Register Your Kid(s)Please complete separate form for each child. Parent / Guardian * First Name Last Name Relationship to Child Parent Grandparent Guardian Other Email * Phone * (###) ### #### Child Name * First Name Last Name Child Age Food Allergies * Peanuts Environmental Gluten Dairy Other None Entire Summer (9 weeks total) Select Camp Weeks * Week 1 / June 16-20 Week 2 / June 23-27 WEEK 3 NO CAMP Week 4 / July 7 - 11 Week 5 / July 14 - 18 Week 6 / July 21 - 25 Week 7 / July 27 - Aug 01 Week 8 / Aug 04 - 08 Week 9 / Aug 11 - 15 Week 10 / Aug 18 - 22 Drop-in Day (s) Select Emergency Contact First Name Last Name Relationship to Child Parent Grandparent Guardian Other Emergency Contact Phone * (###) ### #### Emergency Contact First Name Last Name Relationship to Child Parent Grandparent Guardian Other Emergency Contact Phone (###) ### #### Pick Up Person * First Name Last Name Phone (###) ### #### Alternate Pick Up Person * First Name Last Name Phone (###) ### #### Message (Anything we should know) Thank you!
