Camp Edge: Supplemental Information Form

Camper Name*

First NameLast Name

Parent 1 Name*

First NameLast Name

Parent 1 Place of Employment, Work Phone Number*

Parent 1 Email Address: *

example@example.com

Parent 2 Name

First NameLast Name

Parent 2 Place of Employment, Work Phone Number

List of school's attended. (current - first schooling experience)*

Camper's Physician's Name*

First NameLast Name

Physician Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Physician Email Address

example@example.com

YesNo

If you selected "no" for the previous question, please exit the form and contact the parent or guardian to complete. If they are unable to complete this form, direct them to contact us at camps@horizonsedgeva.com for next steps.

Sunscreen Authorization Acknowledgement:

This form must be completed for each camper, and is valid for the current summer. Camper sunscreen will be collected by camp staff, labeled with their name, and kept in a box until application is needed per Virginia law 8VAC20-780-520.

Campers nine years old and older may self-administer. Campers younger than nine years old will have staff administer sunscreen prior to going outside.

This authorization is effective from June 10, 2024 - August 9, 2024.

YesNo

Typing parent name below constitutes an electronic signature to the above Sunscreen Authorization. Parent/Guardian Name: *

Today's Date

Date

Swimming Authorization Acknowledgement:

This form must be completed for each camper, and is valid for the current summer. If no form is completed for a camper, the camper will be ineligible to swim at Camp Edge.

The Horizons Edge Sports Campus facility pool does not exceed 5 feet. Campers will only be permitted to swim when there is a certified lifeguard on stand.

This authorization is effective from June 10, 2024 - August 9, 2024.

YesNo

Please indicate here if there is a lower depth you would like to limit your child to:

Ex: 3 feet

Typing parent name below constitutes an electronic signature to the above Swim Authorization. Parent/Guardian Name: *

Today's Date

Date

Parent Handbook Acknowledgement:

In order to facilitate a succesful summer, we ask that all parents acknowledge receipt of the Parent Handbook. Please read the full handbook each year for updated policies and guidelines to prepare yourself and your campers for Camp Edge.

Typing parent name below constitutes an electronic signature to confirm receipt of the Parent Handbook. Parent/Guardian Name: *

Today's Date

Date