Register Online

Register your child for Camp Brave Eagle

Your name

Your email address

Name(s) and age(s) of child/children attending camp, including siblings, and whether they will be taking the bus to camp from St. Vincent Hospital in Indianapolis:

Name of camper

age

bus to camp?

bus home?

yes
no

yes
no

yes
no

yes
no

yes
no

yes
no

yes
no

yes
no

yes
no

yes
no

Names of family members

Names of family members (including Pre–Campers) attending the Family Program on Friday, June 18th, 2010.

Also, will they need round–trip bus transportation on Friday, June 18th, 2010 from St. Vincent Hospital to the Family Program.

name of family members

bus?

yes
no

yes
no

yes
no

yes
no

yes
no

Name of family member we can contact, as well as address and day and evening phone numbers

name of family contact

Address, include state and zip code, please

Daytime phone number and area code:

Evening phone number and area code: