Summer Camp Registration

Child Information

List any special needs that your child may have, such as allergies, existing illness, previous serious illness, injuries and hospitalizations during the past 12 months, any medication prescribed for long-term continuous use, and any other information which caregiver’s should be aware of.
If you have more than one child to register (up to 2 more children), please check the boxes below and fill in the required information.
List any special needs that your child may have, such as allergies, existing illness, previous serious illness, injuries and hospitalizations during the past 12 months, any medication prescribed for long-term continuous use, and any other information which caregiver’s should be aware of.
List any special needs that your child may have, such as allergies, existing illness, previous serious illness, injuries and hospitalizations during the past 12 months, any medication prescribed for long-term continuous use, and any other information which caregiver’s should be aware of.

Parent/Guardian Contact Information #1

Please enter your information below. You will have to accept the terms and policies at the end of this form.
Please enter your full street address as it is printed on your mail.

* Contact Numbers

Email Address

Please fill out two email addresses below. We will use the primary email address for billing purposes and our newsletter.

Employer

Parent/Guardian Contact Information #2

* Contact Numbers

Email Address

Employer