Summer Camp Enrollment Form

Summer Camp Enrollment Form

Teensy Toes Preschool
Child's Information
Child's Name

First NameLast Name
Age
Gender
Date of Birth

MonthDayYear
Date
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Media Consent
I give my permission for my child to be photographed while participating in activities . I understand these photos may be used by the program for purposes such as classroom displays, newsletters, social media, or promotional materials. I understand that my child's name will not be shared publicly without additional permission.
Previous/Current Childcare?
Camper's Photo (Optional)

Cancelof
Parent/Guardian Information
- The parents/guardian listed below will be the authorized person to pick-up the child after the camp.
- The parents/guardian listed below will also be the primary emergency contact person.
Name

First NameLast Name
Relation
Phone Number
Format: (000) 000-0000.
Picture upload

Cancelof
Name

First NameLast Name
Relation
Phone Number
Format: (000) 000-0000.
Picture upload

Cancelof
Medical Information
Does the child have any allergies? If yes, please list them below:
Does the child have any previous injuries? If yes, please explain them below:
Does the child have any current medical conditions? If yes, please list them below:
Does the child takes any medication? If yes, please list them below and explain its purpose:
Payment Details
Method of Payment
My Products
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June 8th - 12th
Inventors Camp

$125.00



June 15th - 19th
Going Green!

$125.00



June 22nd - 26th
Ocean Week

$125.00



June 29th - July3rd
Magic of Storytelling!

$125.00



July 6th - July 10th
Figure it Out!

$125.00



July 13th - 17th
Detective Discovery Camp

$125.00



July 20th - 24th
Farm to Table

$125.00



July 27th - July30th
Jedi Training

$100.00



August 4th - 7th
Color Wars!

$100.00



Total

$0.00
Authorization
- I, the parent/guardian of this camper gives authority to the staff of this camp to apply judgment in regards to medical assistance in the event of an accident, injury, or illness if the emergency contact person cannot be reached. I authorized first aid, medical/surgical diagnosis, and treatment which may deem necessary.
- I released the organizers, staff, or managers of this camp for any responsibility in case of accident, illness, or injury during my child's enrollment.
- I confirm that all information given in this form is true, complete, and accurate.
Parent/Guardian Signature
Should be Empty:

Summer Camp Enrollment Form

Child's Information

Parent/Guardian Information

Medical Information

Payment Details

My Products

Authorization