Clone of Individual Day Camp Westhaven 2025 Registration

  • Camp Westhaven 2026 Individual Day Registration

    Southern Sitters

  • Camper Information

  • Select your Drop in Dates:
  •  - -
  •  - -
  •  - -
  • Camper 1 Swimming Ability*

  • Camper 2 Swimming Ability

  • Camper 3 Swimming Ability

  • Parents' Information

    Parent/Guardian 1
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Where would you like to be reached while your child is at camp?*

  • Contact

    Parent/Guardian 2
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Where would parent/guardian 2 like to be reached while your child is at camp?

  • 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. Person listed must be within one hour of the Westhaven Resident's Club able to take responsibility for the child in case the parent/guardian cannot be contacted and should be at least 18 years of age.
  • Format: (000) 000-0000.

  • Medical / Health Information

  •  -
  • Is this camper up-to-date on all immunizations?*

  • Do your children have any food, medication or environmental allergies?*
  • 0/150
  • Does your child’s/children'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?*

  • 0/150
  • Does the special health or medical condition require child care staff to perform a procedure, or perform child specific care such as: to monitor your child/children for symptoms or administer medication during child care hours?
  • Does your child have any dietary restrictions, including those for medical, religious or cultural reasons?*
  • 0/150
  • 0/200

  • Additional Medication

    Skip Page if N/A
  • My child requires

  • If your child's medication meets any of these criteria:

    1. A physician's instruction is needed for a nonprescription medication (e.g. child is underage or underweight per the label instructions); or
    2. It is a sample medication without a prescription label; or
    3. The nonprescription medication is to be given longer than three consecutive days within a fourteen day period or is a topical product or lotion that is being used for a skin ailment and is to be given no longer than fourteen consecutive days; or
    4. The child is on a modified diet (an entire food group is eliminated); or
    5. The medication contains codeine or aspirin.

    ***The topical product or lotion and the physician's instructions exceed the manufacturer's instructions or use

     

  • Upload a File
    Cancelof

  • Payment and Statement of Understanding


  •  - -
  • Thank you for registering!
  • Should be Empty: