Summer Camp

Camp Registration Form

These forms are required for your children to attend Summer Camp.
Camper's Information
Camper Name*
Nickname*
Age*
Camp Dates (Please choose one below)*
If Single Day Pass Please select days
Email to send camp updates to
example@example.com

Emergency Contacts/Authorized Pickup

Parents cannot be listed as emergency contacts. List the name of at least one person who can be contacted in the event of an emergency or illness if you cannot be reached. Any person listed should be able to assist in contacting you.
Emergency Contact Form
Full Name*

First NameLast Name
Primary Phone Number*
Relationship to Child*

Medical / Health Information
Date of Last Tetanus or Diphtheria, Tetanus, Pertussis (DTaP) Vaccine?*

MonthDayYear
Does your child have any food, medication or environmental allergies?*

YesNo
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?*

YesNo
Does your child have a special health or medical condition?*

YesNo
Please explain*

0/150
Medication
Name of medication*
Exact dosage*
L&F Stables Farm has permission to secure emergency transportation for my child in the event of an illness or injury which requires emergency treatment. The emergency transportation service will determine the facility to which my child will be transported.*
Type first and last name above to consent

Payment Methods

Debit or Credit Card

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info

Camp Registration Form