2024 FUN AND FREEDOM DAY CAMP

9th Grade and above SENIOR COUNSELOR REGISTRATION FORM

(You will receive a “confirmation” E-mail once your registration is received.)

Counselor Name: *

First

Last

Gender *

Current Age *

Present Grade

What School District do you attend:

CAMPER T-Shirt Please check one: *

Counselor Cell Phone

Counselor Email *

Parent / Guardian Name: *

First

Last

Address: *

City, State, Zip

Guardian Email: *

Home Phone

Cell Phone

Email *

Emergency Contact: *

First

Last

Emergency Contact: Phone

Fun and Freedom is a 501(C)(3) non-profit organization.

P.O. Box 63
Tarentum, PA 15084

724.274.7773

Mon. - Fri. 8AM - 6PM