Summer Camp Registration - FREE for Family Caregivers

Summer Camp Registration - FREE for Family Caregivers

Register your child for a fun summer camp experience at Solar Swim & Gym, spots sponsored by Caregiver OneCall. Limited spots available, so sign up early.
Only 5 spots available weekly. Limit 1 child per family. First-come, first-served.
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Email Address
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Your relationship to child attending camp
Caregiving Verification
Who are you currently caring for?
What condition/need requires your caregiving?
Child's Full Name

First NameLast Name
Child's Date of Birth

MonthDayYear
Date
Child's Age
Child's Gender
Does this child receive RCEB or IHSS services? (RCEB pays for summer camp, and this camp has availability)
Does this child have any disabilities or special needs we should be aware of?
Any allergies (food, medication, environmental)?
Any medical conditions we should know about?
Current medications child takes (NA if none)
Camp Attendance
Which weeks can your child attend? Check all that apply
I authorize Solar Swim & Gym emergency medical treatment if needed
I give permission for my child to participate in swimming activities
I give permission for photos/videos for Caregiver OneCall promotional use
I understand this is a free program for family caregivers and my child must NOT be a RCEB or IHSS recipient
I understand Solar Swim & Gym will have their own intake process and camp rules
How did you hear of this camp?
Parent/Guardian Signature
Date

MonthDayYear
Date
Emergency Contact Name (not you)

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Child (Emergency Contact)
Should be Empty:

Summer Camp Registration - FREE for Family Caregivers

Caregiving Verification

Camp Attendance