Clone of Fairfax Day Camp October 2025

Fairfax Day Camp November Registration
Welcome to the all new Day Camp options in Fairfax! Located at the James Herbert Bellows Fairfax Community Center, this camp is open to children in grades K - 5. Hours of operation are 8:00 AM until 4:00 PM. Children will need to bring 2 snacks, a lunch and a refillable water bottle. Change of clothes is recommended.

Kids will play games, do crafts, play outside and more. Each day has a different theme:

November 24th: Harvest Festival

November 25th: Turkey Tuesday

Payment for each day of camp is due at registration. $60/day single child; $100/day for two children. Payment can be made via cash or check to 'Town of Fairfax' at 12 Buck Hollow Road, Fairfax, VT.

Please submit only one application form for each child you register. If there is an issue with the form you submitted, please contact Danielle at recreation@fairfax-vt.gov instead of submitting a duplicate form.
Child Information
Child's Name*

First NameLast Name
Child's Date of Birth*

MonthDayYear
Date
What grade is your child currently enrolled?*
Prefer not to sayMaleFemaleOther
Please list all known allergies your child has*
Please list any dietary restrictions your child has*
Please list any medications your child takes*
Are there any modifications or accomodations that can be made to the camp to assist your child in a better camp experience? If so, briefly describe and we will be in touch.*
I acknowledge that I have notified the Fairfax Day Camp of any disabilities that may impact the health or wellbeing of my child, other camp children, or staff.

Clear
Date

MonthDayYear
Date
Week Selection

Select the day(s) which you'd like to register your child for our day camp - if a certain day is listed as "[FULL]" we will add them to the wait list for that day. Please remember that payment is due upon registration to confirm your spot. Cash or check can be sent to or dropped off to Town of Fairfax at 12 Buck Hollow. Electronic payment can be made over the phone to the Town Clerk (802-849-6111 x 10), however there will be a 3% processing fee added on.
November 24th: Harvest FestivalNovember 25th: Turkey Tuesday
Contact Information
Primary Parent or Guardian Name*

First NameLast Name
Primary Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Primary Email*
example@example.com
Primary Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact (Cannot be the same as Primary)*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contacts Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Additional person who has permission to pick up this child

First NameLast Name
Additional person's phone number
Please enter a valid phone number.Format: (000) 000-0000.
Permissions
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, INDEMNITY, AND PARENTAL CONSENT AGREEMENT

I hereby release and discharge the Town of Fairfax, it's agents, employees, staff members, directors, and volunteers from any claims, responsibilities or liabilities for injuries or harm incurred as a result of my child's involvement as a participant in day camps through the Town of Fairfax.

I accept that allowing my child to participate in educational, instructional or recreation activities includes risks. These activities may be led or conducted by staff, contracted staff or others, and may include but are not limited to: Hiking, walking, and biking near rivers and over even or uneven terrain; Basic ropes or challenge course activities; Interactive games and other sporting activities; Swimming and wading in natural rivers; socializing; outdoor cooking or other chores; Use of any equipment, facilities or premises; and travel by foot.
Signature*

Clear
Date (Today's Date)*

MonthDayYear
Date
MEDICAL RELEASE

I hereby grant consent to any and all health care providers designated by the Town of Fairfax to provide my child with any necessary medical care as a result of any injury or illness. This consent includes First Aid and CPR administered by staff of the Town of Fairfax and transportation by Fairfax Rescue to the hospital.

If an emergency should arise, I understand that a thorough effort will be made to contact me or or an emergency contact before action is taken, but I agree to accept any expense associated with such an emergency if it is not possible to contact me in advance of treatment.
Signature*

Clear
Date (Today's Date)*

MonthDayYear
Date
PICTURE / VIDEO WAIVER

I give my consent and authorization for my child to be photographed while participating in the Fairfax Day Camps. By willingly signing below, I grant the Town of Fairfax permission to use photographs and videos taken during these summer camps. Pictures and videos may be used for up to 10 years after the date they were captured.
Signature

Clear
Date (Today's Date)

MonthDayYear
Date
PERMISSION TO ATTEND CAMP

I, Parent / Guardian of the participant, authorize him / her to attend a 2025 Fairfax Parks & Recreation day camp.

I give permission for my child to go on trips by foot while accompanied by camp staff members away from the main camp location to the Fairfax Community Library, the Fairfax Rec Park and Lamoille River, the BFA Fairfax School Woods.

I give permission for my child to watch "G" or "PG" rated movies with staff members present during showings.

I give permission for the people I have listed to pick up my child. I understand that these people will be asked for identification if not recognized by camp staff members. I additionally acknowledge that my child will not be released to any person other than those I have listed.
Signature*

Clear
Date (Today's Date)*

MonthDayYear
Date
Payment
We will contact you within 72 hours of registration submission (Monday - Friday) to organize payment with you.

If you are a Franklin County resident interested in applying for a scholarship for camp, please fill out the application through the Campership program at the Warner Home for Little Wanderers. Applications are requested by April 1st to be considered.

http://www.warnerhomeforlittlewanderers.org/campership.html

If you otherwise are needing additional help to pay for camp, please reach out to recreation@fairfax-vt.gov to discuss options.
Additional Notes

Please enter any additional information about your child you think we should know
Notes or Comments
Should be Empty:

Fairfax Day Camp November Registration

Child Information

Week Selection

Contact Information

Permissions

Payment

Additional Notes