2024 Summer Camp Form

ENROLLMENT FORM
Child's Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Age*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parents Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Alt. Phone Number
Please enter a valid phone number.
Email*
example@example.com
Parents Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Give the name, address, and phone number of the responsible individual to call in case of an emergency if parents/guardian cannot be reached:
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Relationship*
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Relationship
CHECK ALL THAT APPLY:
1. TRANSPORTATION: I give consent for my child to be transported and supervised by the operation’s employees:*

for emergency careon field tripsto and from hometo and from school
2. FIELD TRIPS*

I give consent for my child to participate in field trips.I do NOT give consent for my child to participate in field trips.
3. WATER ACTIVITIES: I give consent for my child to participate in the following water activities:*

water table playsprinkler playsplashing/wading poolsswimming poolsaquatic playgrounds
4. PHOTO CONSENT: Do you give consent for photographs of your child to be taken and used in promotional materials, including social media and our website?*

YESNO
Authorization For Emergency Medical Attention

In the event I cannot be reached to make arrangements for emergency medical care, I authorize the person in charge to take my child to:
Name of Physician*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Name of Emergency Care Facility*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Consent*

I give consent for the facility to secure any and all necessary emergency medical care for my child.
Signature*

Clear
Permission to treat with over-the-counter medication if needed:
Cough Drop*

YesNo
Children’s Tylenol*

YesNo
Children’s Motrin*

YesNo
Pepto Bismal*

YesNo
Benedryl*

YesNo
Tylenol*

YesNo
Ibuprofen*

YesNo
Midol*

YesNo
Tums*

YesNo
Neosporin*

YesNo
Hydrocortisone (Anti Itch)*

YesNo
Hydrogen Peroxide (Wound Cleaner)*

YesNo
PICKUP INFORMATION FORM

SONNY JAMES RANCH
Please fill out this form as completely as possible and with the best contact information available.

The information below will be used to authorize who is allowed or not allowed to pick up your child from camp or camp-related activities. It will also go with us anytime we leave the premises (if applicable) in case of emergency. Thank you!
Student*

First NameLast Name
Age*
Date of Birth*

MonthDayYear
Date
Needs Booster Seat?*

YesNo
Height*
Weight*
Allergic to:*
Medications:*
Parent/Guardian:
Mother*

First NameLast Name
Contact Number*
Please enter a valid phone number.
Father*

First NameLast Name
Contact Number*
Please enter a valid phone number.
Alternate Contact*

First NameLast Name
Contact Number*
Please enter a valid phone number.
Please list all persons authorized to pickup your child. They will need to show ID before we can release your child.*
Please list anyone NOT authorized to pickup your child. If there are legal proceedings or documents confirming this, please be prepared to show or provide us a copy of the court order.*
Should be Empty:

ENROLLMENT FORM

Authorization For Emergency Medical Attention

PICKUP INFORMATION FORM