *

Home Email Address – (Parent one)

Cell Phone – (Parent one)

Home Phone – (Parent one)

Parent two (select one) Please Select Mother Father Guardian

Parent 2 First Name

Parent 2 Last Name

Secondary Email Address – (Parent two)

Home Email Address – (Parent two)

Cell Phone – (Parent two)

Home Phone – (Parent two)

Camper Information

Camper First Name

Camper Last Name

Name Camper Prefers To Be Called

Select Sex * Please Select Female Male

Age

Entering Grade After Camp Please Select 2 3 4 5 6 7 8 9 10 11

Home Street Address *

City *

State *

Zip Code *

Country Please Select United States Other – please specify

Was this camper at Anokijig last year? * Please Select Yes No

How did you hear about us? * Please Select Camp Stay Chamber of Commerce Expo Friend Internet Camp Directory Internet Web Search Magazine Mailing Newspapers – Chicago Area Newspaper – Madison Area Newspaper – Milwaukee Area News paper – Other Newspaper – Sheboygan Area Other Radio Relative School Brochure School Website Special Event TV Alumni Parent is Alumni Camp Fair

We will honor one housing request per camper so that two friends in the same age group can live together in one housing section.

Enter Only One Friends Name