Ohio LTC – Summer 2018

Your Name:
Age:
Sex:  Male Female
Grade (your grade level fall, 2019):
Email Address:
Home Address:
City:
Zip:
Home Phone:
School:
County:
Principal's Name:

I would like to register for the following camp:

Roommate Request

Please list your roommate choice(s) below. Please make sure your requested roommate(s) lists you as a roommate on their registration form. This will guarantee that you will be housed together.

 No roommate request My roommate request is: