Outlife Summer Camp Registration Form - Hyderabad 04 June

Outlife Summer Camp Registration Form - Hyderabad -04-08 June 2025

Please fill all the details below pertaining to the attending child.
Full Name of the Child
Date of Birth

DayMonthYear
Age(in years)
Gender

Other
Blood Group
Does the child have any Allergies(Tick below)
Please Specify
Does the child have any of the following Conditions:
Please Specify/Elaborate
Please mention any behaviours of the child that may need special care
Please mention any issue/condition based/regular medicine that the child has to take during the camp. Please mention the name, dosage and frequency of the medicine and where it is kept/stored in the bag(and any support needed from the facilitators side)
Please Note: For children with any Medical / Behavioural Condition, must provide a doctor's certificate mentioning that the child can attend the outdoor summer camp for a week.
Father's Name
Father's Mobile Number
Mother's Name
Mother Mobile Number
Guardian's Name
If Guardian is Registering the Child
Guardian's Mobile Number
If Guardian is Registering the Child
Guardian's Relationship with the child
If Guardian is Registering the Child
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please list the Name & Number of the person who has permission to pick the child up (if other than parent/Guardian) from the camp on the last day
Emergency Contact Name
Emergency Contact details other than Parent/Guardian
Emergency Contact Number
Emergency Contact details other than Parent/Guardian
Family Doctor Name
Family Doctor Number
Medical Insurance Company
Medical Insurance Number
Date

DayMonthYear
Signature
Should be Empty:

Outlife Summer Camp Registration Form - Hyderabad -04-08 June 2025