Camp Fruit Loop Registration Form

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Parent/Guardian Permission Slip

Please note: if you are new to Camp Fruit Loop, you will be contacted by a Camp Fruit Loop leader to schedule an interview prior to acceptance of your application. By completing this form, you are signing up to attend Camp Fruit Loop June 22 - 27, 2026. You are also agreeing that all information submitted is correct and accurate.

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian Phone

Parent/Guardian Home Address*

Multi-line address

Country/Region

Address

City

Zip / Postal code

Add an additional Parent/Guardian

Is there a parent/guardian that is not allowed to pick up camper?

Please write full names, separated by commas if more than one, otherwise N/A.

In the event of an emergency, which ER should your camper go to?

In the event of an emergency, your camper will be taken to the stated ER unless the nature of the injury or illness requires immediate care at the closest ER facility.