1. Camp Primavera 2014

This is a short registration form for your child to attend Camp Primavera from April 14-17 at Camp Crowell in Oakton, VA. Please answer every question.

You will receive a confirmation e-mail that your daughter has been placed after the April 4th deadline. Please do not contact us until after that date. We ask that you only register one time. Entering multiple registrations for your child will slow down the process.

Please note: If your daughter is a Girl Scout, she will be placed on a waiting list. Thank you.

* 1. Child's Name and Last Name:

* 2. I am registering a:

* 3. Age:

* 4. Date of Birth:

* 5. Address:

* 6. Current School Attending:

* 7. Parent/Guardian:

* 8. Parent/Guardian 2:

* 9. If divorced or legally separated, please indicate the custodial parent(s):

* 10. Emergency Contact Information (not listed above):

* 11. Are you currently a registered Girl Scout?

* 12. Do you need Bus Transportation?

* 13. Which Bus Stop will your child use?

* 14. For security reasons we need an adult at every bus stop making sure the girls safely get on and off the bus. Can you help us with such an important job?

* 15. Registrants Racial Background is:
We encourage you to voluntarily provide the following information on racial background and ethnicity. This information will be used by Girl Scouts of the USA to help improve outreach efforts and advance the Girl Scout movement.

* 16. Registrant's Ethnic Background:

33% of survey complete.