2025 ALCA Camp Registration
* Please fill out one application per Camper
Type a question
*
I am registering my child for Session I – June 16th – July 11th, 2025
I am registering my child for Session II – July 14th – August 7th, 2025
Camp Programs: Please only select ONE (1) program you would like your child to participate in
*
Eaglets Recreational Camp (2 -4 years of age)
Trailblazers Recreational Camp (K - 8th Grade)
Athletic Camp (K-12th)
*Please be aware that Athletic Camp does not travel on any fieldtrips.
Camper's Information
Camper's Name
*
First Name
Last Name
Campers Birthdate
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Current Grade (Aug. 2024 - June 2025)
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Ethnicity
T-Shirt Size
*
Please Select
Preschool Size
Youth-Small
Youth-Medium
Youth-Large
Xtra Small
Small
Medium
Large
Xtra Large
What Language would you prefer for school to home communication?
English
Other
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Contact Information
Permanent Address
*
Street Address Line 1
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number
Please enter a valid phone number.
Email
*
example@example.com
Mother's / Guardian Name
*
First Name
Last Name
Daytime Phone
Please enter a valid phone number.
Phone / Cell Number
*
Please enter a valid phone number.
Allow Text Messages
Yes
No
Father's / Guardian Name
First Name
Last Name
Daytime Phone
Please enter a valid phone number.
Phone / Cell Number
Please enter a valid phone number.
Allow Text Messages
Yes
No
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Emergency Contacts
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Are any of the children noted in this registration currently enrolled in a Special Education Program?
*
Yes
No
If Yes, what's the name of the program?
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Medical Information
If medical care is necessary, call:
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Mother
Father
Hospital
Do any of the student(s) registered have a health/medical concern/need or food allergy?
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Yes
No
If yes, please explain:
Will they take daily medication during Summer School?
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Yes
No
Medication Name
Dosage
Note:
*Please be advised that all prescribed medication MUST be sent to camp with a doctors note stating theexact dosage, labeled with the child’s name, and name of the medication. All meds will be kept thenurse’s office and camp administrators. Campers are prohibited from carrying medication during thecamp.
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Media Release
Select your preference:
*
I WOULD like my child to be photographed during ALCA’s Summer Program activities andprojects. I understand that these photos will be used for school and program promotional purposes
I WOULD NOT like my child to be photographed during ALCA’s Summer Program activities andprojects. I understand that these photos will be used for school and program promotional purposes.
Signature
*
Date
-
Month
-
Day
Year
Date
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