Counselor Connection Registration

*indicates required fields

Your Name and Address

First Name*
Last Name*
Title*
Street Address*
City*
State*
Zip Code*

Your School/Organization Information

School/Organization*
School Email*
School Phone*

Event Information

Best Summer Contact Email*
Best Summer Contact Phone*
Arrival Date*
Departure Date*
Total Number of Guests including Self*
Names of Guests (if available at this time)
Any food allergies?
Any special requests or comments:


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