Address:
City: State: AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip:
Phone: Fax:
Arrival: Wednesday, 6/18 Thursday, 6/19 Friday, 6/20 Saturday, 6/21 Sunday, 6/22 Depart: Wednesday, 6/18 Thursday, 6/19 Friday, 6/20 Saturday, 6/21 Sunday, 6/22
Number of packets: 1 2 3
Plan to recruit at the Camp? Y N Plan to recruit at the Dynamite Classic: Y N