GLAM Camp Sign Up Form - Sign up Deadline is April 1, 2024
GLAM Camp is held 9am-3:30pm Monday to Friday, April 15 to April 19, 2024 during the week of April public school vacation at the Mashpee Wampanoag Reservation. Free transportation is provided from Mashpee, Martha's Vineyard, Plymouth, Bourne and Assonett. The following information is required to register for the camp. There is NO COST to you or your child to attend. This camp is open to female and female identifying children only.
Camper's Name
*
First Name
Last Name
Does your child prefer to be called by something besides her first name? If so, please enter it here.
Date of Birth of the Camper
*
-
Month
-
Day
Year
Date
Camper's age
Tribal Affiliation
*
Camper's current grade (GLAM camp is open to girls in grades 4-8)
*
Please Select
4th grade
5th grade
6th grade
7th grade
8th grade
Primary Parent/Guardian Full Name
*
First Name
Last Name
Primary Parent/Guardian address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Parent/Guardian Cell/Mobile Number
*
Please enter a valid phone number.
Primary Parent/Guardian Email
*
example@example.com
Second Parent/Legal Guardian (optional)
First Name
Last Name
Second Parent/Legal Guardian cell phone
Please enter a valid phone number.
Second Parent/Legal Guardian Email
example@example.com
Is the address of the second parent/legal guardian the same as the primary? If yes, skip this address/contact section, if NO, this information is required
Please Select
YES
NO
Second Parent/Legal Guardian address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Who is the emergency Contact
*
First Name
Last Name
Emergency Contact's cell Number
*
Please enter a valid phone number.
Relationship to child
*
Who is the second emergency contact
First Name
Last Name
Second emergency contact's cell number
Please enter a valid phone number.
Relationship to child
Additional Information about your camper
Please fill out one form per camper. The below information is about the camper, not the parent/guardian
Any medical issues
*
Please Select
YES
NO
If you answered YES to the above question about any medical issues, please be specific here.
Any known allergies, if so please list them here or say NONE
*
Any recent injuries or hospitalizations, if so please list them here or say NONE
*
Please list any additional relevant information, if none, please write NONE
*
T-Shirt Order Form please choose one
*
Please Select
XL
M
L
XL
Authorization Release
Authorization to take Pictures: The parent/Guardian of the above child gives authorization allowing the child to be photographed, and the photos to be used in the promotion of the Global Local Athletic Movement (GLAM) and Wampanoag Tribe. By signing below, which is mandatory to participate in this camp, you agree to give said authorization.
Signature
*
Transportation Authorization
The Parent/Guardian of the above child gives authorization allowing the child to be transported to and from GLAM Camp at the Mashpee Wampanoag Community Center. By signing below, which is mandatory to participate in this camp, you agree to give said authorization. One your child is registered for camp, organizers will be in touch with the drop off+pick up location near you.
Signature
*
Does the child attending Glam Camp have health insurance
*
Please Select
YES
NO
Insurance Information - Medical Insurance Company Name:
*
Insurance Information - Group Number:
*
Insurance Information - Policy Number:
*
Medical Release
I nearby give my permission to the Mashpee Wampanoag Tribe and GLAM to seek medical treatment (private physician or hospital) or transportation for my child should any emergency arise. I understand that a conscientious effort will be made to locate me or my spouse/other legal guardian before any action will be taken.
Parent/Guardian signature
*
Liability Release
GLAM and the Mashpee Wampanoag Tribe are not responsible for any child's lost or broken articles. Please remember to LABEL all belongings. Children are not allowed to bring possessions from home (i.e. toys, electronics, phones, computers etc).
Signature
*
Final Submission
By clicking SUBMIT below, you agree all the above information is accurate to the best of your knowledge, and you agree to hold GLAM and the Mashpee Wampanoag Tribe harmless.
Submit
Submit
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