Day Camp Registration Form

Summer Camp Registration Form

These forms are required for your children to attend camp.
Camper's Information
Camper Name*
Nickname
Age
Birthday

MonthDayYear
Date
Entering Grade in 2023/24*
Camp Registering For?*
2nd Camp Registering For?
3rd Camp Registering For?
4th Registering For?
Please provide any additional information that you think is important or may affect the camper's ability to fully participate in the camp program.

Parent/Guardian 1
Parent/Guardian 1*

First NameLast Name
Relationship to Child*
E-mail*
Cell Phone*
Home Phone*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent's Work/School Name*
Or enter N/A if not applicable
Parent's Work/School Phone
Parent's Work/School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Where would you like to be reached while your child is at camp?*

Cell PhoneWork PhoneHome Phone
Parent/Guardian 2
Parent/Guardian 2*

First NameLast Name
Relationship to Child*
E-mail*
Cell Phone*
Home Phone*
Home Address Same as Parent/Guardian 1?

Yes
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent's Work/School Name*
Or enter N/A if not applicable
Parent's Work/School Phone*
Parent's Work/School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Where would parent/guardian 2 like to be reached while your child is at camp?

Cell PhoneWork PhoneHome Phone

Emergency Contacts/Authorized Pickup

Parents cannot be listed as emergency contacts. List the name of at least one person who can be contacted in the event of an emergency or illness if you cannot be reached. Any person listed should be able to assist in contacting you. At least one person listed must be within one hour of the center/home, able to take responsibility for the child in case the parent/guardian cannot be contacted and should be at least 18 years of age. The first emergency contact must live no more than 1 hour away and be over the age of 18.
Emergency Contact #1
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*
Secondary Phone Number*
Relationship to Child*
Emergency Contact #2
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*
Secondary Phone Number*
Relationship to Child*

Medical / Health Information
Name of Physician or Clinic/Hospital
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Does your child have any food, medication or environmental allergies?*

YesNo
Allergies? Check all that apply*

FoodMedicationEnvironmental
Please list and explain any allergies*

0/150
Does your child have a special health or medical condition?*

YesNo
Please explain*

0/150
Does your child have any dietary restrictions, including those for medical, religious or cultural reasons?*

YesNo
Please explain*

0/150
List any additional information about your child that would be useful for staff to know, such as fears, eating, interests or special routines. This information should not be medical or health related, as that information should be included in the previous questions.*

0/200

Payment and Statement of Understanding

Your child's place will be secured for camp when their completed registration is received along with payment for their camp session(s.) Payment can be made through venmo to Creative Caps Studio or through check made to Creative Caps Studio or cash.
Camp Pricing:

Storybook Camp- June 12-15, for ages 3-5, $115

Harry Potter Camp- June 26-29, for ages 5-9, $115

Nature Camp- July 3,5,6,7, for ages 4-6, $115

Disney Camp- July 10-13, For ages 4-6, $115

Animal Safari Camp- July 17-20, for ages 3-5, $115

Mini Picasso Art Camp- July 24-27, for ages 4-6, $115

American Girl Camp- July 31-August 3, for ages 5-9, $115

Under the Sea Camp- August 7-10, for ages 3-5, $115

Sibling or multiple camp discount:

1st camp- full price

each additional camp receives a $15 discount
Please review our policies disclaimer at: https://creativecapsstudio.com/policies-and-faq. After reviewing, please acknowledge your understanding by choosing "yes" or "no" below.*

YesNo
Date Signed*

MonthDayYear
Please remember that your registion is complete when payment is received!
Should be Empty: