2023/2024 School Year Camp Registration Form Please enable JavaScript in your browser to complete this form. - Step 1 of 2Camper's Name *What days of camp is your child attending? *October 24thNovember 7thNovember 10thNovember 21stNovember 20thNovember 22ndDecember 26thDecember 27thDecember 28thDecember 29thJanuary 2ndJanuary 3rdJanuary 4thJanuary 5thJanuary 15thJanuary 22ndFebruary 19thMarch 22ndMarch 25thMarch 26thMarch 27thMarch 28thMarch 29thApril 10thDo you have any friends requests? *Address *City, State & Zip Code *Parent/Guardian Names *Cell Number *Home Number Work Number Emergency Contact & Phone Number *Relationship to Camper *Section DividerMedical Insurance Company *Your personal medical policy is your primary coverage. All registered campers are covered by excess coverage accident insurance while at camp.Policy Holder *Policy #: *Group #: *Pediatrician's Name *Pediatrician's Phone Number *AllergiesCurrent MedicationsDo we have permission to give your child Children's Tylenol?YesNoAre there any special instructions or things we should be aware about your child? *Do we need to administer any medication to you child during camp hours? *YesNoIf yes, we will need you to fill out a Medication Authorization Form - link is in summer camp section of our website.Will someone other than the parents/guardian being picking up your child from camp? *YesNoIf yes, we will need you to fill out a Pickup Authorization Form - link is in summer camp section of our website.NextSingle Line TextSignatureClear SignatureCaptcha * = Single Line TextMessageSubmit