Treasure Oak Day Camp Registration Form

TOCC Day Camp Registration and Consent

June 13 - 15, 2023
If you have any questions, please contact Treasure Oak Country Club by phone at 228-875-0086 or email at toccoffice@gmail.com.

Steve Pennington - Tennis Director and Club Manager
Parent/Guardian Information
Parent/Guardian Name*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Primary Email*
*Important camp information and updates will be sent to the email address on file.
Member or Guest
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child Information
Child's Name*

First NameLast Name
Child's Gender*
Child's Date of Birth*

MonthDayYear
Child's Age*
Activity Sign-Up

TOCC will provide the following acticities each day during Day Camp.

Tennis

Soccer

Music

Pickleball

Arts & Crafts

Swimming (11:45 to 12:30)

NECESSARY ITEMS: Water/Gatorade, sunscreen, hat, lunch, swimsuit, towel, and tennis racket (if available). TOCC IS NOT RESPONSIBLE FOR LOST ITEMS.

Please select the acitivity options in order of preference. All Campers will participate in Swimming from 11:45 to 12:30 each day and isn't included in the options below.
Activity Option 1*
Activity Option 2*
Activity Option 3*
Activity Option 4*
Activity Option 5*
If you are registering more than one child, please fill out the fields below for each child.
Camper #2 Name

First NameLast Name
Camper #2 Gender
Camper #2 Date of Birth

MonthDayYear
Camper #2 Age
Activity Option 1 - Camper #2
Activity Option 2 - Camper #2
Activity Option 3 - Camper #2
Activity Option 4 - Camper #2
Activity Option 5 - Camper #2
Camper #3 Name

First NameLast Name
Camper #3 Gender
Camper #3 Date of Birth

MonthDayYear
Camper #3 Age
Activity Option 1 - Camper #3
Activity Option 2 - Camper #3
Activity Option 3 - Camper #3
Activity Option 4 - Camper #3
Activity Option 5 - Camper #3
Camper #4 Name

First NameLast Name
Camper #4 Gender
Camper #4 Date of Birth

MonthDayYear
Camper #4 Age
Activity Option 1 - Camper #4
Activity Option 2 - Camper #4
Activity Option 3 - Camper #4
Activity Option 4 - Camper #4
Activity Option 5 - Camper #4
YesNo
If yes, please list below:
YesNo
If yes, please list below:
Other Known Conditions*
*If none, please type N/A
Emergency Contact

The person(s) listed below are authorized to pick up my child from TOCC Day Camp.
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Relationship*
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
Waivers and Releases
PARENT'S CERTIFICATION FOR PARTICIPATION: By my signature below, I certify that as the parent or legal guardian of the above named camper, I release from and all liability, claim, or right of action of any kind which my child or legal representative may have for any and all bodily or personal injuries or property damages resulting from or during participation in this program, any host, representative, management, board of directors, trustees, or club in which the program is conducted.
Name*

First NameLast Name
Signature*

Clear
PHOTO/VIDEO WAIVER: I knowingly give consent for the release of any photo and videos that may be taken during my child’s participation in TOCC Day Camp for the use by Treasure Oak Country Club, for its publications, promotional materials, website, social media, advertisement, press releases, and/or any other marketing materials. I hereby grant permission to the rights of my child’s image, likeness and without payment or any other consideration. There is no time limit on the validity of this release.
Name*

First NameLast Name
Signature*

Clear
Payment Information
Please select payment type*
Any additional notes or requests for TOCC Day Camp?
Should be Empty:

TOCC Day Camp Registration and Consent

Parent/Guardian Information

Child Information

Emergency Contact

Waivers and Releases

Payment Information