Summer Camp Enrollment Form

PLEASE FILL OUT THIS FORM AND SOMEONE WILL REACH OUT TO CONFIRM YOUR REGISTRATION AND ARRANGE PAYMENT

We look forward to having your child attend Summer Daze Day Camp this Summer at Braemar Country Club! Please do a separate form for each child.
Child Name *

First Name Last Name
Age *
Name of School
T-Shirt Size *
Are you a Braemar Club member? If so, provide Member # *
Must provide a member number to receive member rate
PARENT/GUARDIAN INFORMATION:
1st Parent/Guardian Name *

First Name Last Name
Phone Number
Email *
example@example.com
2nd Parent/Guardian Name (optional)

First Name Last Name
Phone Number
Email
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

I would like to sign up for week(s): *

Once your form is submitted, we will contact you to confirm weeks and get days if you selected 3x a week or daily.

There is a $25 registration fee for all participants. This includes a t-shirt. Additional t-shirts can be purchased for $15.

We offer extended care. If you are interested in care between 8:30-9:00 am or 4:00-4:30 pm for an additional fee of $45/week or $10/day please let us know when we confirm registration. You can always do extended care on a daily or weekly basis when camp begins.

Please allow 24 hours after completing this form to hear from us.

We will invoice you and payment is due within 5 days to confirm your child's registration.

If you have any question, please contact us:

SummerDaze@losangelesswim.com or 818.900.3319 call/text
In case of an emergency please contact if neither parent/guardian can be reached *

First Name Last Name
Emergency Phone Number *
Please list any adults authorized to pick up your child in your absence
Is your child water safe and able to swim on their own without assistance? *
If not, please inquire about lessons info@losangelesswim.com
Does your child have any allergies (food, medication, etc)? *
Does your child have any physical limitations, conditions of hearing, vision, etc? *
Any other information you'd like us to know about your child?
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