2700 Debarr Road Anchorage, AK 99508

2022 Statewide Family Camp #1

Director: Jason Gardner.

Name*

First Name Last Name

Address*

Phone*

Home or Cell Number

Email*

Home Congregation

Marital/Family Status*

Needed for Cabin Assignments

Child #1 Name & Age (if attending)

Child #2 Name & Age (if attending)

Child#3 Name & Age (if attending

Child #4 Name & Age (if attending

Child #5 Name & Age (if attending)

Child #6 Name & Age (if attending)

Will you need transportation from town?

***4 WHEEL DRIVE VEHICLES ARE RECOMMENDED ON THE CAMP ROAD. ***MUST HAVE 2 KEYS (One to unlock each of the two gates to onto the property.

We would like to share a cabin with...

Are you staying in your own camper of tent? If so, which?

Please list any special housing needs, allergies, medical needs, etc.