| Parent or Guardian's Email | First | Last | Gender | Birthday | Next Grade | Address | Guardian | Relationship | Phone | Emergency | Relationship | Phone | Congregation | Cabin Request | T-Shirt Size (adult sizes only) | Physician | Phone | Allergies, Medications and Conditions | Non-Participating Activities: | OTC Medications | Date of Last Tetanus shot: | Can this camper swim? | Medical and Emergency Consent | Media Consent | Electronic Signature | Date | Payment Amount | Payment Date |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Email hidden; Javascript is required. | James | Neal | Male | 07/13/2012 | 8th | 5422 45th Ave N Saint Petersburg, FL 33709 Map It | Halie Walden | Mother | (727) 520-3278 | Jayce Ruley | Step Father | (727) 288-4378 | Pinellas Park C.O.C | Boy's Cabin 6 | M | St.Pete Pediactrics | (727) 547-4000 |
| 01/01/2025 | Yes |  I agree | I agree | 05/25/2025 | $175.00 | May 24, 2025 | |||
| Email hidden; Javascript is required. | Mico | Ruley | Male | 09/04/2014 | 4th | 5422 45th Ave N Saint Petersburg, FL 33709 Map It | Halie Walden | Step Mother | (727) 520-3275 | Jayce Ruley | Father | (727) 288-4378 | Pinellas Park C.O.C | Boy's Cabin 3 | M | Everett Health | (727) 533-2015 | Lacitid | No |
| 08/01/2024 | Yes | I agree | I agree | 05/24/2025 | $175.00 | May 24, 2025 | |
| Email hidden; Javascript is required. | Milliyon | Ruley | Male | 09/22/2015 | 3rd | 5422 45th Ave N Saint Petersburg, FL 33709 Map It | Halie Walden | Mother | (727) 520-3278 | Jayce Ruley | Father | (727) 288-4370 | Pinellas Park C.O.C | Boy's Cabin 3 | M | Saint Pete Pediatrics | (727) 547-4000 |
| 12/01/2024 | Yes | I agree | I agree | 05/24/2025 | $175.00 | May 24, 2025 | |||
| Email hidden; Javascript is required. | Rachael | Wright | Female | 04/27/2010 | 10 | 1544 lime street Clearwater, Fl 33756 Map It | Deb wright | Mom | (813) 775-8516 | Tony wright | Dad | (727) 644-9583 | Ppcoc | Girl's Cabin 3 | M | Evara Health | (727) 727-8248 | Nuts, some fruit, insects and grass | No |
| 05/15/2024 | Yes | I agree | I agree | 05/25/2025 | $175.00 | May 25, 2025 | |
| Email hidden; Javascript is required. | Sadie | Roddenberry | Female | 05/05/2014 | 6th | 3280 Piccard Loop New Port Richey, FL 34655 Map It | Halie | Roddenberry | (352) 364-2613 | Roy Lauren | Step dad | (813) 381-2114 | Trinity church of God | Girl's Cabin 1 | XS | Dondaro | (727) 844-3551 |
| 03/14/2025 | Yes | I agree | I agree | 05/25/2025 | |||||
| Email hidden; Javascript is required. | Xavier | Padron | Male | 10/11/2012 | 7th | 3280 Piccard Loop New Port Richey, FL 34655 Map It | Halie Roddenberry | Mother | (352) 364-2613 | Roy Lauren | Step dad | (813) 381-2114 | Trinity | Boy's Cabin 3 | S | Dondaro | (727) 844-3551 |
| 03/14/2025 | Yes | I agree | I agree | 05/25/2025 | |||||
| Email hidden; Javascript is required. | Ryleigh | Zentz | Female | 07/21/2012 | 8 | 10345 Snowbird Ave. Weeki Wachee, Florida 34614 Map It | Christina Zentz | Mother | (505) 615-3903 | Bradley Zentz | Father | (360) 265-5319 | Spring Hill Church of Christ | Girl's Cabin 1 | M | Alicia Pierce-Kee | (813) 968-7171 |
| 09/22/2023 | Yes | I agree | I agree | 05/25/2025 | $175.00 | May 25, 2025 | |||
| Email hidden; Javascript is required. | Haylo | Sandroni | Female | 04/17/2013 | 7 | 4 N Lee St Hudson, FL 34667 Map It | Brittany Sandroni | Mother | (727) 333-1121 | Angelo sandroni | Father | (352) 770-9740 | Grace | Girl's Cabin 4 | M | Kids care | (352) 686-1914 |
| 05/18/2024 | Yes | I agree | I agree | 05/26/2025 | $175.00 | May 26, 2025 | |||
