Falcon Millionaires Registration

»Select Camp Session:	June 12th-16th June 26th-30th
»Select Your Current School:	If Other, please specify:
»Select Your Current Grade:	7th 8th

Student Information

»Name:

First	Middle	Last

Preferred first name:

»Gender:

Male Female

Dietary Restrictions:

»Mailing Address:

Address

Apt, floor, suite, etc.

City	State	Zip Code
,

County

Phone Number:

Area, Prefix, Number

– –

»Birth Date:

Month, Day, Year

»T-Shirt Size:

Adult Sizes

S M L XL

Parent/Guardian Information

»Relationship:

Father Mother Other

»Name:

First	Last

»Mailing Address:

Address

Apt, floor, suite, etc.

City	State	Zip Code
,

County

»Daytime Phone:

Area, Prefix, Number

– –

»Cell Number:

Area, Prefix, Number

– –

»Email Address:

Relationship:

Father Mother Other

Name:

First	Last

Mailing Address:

Address

Apt, floor, suite, etc.

City	State	Zip Code
,

County

Daytime Phone:

Area, Prefix, Number

– –

Cell Number:

Area, Prefix, Number

– –

Email Address:

Contact Information:

Adult driving camper to BGSU

»Name:

First	Middle	Last

»Relationship

»Cell Number

Area, Prefix, Number

– –

»How did you learn about BGSU Falcon Millionaires?

If Other, please specify:

Updated: Tuesday, October 25, 2016

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