Camp Dates:

MONDAY August 4 - FRIDAY August 8, 2025

Please fill out the following application to the best of your ability.

We want your child to have the best experience possible at camp and appreciate and value your input.

Please start the application when you have the following items available:

*Immunization record

*Child's Medi-Cal number

*A recent picture of the child available to upload

If you have any questions or issues completing the application,

please email us at: rfkwestla@gmail.com

or call the Camp Co-Director Mariana at (203) 970-8772

This health history is correct so far as I know, and the above named minor has permission to engage in all prescribed program activities, except as noted. The undersigned do hereby authorize the directors of Royal Family KIDS Camp, or such substitute as they may designate, as agent for the undersigned to consent to an X-Ray examination, anesthetic, medical, dental or surgical diagnosis or treatment and hospital care for the above minor which is deemed advisable by and to be rendered under the general or special supervision of any physician and surgeon, licensed under the provision of the Medicine Practice Act or any dentist licensed under the Dental Practice Act, whether such diagnosis or treatment is rendered at the office of said physician or dentist, at a hospital, camp or elsewhere. This authorization will remain effective while the above minor is enroute to and from or involved or participating in any camp program, unless revoked in writing by the undersigned and delivered to the Director of Royal Family as legal guardian/social worker/other. I give my permission for the above named minor to attend Royal Family KIDS Camp August 2-6, 2021 through Cornerstone West LA.