interest form

Adult 1:

Required

Enter Name

Adult 1 Email:

Required

Enter Email Address

Adult 2: (optional)

Required

Enter Name

Adult 2 Email: (optional)

Required

Enter Email Address

Child(ren):

Required

Enter name, age, and birthplace for each child

Street Address:

Required

Enter Street Address

City:

Required

Enter City

State:

Required

Enter State

Zip code:

Required

Enter Zip

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Tell us about yourself!

Please complete the form with information about your family. We will include you in our distribution list to notify you directly when our registration opens. Your information is only used by the Camp Iakwe committee and will not be shared.