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Registration Form

The document contains a registration form and medical release for Camp Sunshine. It requests information about the camper, emergency contacts, selected camp dates, medical details, and provides waivers for transportation and medical treatment. Parents calculate fees based on the number of weeks attending and shirt size. Signatures are required on the medical release and transportation waiver to authorize any necessary care of the camper and transportation during camp hours.

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campsunshinenyc
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132 views3 pages

Registration Form

The document contains a registration form and medical release for Camp Sunshine. It requests information about the camper, emergency contacts, selected camp dates, medical details, and provides waivers for transportation and medical treatment. Parents calculate fees based on the number of weeks attending and shirt size. Signatures are required on the medical release and transportation waiver to authorize any necessary care of the camper and transportation during camp hours.

Uploaded by

campsunshinenyc
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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camp sunshine

REGISTRATION FORM

CAMPER INFORMATION
(Please register each camper/junior counselor separately)

Child’s Name_____________________________ Age___________ Birth Date__________________

I am registering my child as a (camper/jr counselor) ______ I will be registering____ #additional kids

Parents’ Names _______________________________ ________________________________

Dad’s Cell _____________________________ Mom’s Cell _____________________________

Dad’s Email ___________________________ Mom’s Email _____________________________

Address__________________________________________________________________________
(Number and Street) (Apt #) (City) (State) (Zip)

Mother’s Occupation ___________________ Employer ____________________Phone __________

Father’s Occupation __________________ Employer _____________________ Phone__________

In Case of Emergency Contact ______________________________________ Phone ___________

Relationship to Child ______________________________

The best way to notify me of rainy day changes/emergencies is (check all that apply):

Text ______ Email _____ Call to Office _____ I’ll check the website daily _____

SELECT YOUR CAMP PROGRAM

My child would like to attend:

week 1 ___ week 2___ week 3____ week 4 ____ week 5 ___ week 6 ___ week 7 ___ week 8____

week 9 ____ week 10 ____ week 11 ___ week 12 ___ week 13____ Total number of weeks: _____

I qualify for the Sibling Discount (Y/N) ____ I qualify for the Group Rate (Y/N) _____

T-shirt size (Youth S M L or Adult S M L) __________

CALCULATE YOUR BALANCE

Number of weeks attending: ___ X RATE ($440/discount rate $415): ___ + $35 (t-shirts) = $ ______

Signature ________________________________________ Date: ___________________________


camp sunshine
MEDICAL RELEASE

Camper’s Name___________________________________ Age______ DOB __________________

Camper’s doctor__________________________________ Doctor’s phone___________________

Hospital of
choice___________________________________________________________________________

Any health problems, allergies, limitations?

________________________________________________________________________________

Any medication to be taken during camp?

IN CASE OF MEDICAL EMERGENCY, I understand every effort will be made to contact parents or
guardians of campers. In the event I cannot be reached, I hereby give permission to the physician
selected by the camp director to hospitalize, secure proper treatment for, and order injection,
anesthesia or surgery for my child, as named above.

Parent’s/Guardian’s Signature Date


camp sunshine
TRANSPORTATION WAIVER

I hereby authorize the counselors and staff of ____________________________________________

to transport my son/daughter ________________________________ by foot, public transport and

taxi cab (in case of emergency) during the hours of ______________ a.m. and _____________ p.m.

from (MM/DD/YR) _____________________ and to (MM/DD/YR) ___________________________

Date: ____________________

Parent Signature: __________________________________________________________________

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