Alumni Information Update

Camper Counselor Other

First Name:
Last Name:

Address:
City:
State:	Zip:

Phone:
Email:

Would you like to receive the CHAMP Camp newsletter via email? Yes No
If no, would you like to receive the CHAMP Camp newsletter via snail mail? Yes No

Date of Birth:

How many years did you attend camp?
What years did you attend? (e.g. 2005-2008)

Additional information you want us to know (i.e. marriage, kids, graduation, college updates, work updates, etc):