Individual Registration

Please enter information in the form below to process registration for event Bears Ears Summer Camp: June 3-5 .

First Name *

Last Name *

Address

City

Zip

State

Email *

How did you hear about Summer Camp? *

Newspaper

Radio

Flyer

Online

Social Media

Participant's Tribal Affiliation *

Parent or Guardian's Full Name *

Parent or Guardian's' Email Address *

Parent or Guardian's Phone Number *

I will attend, or send someone to attend on my behalf, a required virtual orientation on May 19. *

Yes

I acknowledge that if I don't complete registration information by May 19, I understand that my spot will be given to another attendee. *

Yes

Coupon

Amount

Discount Amount

Gross Amount

Payment Method *

Credit Card Pay at the Door

Credit or debit card*