Funcamps Application Form 2024

Weekend Camping Excursion For Boys

Ages 10-13

Sports Camp - July 5th-7th at Darrell's Island

Adventure Camp - July 26th-28th at Paget Island

Senior Camp Counselors: Keishen Bean, Darius Cox, Anthony Bascome

Camp Rates

$250.00 per camper (due when confirmation is received)

When confirmation of registration form is recieved, please send $250.00 to:

[HSBC ACCOUNT: W.K.BEAN 006-061527-012

Camper's Name*

Date of birth*

MonthDayYear

Age*

Current School Attending*

Current Home Address*

Parish*

Postal Code*

Contact #1*

E mail*

example@example.com

Cellular*

Relationship to Camper*

Contact #2*

E mail

example@example.com

Cellular*

Relationship to Camper*

Emergency Contact (IF CONTACT 1 OR 2 CANNOT BE CONTACTED)

Name

Cellular

Relationship to Camper

Camp Dates - Check Applicable Dates*

SPORTS CAMP: July 5th-July 7th At Darrell’s IslandADVENTURE CAMP: July 26th-July 28th at Paget Island

Shirt Size*

Physician

Phone

Prescription Medication Currently Taking*

Non-prescription Medication Currently Taking*

I give my child permission to self-administer their prescription medication*

I give my child permission to self-administer their non-prescription medication*

My child is aware that they cannot share any medication with other campers. Camper initals:

Administration of the below medications will be given to campers by camp counselors if deemed necessary. Please select the medications you approve of:*

TylenolBenadrylTums

Allergic to

Medication prescribed

Special Instructions

Drop off: Friday 5:30pm

Pick up: Sunday 3:00pm

Location: Albouy's Point

My child will be collected on Sunday at 3:00pm by:*

Relationship*

Any additional Information that would be helpful to camp counselors (CONFIDENTIAL)

PARTICIPATION AGREEMENT & REFUND POLICY

PLEASE READ & SIGN THIS STATEMENT

1 enroll my child in FunCamps Camping Excursion. In signing this application, I certify that my child has not come into contact with anyone who has tested positive for COVID-19. I have supplied the camp counselors with my child's negative antigen test taken one (1) day prior to camp departure date. I agree to pay the balance of camp fees two weeks before camp begins. I understand that reserved space may not be held without deposit and/or full payment. REFUND/CANCELATION POLICY: A full refund is available if canceled 48 hours before the start of camp. There will be no refunds if canceled after this time period. Extenuating factors may be considered. Igrant permission for the applicant to participate in all planned camp activities. I grant FunCamps and it's counselors full authority to takewhatever actions they deem necessary regarding my child's health and safety, and I fully release FunCamps from any liability in connection there within. In the event of an emergency, I understand that prudent attempts will be made to contact the undersigned immediately. 1understand that my child must comply with the camp's rules and standards of conduct and that if deemed necessary, FunCamps may terminate my child's participation in the camp program if he does not maintain these standards, Iunderstand that FunCamps is not responsible for lost, stolen, or damaged personal articles. 1 authorize FunCamps to own and have full right of disposition to any video film, footage, sound recordings, and photo reproductions of the camper named on this contract. 1acknowledge that with participation carries risk of physical injury. I agree that FunCamps, and its employees shall not be liable for any injury or damage, howsoever caused, resulting directly or indirectly from my child's participation in FunCamps.

Parent/Guardian Signature

Date

Print name of Parent or Guardian

Camper Name

FUNCAMPS

Medical Information

Allergies

Drop off and Pick up