Earl Grey CC Day Camp Registration Form

Earl Grey CC Day Camp Registration Form

These forms are required for your children to attend camp.
AGES 6-12

DAY CAMP COST
$100 WEEKLY FOR FULL DAY CAMP

CAMP HOURS ARE 8:00AM -5:30 ( REQUEST FOR LATE PICK UP 6:00)

NO REFUNDS OR CREDITS FOR DAYS NOT ATTENDED.

MORNINGS ONLY 8:30AM-12:30PM $50 WEEKLY

$25 DAILY DROP IN FEE PLUS FIELD TRIP COSTS.
REQUEST AND APPROVAL THROUGH THE GENERAL MANAGER ONLY

DAILY SCHEDULE :

8:30-10:00 -DROP OFF/FREE PLAY -CAMPERS MUST ARRIVE BY 10:00 AM

10:00-11:30 - GROUP ACTIVITIES

11:30-12:30 - LUNCH

12:30-2:30 OUTDOOR FUN ( THEMED ACTIVITY )

2:30-4:30 - SPECIAL ACTIVITY/FREE PLAY

4:30-5:30 - MOVIE TIME

CAMPERS MAY BE PICKED UP BETWEEN 4:00-5:30 PM . PLEASE MAKE ARRANGEMENTS WITH THE STAFF IF EARLY PICK UP IS REQUIRED.

ALL MONEY TO BE HANDED INTO STAFF FOR CANTEEN

ALL CAMPERS TO HAVE A REFILLABLE WATER BOTTLE TO STAY WITH THEM AT CAMP

YOU MUST PROVIDE SUNSCREEN

BATHING SUIT AND TOWEL DAILY/CHANGE OF CLOTHING
Camper's Information
Camper Name*

LEGAL NAME
Nickname
Date of Birth*

MonthDayYear
NOTE - Children need to have completed Kindergarten or have an older sibling attending before they are eligible to participate in traditional day camp.
Entering Grade in 2026/2027*
Chose your weeks - PLEASE NOTE THERE IS NO CARE JUNE 30-JULY 3, 2026

week 1 -JULY 6-10week 2 -JULY 13-17week 3 - JULY 20-24week4 -JULY 27-31week 5 - AUGUST 4-7 (SHORT WEEK)week 6 - AUGUST 10-14week 7- AUGUST 17-21week 8- AUGUST 24-28week 9 - AUGUST 31-SEPTEMBER 4
Please provide any additional information that you think is important or may affect the camper's ability to fully participate in the camp program.

Parents' Information

Parent/Guardian 1
Parent/Guardian 1*

First NameLast Name
Relationship to Child*
E-mail*
example@example.com
Cell Phone*
Parent can be reached at Format: (000) 000-0000.
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent's Work/School Name*
Or enter N/A if not applicable
Parent's Work/School Phone
daytime numberFormat: (000) 000-0000.
Where would you like to be reached while your child is at camp?*

Cell PhoneWork Phone
Parent/Guardian 2

Parent/Guardian 2
Parent/Guardian 2

First NameLast Name
Relationship to Child
E-mail
example@example.com
Cell Phone
parent can be reached atFormat: (000) 000-0000.
Home Address Same as Parent/Guardian 1?

Yes
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent's Work/School Name
Or enter N/A if not applicable
Parent's Work/School Phone
day time numberFormat: (000) 000-0000.
Where would parent/guardian 2 like to be reached while your child is at camp?

Cell PhoneWork Phone

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. At least one person listed must be within one hour of the center/home, able to take responsibility for the child in case the parent/guardian cannot be contacted and should be at least 18 years of age.
Emergency Contact

Emergency Contact
Full Name*

First NameLast Name
Primary Phone Number*
day time numberFormat: (000) 000-0000.
Relationship to Child*
how does the child know them

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Sign Document*
Date Signed*

MonthDayYear
Should be Empty:

Earl Grey CC Day Camp Registration Form

Camper's Information

Parents' Information

Parent/Guardian 2

Emergency Contacts/Authorized Pickup

Emergency Contact

Medical / Health Information