Talk/Text (260) 352-2607

Sponsored Camper Registration

If you have been notified that your camper has been sponsored, please fill out the form below. If you are interested in receiving a camp sponsorship, please contact the Mollenhour Board at comollenhourcamp@gmail.com.

Boys CampGirls Camp

Shirt Size

I hereby grant permission to C.O. Mollenhour Conservation Camp to use photographs and/or video of my child during camp week in publications, news releases, online, and in other communications related to the mission of C.O. Mollenhour Conservation Camp.

YesNo

If we are unable to include your camper in camp photos for personal reasons, please email us at comollenhourcamp@gmail.com.

Will your camper be taking medications during camp week?

YesNo

If you answered yes to the question above, please list the medication(s), dosage, specific times taken each day and reason for taking medication below. NO medication will be administered without proper verifications. All prescription and over- the-counter (OTC) medications to be taken by a camp participant must be left and kept with the camp director or camp nurse. All medication must be in the pharmacy bottle or original store container with proper labeling.

Please list all medical information you would like staff to know about your camper and any allergies.