Summer Camp Application Form

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* 1. Which camp are you interested in?

Camp A

Camp B

Camp C

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* 2. Which session are you interested in?

Session 1: [DATE-DATE]

Session 2: [DATE-DATE]

Session 3: [DATE-DATE]

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* 3. Camper Name

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* 4. Camper Age Group

7-10

11-14

15-18

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* 5. Parent/Guardian Name

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* 6. Parent/Guardian Email

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* 7. Parent/Guardian Phone

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* 8. Address

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* 9. What allergies does your camper have, if any?

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* 10. What medication does your camper need to take, and at what time, if any?

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* 11. Camper T-Shirt Size

Small

Medium

Large

Extra Large

Other (please specify)

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* 12. Emergency Contact

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* 13. Emergency Contact Email

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* 14. Emergency Contact Phone

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* 15. Is this person authorized to pick up your child in the event of an emergency?

Yes

No

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