Camp Bolivar

Camp Date: July 14-17, 2026

(DAY CAMP ONLY - SEE HOURS BELOW)

Address: Bolivar Municipal Center, 211 North Washington Street, Bolivar, TN 38008

Contact: Sarah Rice at (731)658-9545 or by email to sarah.rice.cityofbolivar@gmail.com

If you have more than one child for whom you are submitting an application, please submit one application per child.

Camper's Name

What grade will this child be entering in August 2026?

What school will this child be attending in August 2026?

Parent/Legal Guardian's Name

First NameLast Name

Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent Phone Number

Parent Email Address

example@example.com

Camper's T-Shirt Size

Does your child have any known allergies or medical conditions that we need to be aware of? Please do not disclose confidential medical information on this form. We will contact you if more information is needed.

This question to be completed by camper. In 25 words or less, please tell us why you want to attend Camp Bolivar?

I understand and give permission for my child to be photographed and for my child's photograph to be used as expressed above.

I certify that my child, as named on the application, is covered by medical insurance. As such, should injury occur, it will be my responsibility to notify my insurer and/or pay for any treatment, transportation costs, and medical bills incurred by my child as a result of injury.

Parent/Legal Guardian Signature

By submitting this form, you are giving permission for your child to attend Camp Bolivar 2026!