Camp Wasiu II Registration Form

Please fill out entire form.

This is a secure form. If you do not wish to submit online, you may print out this form, fill it out and send it directly to

Girl Scouts of the Sierra Nevada, Attn: Camp Wasiu

FAX: (775) 322-0701 or

MAIL: 605 Washington Street, Reno, Nevada 89503.


First Summer Camp Choice
Session Number: *
Program Name: *
Alternate Session Number: *
Program Name: *
Second Summer Camp Choice
Session Number:
Program Name:
Alternate Session Number:
Program Name:
Camper Information
Camper's Name: *
Address: *
City: *
State: *
Zip Code: *
Phone Number: *
Age: *
Date of Birth: *
Grade in the Fall: *
Camper's Email:
School:
My daughter is currently: *	a Girl Scout Not a Girl Scout (An additional $15 fee will be added.)
Local Girl Scout Council:
Troop Number:
Parent/Guardian Information
Parent/Guardian 1 Full Name: *
Email Address: *
Day Time Phone: *
Evening Time Phone: *
Parent/Guardian 2 Full Name:
Email Address:
Day Time Phone:
Evening Time Phone:
Emergency Contact
Emergency Contact Full Name: *
Relation: *
Day Time Phone: *
Evening Time Phone: *
Additional Information
Name of ONE girl your camper would like to have in the same unit. Both campers must request each other. Placement together cannot be guaranteed. Name:
How did you hear about camp? *
Please check all that applies, if Camper: *	Has earned cookie credits. Has applied for financial aid. N/A
Online Payment
Credit Card: *
Card Holder Name: *
Credit Card Number: *
Card Expiration Date: *
Security Code: *
Card Billing Zip Code: *