Name:       

Address:   

City:         

State:           Zip:

Phone:        

E-mail:      

UA Number:

Child's Name, Age, Birthdate, Sex
Camp Konocti is unable to accept any child who is not seven (7) years old on or before June 9, 201. Parents may be asked for verification of their child’s age if questions arise.

Please click on the Camp Konocti session which your child will be attending:

Session 1 - 7 & 8 Years old - June 14-27

Session 2 - 9 & 10 Years old - June 28-July 11  

Session 3 - 11 & 12 years old - July 12-25 

Session 4 - 13 & 14 years old - July 26-Aug. 8  

  I certify that I am the legal parent, grandparent or guardian of the above-names child,
              and that he/she has my permission to attend Camp Konocti

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