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* 1. Camper Name

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* 2. Camper Date of Birth

Date

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* 3. Camper Age on July 1, 2025 (must be 11-14 yo)

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* 4. Guardian 1 Name

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* 5. Primary Guardian Home Address

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* 6. Primary Guardian Phone

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* 7. Primary Guardian Alt. Phone

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* 9. Name (Guardian 2)

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* 10. Primary Phone (Guardian 2)

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* 11. Alternate Phone (Guardian 2)

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* 13. Are you a Trout Unlimited member or affiliated with and MTU chapter?

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* 14. What is your local Montana Trout Unlimited chapter?

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* 15. Is your child seeking scholarship assistance from your local TU chapter?

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* 16. Emergency Contact

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* 17. Emergency Contact Relation to Camper

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* 18. Emergency Contact Primary Phone

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* 19. Is there anyone not listed above that is authorized to pick up your child? If yes, please list.

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* 20. Camper T-Shirt Size

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* 21. Does your child have any dietary restrictions? Please describe.

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* 22. Describe your child's swimming ability.

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* 23. Does your child take medication?

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* 24. List any medications and applicable instructions.

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* 25. Does your child have any chronic physical problems, pertinent psychological or developmental issues, or require any special accommodations? Describe.

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* 26. Camper Short Essay - Please describe why you are interested and excited to attend camp and what you hope to learn in 500 words or less. You can also email your response to bill@montanatu.org.

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