| Email hidden; Javascript is required. | Ezra | Fitzgerald | Male | 12/19/2010 | 9th grade | 663 SE 19th St Ocala, FL 34471 Map It | Kyla Fitzgerald | Mother | (321) 474-5455 | Jason Fitzgerald | Father | (321) 474-2078 | Maricamp Road Church of Christ | Boy's Cabin 3 | L | Dr. Al Avendano | (352) 732-8955 |
| 02/19/2021 | Yes | I agree | I agree | 05/26/2025 | $175.00 | May 26, 2025 | |||
| Email hidden; Javascript is required. | Bryson | Fitzgerald | Male | 09/02/2013 | 6th grade | 663 SE 19th St Ocala, FL 34471 Map It | Kyla Fitzgerald | Mother | (321) 474-5455 | Jason Fitzgerald | Father | (321) 474-2078 | Maricamp Road Church of Christ | Boy's Cabin 3 | M | Dr. Al Avendano | (352) 732-8955 |
| 10/13/2017 | Yes | I agree | I agree | 05/26/2025 | $175.00 | May 26, 2025 | |||
| Email hidden; Javascript is required. | McKenna | Fitzgerald | Female | 10/08/2015 | 4th grade | 663 SE 19th St Ocala, FL 34471 Map It | Kyla Fitzgerald | Mother | (321) 474-5455 | Jason Fitzgerald | Father | (321) 474-2078 | Maricamp Road Church of Christ | Girl's Cabin 3 | M | Dr. Al Avendano | (352) 732-8955 |
| 10/28/2019 | Yes | I agree | I agree | 05/26/2025 | $175.00 | May 26, 2025 | |||
| Email hidden; Javascript is required. | Dante | Oliver | Male | 03/19/2009 | 10 | 4305 RIVER BIRCH DR Spring Hill, FL, Florida 34607 Map It | Yvonne Caskey | Grandmother | (786) 776-7510 | Sara Oliver | Aunt | (352) 515-3644 | Saint Theresa Catholic Church | Boy's Cabin 3 | M | Dr. Wong | (352) 597-7373 |
| 06/06/2022 | Yes | I agree | I agree | 05/27/2025 | $175.00 | May 27, 2025 | |||
| Email hidden; Javascript is required. | Haylee | Smith | Female | 09/07/2013 | 6th | 632 NE 389th Ave old town, fl 32680 Map It | Rosa McAllister | gma | (352) 356-0961 | Virginia Mosley | gma | (813) 924-5379 | Rafter Cross cowboy church | Girl's Cabin 4 | S | UF Ped | (352) 594-7337 |
| 06/28/2018 | Yes | I agree | I agree | 05/28/2025 | |||||
| Email hidden; Javascript is required. | Jaden | Smith | Male | 11/24/2007 | 12th | 632 NE 389th Ave old town, fl 32680 Map It | Rosa McAllister | gma | (352) 356-0961 | Virginia Mosley | gma | (813) 924-5379 | Rafter Cross cowboy church | Boy's Cabin 6 | M | Uf Ped | (352) 594-7337 |
| 11/28/2011 | Yes | I agree | I agree | 05/28/2025 | |||||
| Email hidden; Javascript is required. | Jacob | West | Male | 06/26/2009 | 11th | 632 N.E., 389th ave Old Town fl 32680 Old town, Florida 32680 Map It | Rosa McAllister | gma | (352) 356-0961 | Virginia Mosley | gma | (813) 924-5379 | Rafter Cross Cowboy church | Boy's Cabin 3 | M | UF Ped | (352) 594-7337 |
| 08/07/2013 | Yes | I agree | I agree | 05/28/2025 | |||||
| Email hidden; Javascript is required. | Liam | West | Male | 08/02/2010 | 10th | 632 NE 389th Ave old town, fl 32680 Map It | Rosa McAllister | gma | (352) 356-0961 | Virginia Mosley | gma | (813) 924-5379 | Rafter Cross cowboy | Boy's Cabin 5 | M | UF ped | (352) 594-7337 |
| 08/06/2015 | Yes | I agree | I agree | 05/28/2025 | |||||
| Email hidden; Javascript is required. | Aubry | Webster | Female | 10/14/2008 | 12 | 6302 Hillside Avenue Cincinnati, OHIO 45233 Map It | Shawn Webster | Father | (513) 823-6462 | Kelly Cahill | Church friend | (727) 558-3300 | Point Pleasant Church of Christ | Girl's Cabin 3 | S | Dr. Mammari | (513) 922-8200 |
| 02/04/2022 | Yes | I agree | I agree | 05/29/2025 | $175.00 | May 29, 2025 | |||
