Camp Purple Tree
Camp Application Form 2022
Name of Camper
*
First Name
Last Name
Age at time of Camp
*
Weeks Attending
*
Full Term August 3 - Sept 9
Week 1 (Aug 3 - 5)
Week 2 (Aug 8 - 12)
Week 3 (Aug 15 -19)
Week 4 (Aug 22 - 26)
Week 5 (Aug 29 - Sept 2)
Week 6 (Sept 5 - 9)
Tshirt Size
*
Name of Parent/Guardian
*
First Name
Last Name
Home/Work Phone of Parent/Guardian
Please enter a valid phone number.
Cell Phone of Parent/Guardian
*
Please enter a valid phone number.
Email Address
*
example@example.com
Emergency Contact 1
*
First Name
Last Name
Relationship
*
Contact Number Emergency Contact 1
*
Please enter a valid phone number.
Emergency Contact 2
*
First Name
Last Name
Relationship
*
Contact Number Emergency Contact 2
*
Please enter a valid phone number.
List any medical conditions, allergies, or special needs the staff should know about?
*
State any behaviours of which the staff should be aware, to aid in providing the possible care to your child/ward.
*
I grant permission to Camp Purple Tree, to produce photographs and video taken of my child, while at Camp Purple Tree and to use these photos for promotion of the camp on flyers and on the Camp's social media pages including, Facebook and Instagram.
*
Yes
No
I give permission for my child/ward to attend tours to attend tours off site with Camp Purple Tree.
*
Yes
Type No
Submit
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