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registration
 

 

Camper's name
DOB
Grade as of 9/1/2011
Address
City
State
Zip
Home phone
E-mail
Guardian / parent's name
Cell / business phone
Emergency contact
Other people permitted to pick up child(ren)



Child(ren)'s physician name
Special concerns / allergies
Kosher needs
Swimmer
Non-swimmer
Weeks signed up for
Tuition
Sibling discount
Sibling / other discount
Enclosed payment
Check
Cash

Camp must be paid in full by the first week of camp



Medical Emergency Authorization:

It is our policy to make every effort to reach a parent/guardian in case of emergency. However there are certain times that the camp director needs to act on behalf of the parent. Please authorize the camp director to act on your behalf in the case of a medical emergency.
Yes I authorize.



Movie Authorization:

My child (name)

Can watch the following rated movies:
G
PG
PG-13

 


 

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