Starbase Camp (6/9-6/12)

Starbase Registration

* Indicates required field

Parent's Name *

First

Last

DOD Affiliation *

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Camper/Child's Name *

First

Last

Birthday *

T-Shirt Size *

Emergency Contact (Different from Registrant) *

First

Last

Relation to Camper *

Phone Number *

I understand I will have to fill out both a medical and photo release at check-in on the first day of camp. *

Acknowledged

Submit