• Camp Registration Form

    Camp Registration Form

    These forms are required for your son(s) to attend camp.

  • Camper Information

    If multiple campers are attending the same week(s) please complete one form but all necessary camper information sections. If multiple campers are attending different weeks, please complete separate forms.
  • Date of Birth*
     - -

  • NOTE - Boys who have completed Kindergarten through Grade 5 (going into Grade 1 - Grade 6) are invited to participate.

  • Date of Birth
     - -
  • Date of Birth
     - -
  • Camper Swimming Ability*

  • Pool on property is 48" deep, round above ground. All swimming opportunities will be adult supervised. Number of children allowed in the pool at one time will be limited.

  • Schedule & Alternate Options

    Before & After Care and Overnight Options
  • Which week(s) will your child be in attendance?*
  • Is this schedule consistent for each child that will be attending? i.e. if enrolling multiple children, one child will attend certain week(s) differing than the other(s).*
  • Overnight Option (+$30/day - includes all meals): We know some campers will be coming from further distances which is why we are able to accomodate on a "first come first served" basis a limited number of overnight campers.*
  • Camp will run Mon - Fri rain or shine. Drop off is 8AM. Pick up will be 4PM. Please indicate if your child/children will require before and/or after care. Before/After care will be available beginning at 7AM and until 6PM.*
  • If your child/children require before/after care, please indicate which weekdays care will be required:*

  • Parents' Information

    Parent/Guardian 1
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Emergency Contact

  • Format: (000) 000-0000.

  • Additional Authorized Pick Up

    Please send a note or a text to camp on the day of any alternate pick-up. If the third party is not listed here, please send this information with your text/note on the day of their authorized pick-up.
  • Would you like to add additional authorized pick-up at this time?
  • Format: (000) 000-0000.

  • Medical / Health Information

  • Format: (000) 000-0000.
  • Does your child have any food, medication or environmental allergies?*
  • Allergies? Check all that apply*
  • Does your child’s allergy/allergies require child care staff to monitor child for symptoms, take action if a reaction occurs, or give emergency medication to your child?*
  • Does your child have a special health or medical condition?*
  • Does the special health or medical condition require child care staff to perform a procedure, or perform child specific care such as: to monitor your child for symptoms or administer medication during child care hours?*
  • If yes, does this medication, food supplement, or medical food need to be administered at the day camp?
  • 0/200
  • 0/200

  • Additional Medication

  • Check all that apply*

  • Statement of Understanding

  • Acknowledgement of Policies and Procedures: I have reviewed the policies and procedures and understand that a hard copy will be made available to me upon request.*
  • Date Signed*
     - -
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              Initial Deposit

              Due at time of Registration

              $50.00
                
              Camper 1 Balance

              Due first day of camp week

              $100.00
                
              Second Camper

              $100 per week per additional camper. Total due on first day of camp

              $100.00
                
              Third Camper

              $100 per week per additional camper. Total due on first day of camp.

              $100.00
                
              Overnight Option

              $30 per night - will include dinner, breakfast, lunch the next day and farm chores :) Due on camper's first day of camp.

              $30.00
                
              Total
              $0.00
            • Should be Empty: