Kid Fit Registration Form

Kid Fit Summer Camp Registration

Beyond Fitness at the Courtyard
Select Weeks to Register

June 8-12July 13-17
Parent or Legal Guardian Information
Parent/Legal Guardian*
Cell Phone*

Area CodePhone Number
Work Phone

Area CodePhone Number
Email*
example@example.com
Additional Parent /Legal Guardian
Relation
Work Phone 2

Area CodePhone Number
Cell Phone 2

Area CodePhone Number
Enter names of Additional Authorized persons for Pick-up / Drop-off
Full Name (separate multiple names with a ","
Camper #1

Additional Campers will be added individually
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender*

MaleFemale
Does the camper swim without the aid of a flotation assistance device*

YesYes but is a weak swimmerNo. Will wear a flotation assistance device
All fileds are required below. If nothing applies, please put "NONE" in the box. Thanks.
Any physical, mental or other condition that would require special attention or medication while at camp?*
List any allergies (ex: bees,peanuts, dairy)*
Do you have another camper to register?*

YesNo
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender*

MaleFemale
Does the camper swim without the aid of a flotation assistance device*

YesYes but is a weak swimmerNo. Will wear a flotation assistance device
All fileds are required below. If nothing applies, please put "NONE" in the box. Thanks.
Any physical, mental or other condition that would require special attention or medication while at camp?*
List any allergies (ex: bees,peanuts, dairy)*
Do you have another camper to register?*

YesNo
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender*

MaleFemale
Does the camper swim without the aid of a flotation assistance device*

YesYes but is a weak swimmerNo. Will wear a flotation assistance device
All fileds are required below. If nothing applies, please put "NONE" in the box. Thanks.
Any physical, mental or other condition that would require special attention or medication while at camp?*
List any allergies (ex: bees,peanuts, dairy)*
Do you have another camper to register?*

YesNo
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender*

MaleFemale
Does the camper swim without the aid of a flotation assistance device*

YesYes but is a weak swimmerNo. Will wear a flotation assistance device
All fileds are required below. If nothing applies, please put "NONE" in the box. Thanks.
Any physical, mental or other condition that would require special attention or medication while at camp?*
List any allergies (ex: bees,peanuts, dairy)*
By hitting submit and putting your initials, you agree that you are the parent or legal guardian of the above named camper, and are over the age of 18. In case of medical emergency or general medical care, I give consent for medical teatment for the aboved named camper by authorized personnel. I understand that the above named camper will only be released to the names listed above, an update may be done at registration. I certify that my child has my permission to attend camp and participate in all activites. I authorize Beyond Fitness to use my camper's picture, testimony, and video in any promotional material(web,print,or media).
Signature*
Electronic signature, please initial*
Should be Empty:

Kid Fit Summer Camp Registration

Parent or Legal Guardian Information

Camper #1