2021 Day Camp Registration Form

Campers Name *

First Name Last Name

Gender *

Age *

Birth Date *

Month Day Year

T-Shirt Size (all sizes youth sizes) *

Parent or Guardian Name *

Parent/Guardian Email

Cell Phone *

Area Code Phone Number

Text?

Yes No

Home Phone

Area Code Phone Number

Emergency Contact *

Phone Number *

Area Code Phone Number

During which week(s) of camp will your child be attending Day Camp (Green Team)? *

Staff Training - June 5-10 Junior Boys' - June 12-17 Junior Girls' - June 19-24 Junior Boys' - June 26- July 1 Junior Girls' - July 10-15 Foster Kids' - July 17-22 Foster Kids' - July 24-29

Parent/Guardian - Please list hours of attendance and your location: Example: Wednesday Hours: 9am-3pm Guardian Location/position: Kitchen Help

Monday hours:

Guardian Location/Position:

Tuesday hours:

Guardian Location/Position:

Wednesday hours:

Guardian Location/Position:

Thursday hours:

Guardian Location/Position:

Friday hours:

Guardian Location/Position:

Does Camper have any allergic reactions to food, drugs, or insect stings? *

Yes No

If so, please describe:

Special considerations?

Epilepsy Diabetes Asthma ADD/ADHD ODD Other

If so, please explain:

IMPORTANT- children must be potty trained to be part of the Day Camp Program. If your child is not, you must be available to stop and change their diaper (the leaders will bring your child to you), or wait until they are potty trained to register them. Our young leaders are unable to change diapers.

Parental Release:

"I understand that I will be responsible for administrating any medications to my children while at camp. I give permission for the healthcare staff to any of the following as they deem fit while the child is at camp: sunscreen, insect repellant, and any first aid."

"I understand that while attending Camp David my child may be involved in various activities including, and not limited to swimming, horse rides, obstacle course, and other traditional camp activities. I do hereby grant permission for my child to attend camp and participate fully in all camp activities.

I accept the risks involved in camp activities and do hereby release Camp David, and all staff and volunteers, from any and all claims for bodily and personal injuries or death sustained by my child, whether such injury occurs on or off the campproperty.

I have instructed my son/daughter to obey the rules of Camp David. I understand that should my child become ill or seriously injured, I will take them to receive treatment and wait until they are healthy to bring them back. I also give permission to Camp David to use camp pictures of my child in promotional materials."

By typing my name in the box, I agree to the above statements: *

Date *

Month Day Year

2022 Day Camp Registration (Green Team)

Medical Information: