SUMMER Camp-A-Thon 2021

SUMMER 2022
BOYS & GIRLS CLUBS OF ST. LUCIE COUNTY
Name

Child's First NameChild's Last Name
Child's Age
Weekly Payment: $85 per child
All children, regardless if they already attend a Boys & Girls Club during the school year, will need to fill out a 2022 membership form.

Please access the 2022 membership form below:
LOCATION
Which Camp Will Your Child Attend?
SUMMER PROGRAM DATES

NOTE: we require 10% payment (about $8.50) for every week signed up
Check the weeks you desire for Summer Camp
YOUTH T-Shirt Size - Please Check ONE (Shirt size may not be guaranteed - depending on quantity)
ADULT T-Shirt Size - Please Check ONE (Shirt size may not be guaranteed - depending on quantity)
NOTE: There will be no refunds or credits of any kind for unattended weeks, trips or behavioral removal.
Parent/Guardian Name (Please Print)
Parent/Guardian Signature
Date

MonthDayYear
Date
Daytime Contact Phone Numbers
Format: (000) 000-0000.
BOYS & GIRLS CLUBS OF ST. LUCIE COUNTY

My son/daughter, (please print)
My son/daughter Name* , Age*
For the safety of your child. Does your child know how to swim?
Parent/Guardian's Name
Parent/Guardian's Phone Number(s)
Format: (000) 000-0000.
Emergency Contact's Name
Emergency Contact's Phone Number(s)
Format: (000) 000-0000.
Parent/Guardian's Signature
Date Signed
Should be Empty:

SUMMER 2022