Day Camp Registration Form

Camp Registration Form

A day of education & fun
Camper's Information
Camper Name*
Nickname
Age*
age on day of camp
NOTE - Children will be grouped according to age. If you choose to do the "Camper & Friend" option, the adult will be in the same group as the child.
My camper will be using the following as a camera (please list brand and model. Cameras on phones are just fine.)
Please provide any additional information that you think is important or may affect the camper's ability to fully participate in the camp program.
Parent or Guardian Information

will also serve as emergency contact
Parent/Guardian 1*

First NameLast Name
Relationship to Child*
E-mail*
Cell Phone*
Home Phone*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please note, if your child has any special medical needs, we request that they have an adult friend attend with them to monitor the situation and administer any needed medications/attention. The friend free will be waived in these situations.
Does your child have any food, medication or environmental allergies?*

YesNo
Allergies? Check all that apply

FoodMedicationEnvironmental
Please list and explain any allergies

0/150
Does your child’s allergy/allergies require child care staff to monitor child for symptoms, take action if a reaction occurs, or give emergency medication to your child?

YesNo
Does your child have a special health or medical condition?*

YesNo
Please explain

0/150
Payment and Statement of Understanding

My Products

Camper Registration$35.00

Registration for 1 child ages 7-18

Quantity
Item subtotal:$0.00

Camper & (18+) Friend$70.00

Registration for 1 child (7-18) and an adult (18+) friend/parent/guardian who will be in their same group.

Enter coupon

Total $0.00

West Texas Photographers has permission to secure emergency transportation for my child in the event of an illness or injury which requires emergency treatment. The emergency transportation service will determine the facility to which my child will be transported.*
Type first and last name above to consent
Sign Document*
Date Signed*

MonthDayYear
Should be Empty:

Camp Registration Form

Camper's Information

Parent or Guardian Information

Payment and Statement of Understanding