2024 Adult/Family Program Information Request

Parent/Guardian Name*
First Last
Phone*
Email*
Address*
Mailing Address City State / Province / Region ZIP / Postal Code Country
Connection to Huckins- Please check all that apply*
- Alumni Relative(Gram, Mom, Aunt, Sister)
- Belknap
- Attended a Huckins Program
- Friends
- No Connection- new applicant
Interested in*
- Family Camp Week
- Mother/Child Weekends
- Womens Wellness
Comment / Question
Email
This field is for validation purposes and should be left unchanged.

YMCA CAMP HUCKINS