Camper Name *
Camper Name
Camper's Date of Birth *
Camper's Date of Birth
Camper Home Address *
Camper Home Address
Guardian #1 Name *
Guardian #1 Name
Guardian #1 Phone *
Guardian #1 Phone
Guardian #2 Name *
Guardian #2 Name
Guardian #2 Phone *
Guardian #2 Phone
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Phone *
Emergency Contact Phone
Mailing Address (Japan) *
Mailing Address (Japan)
How did your child acquire English? *