Stone Edge Prep Summer Camp Enrollment Form 2024

Stone Edge Prep Summer Camp Enrollment Form

May 28th 2024 - August 2nd 2024
Camper's Information
Camper's Name*

First NameLast Name
Age*
Camper's Name

First NameLast Name
Gender*
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School Name
Grade Level (Going into) *
Camper's Photo (Optional)

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Parent/Guardian Information
- The parents/guardian listed below will be the authorized person to pick-up the child after the camp.
- The parents/guardian listed below will also be the primary emergency contact person.
Name*

First NameLast Name
Relation
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Name

First NameLast Name
Relation
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area CodePhone Number
Approved Pick Up List

This is for anybody who is not listed above
Name

First NameLast Name
Relation
Phone Number

Area CodePhone Number
Name

First NameLast Name
Relation
Phone Number

Area CodePhone Number
Name

First NameLast Name
Relation
Phone Number*

Area CodePhone Number
Medical Information
Does the child have any allergies? If yes, please list them below:*
Does the child have any previous injuries? If yes, please explain them below:*
Does the child have any current medical conditions? If yes, please list them below:*
Does the child takes any medication? If yes, please list them below and explain its purpose:*
Miscellaneous Questions
Do you approve photos of your child being posted to the Stone Edge Prep Facebook and Instagram pages?*
Will there be any time throughout the summer that your child will not be attending camp? *
Give me some insight into your child. Does the child have any favorite activities or sports? What is their favorite food? How would you describe their personality? My goal is to make this the best Summer for every child. *
Authorization
I, parent or guardian of this child, authorize my child named above to participate in the summer camp program at Stone Edge Prep. I understand that there are inherent risks associated with participating in such activities, and I release Stone Edge Prep and its staff from any liability for injury or illness that may result from my child's participation.

I also authorize Stone Edge Prep staff to administer any necessary medical treatment in the event of an emergency, and I give my consent for my child to participate in any activities or programs offered by the camp.
Parent/Guardian Signature*

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Date*

MonthDayYear
Date
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Stone Edge Prep Summer Camp Enrollment Form

Camper's Information

Parent/Guardian Information

Approved Pick Up List

Medical Information

Miscellaneous Questions

Authorization