Day Camp Registration

Parent's Name:required

First Name

Last Name

Parent's Email Addressrequired

Best Contact Phone Number:

Complete Addressrequired

I will read and agree to the terms of the Parental Consent Form. I will sign and return via email.required

YES

NO

Child's Name:required

First Name

Last Name

Child's Date of Birth:

Age:required

Ages 5-6

Ages 7-8

Ages 9-10

Ages 11-13

Child's Grade Completed:required

My child can swim:required

Yes

No

Allergies or medical concerns for the child (include peanuts, tree nuts, red dye sensitivities, etc.):

Approved pick up person(s):required

Emergency Contact #1 (Full Name, Relationship, Phone Number(s)required

Emergency Contact #2 (Full Name, Relationship, Phone Number(s)required

Late Fee (after May 9)

$25.00

Refund Policy

Please understand that no refunds will be given after May 9, 2025.

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