| Email hidden; Javascript is required. | Analyse | St John | Female | 08/23/2012 | 8th | 503 Corbett Bluff Dr Ruskin, FL 33570 Map It | Emily St John | Mother | (813) 326-7660 | Roberto St John | Father | (813) 326-7660 | Henderson Blvd., Church of Christ | Girl's Cabin 2 | S | Sharon Dabrow | (813) 821-8700 | EPI pen. Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a rare food allergy where symptoms only occur after consuming wheat and then exercising. She has never needed the EPI pen since it was prescribed and she is well versed and knowledgeable about what she can and can’t eat/do. | No |
| 07/08/2024 | Yes | I agree | I agree | 05/30/2025 | $175.00 | May 30, 2025 | |
| Email hidden; Javascript is required. | Grace | Kaczmarek | Female | 01/14/2015 | 5 | 11908 Foxfire drive 11908 Foxfire drive Hudson, Florida 34669 Map It | Marcia Kaczmarek | Mother | (727) 243-8953 | Mike Kaczmarek | Dad | (727) 243-8952 | None | Girl's Cabin 4 | XS | East Lake Pediatric Center | (727) 372-6760 |
| 11/05/2015 | Yes | I agree | I agree | 05/30/2025 | $175.00 | May 30, 2025 | |||
| Email hidden; Javascript is required. | Jason | Kaczmarek | Male | 10/22/2010 | 9 | 11908 Foxfire drive 11908 Foxfire drive Hudson, Florida 34669 Map It | Marcia Kaczmarek | Mother | (727) 243-8953 | Mike Kaczmarek | Dad | (727) 243-8952 | None | Boy's Cabin 3 | S | East Lake Pediatric Center | (727) 372-6760 |
| 06/26/2023 | Yes | I agree | I agree | 05/30/2025 | $175.00 | May 30, 2025 | |||
| Email hidden; Javascript is required. | Isabell | Kaczmarek | Female | 01/07/2013 | 6 | 11908 Foxfire drive 11908 Foxfire drive Hudson, Florida 34669 Map It | Cassandra Sessa | Mother | (727) 495-1687 | Josh Sessa | Dad | (727) 768-4553 | None | Girl's Cabin 4 | S | East Lake Pediatric Center | (727) 372-6760 |
| 05/31/2017 | Yes | I agree | I agree | 05/30/2025 | $175.00 | May 30, 2025 | |||
| Email hidden; Javascript is required. | Lexi | Cahill | Female | 01/29/2010 | 10 | 1595 Evergreen Ave Clearwater, FL 33756 Map It | Kelly Cahill | Mother | (727) 558-3300 | Kelly Cahill | Mother | (727) 558-3300 | Central CoC Clearwater | Girl's Cabin 3 | L | Dr Sandra Utter | (859) 823-5441 |
| 01/31/2020 | Yes | I agree | I agree | 05/30/2025 | |||||
| Email hidden; Javascript is required. | Hailey | Cahill | Female | 04/23/2011 | 8 | 1595 S Evergreen Ave Cleartwater, FL 33756 Map It | Kelly Cahill | Mother | (727) 558-3300 | Kelly Cahill | Mother | (727) 558-3300 | Central CoC Clearwater | Girl's Cabin 3 | L | Dr Sandra Utter | (859) 323-5541 | Poison Ivy |
| 04/26/2021 | Yes | I agree | I agree | 05/30/2025 | ||||
| Email hidden; Javascript is required. | Nicolás | Carrillo | Male | 03/31/2012 | 8 grade | 11144 upton st Spring Hill, Florida 34608 Map It | Paola Carrillo | Mother | (862) 763-3106 | Ariel Carrillo | Father | (551) 655-0153 | Jahova witnessed | Boy's Cabin 3 | L | All pedestrians care | (352) 688-0100 |
| 06/01/2023 | Yes | I agree | I agree | 05/01/2025 | $160.00 | May 30, 2025 | |||
| Email hidden; Javascript is required. | Julieta | Carrillo | Female | 05/01/2025 | 9 grade | 11144 upton st Spring Hill, Florida 34608 Map It | Paola Carrillo | Mother | (862) 763-3106 | Ariel Carrillo | Father | (551) 655-0153 | Jahova witnessed | Girl's Cabin 3 | M | All pediatric care | (352) 688-0100 |
| 06/02/2023 | No | I agree | I agree | 05/01/2025 | $160.00 | May 30, 2025 | |||
| Parent or Guardian's Email | First | Last | Gender | Birthday | Next Grade | Address | Guardian | Relationship | Phone | Emergency | Relationship | Phone | Congregation | Cabin Request | T-Shirt Size (adult sizes only) | Physician | Phone | Allergies, Medications and Conditions | Non-Participating Activities: | OTC Medications | Date of Last Tetanus shot: | Can this camper swim? | Medical and Emergency Consent | Media Consent | Electronic Signature | Date | Payment Amount | Payment Date |
