Form Designer

2024 Youth Activities Form

Please submit one form per family. We will keep this information on file for the entirety of 2024.

Family Information

Family's Last Name *

Member Number *

Emergency Contact Name (First & Last) *

Emergency Contact's Phone Number *

Please list any and all individuals (including parents) who are authorized to pick up your child in the following format: Full Name, Male/Female, Best Phone Number (can list multiple) *

Only the people listed above may pick up my child from camp. No exceptions are made for family members. Anybody picking up my child from camp must present a government ID that matches the information listed above. If I need to add anybody to this list, I will e-mail the camp director. *

By checking this box, I hearby acknowledge that I have read the Release Form and Procedures & Policies, and I understand and agree to the terms releasing claims and legal rights.

Child 1 Information

Child 1 Name (First & Last) *

Date of Birth *

What grade will child be in fall 2024? *

Please list any allergies, dietary restrictions, diseases, or medical problems we should be aware of *

Please list any swim restrictions, floaties or life jackets that need to be worn by your camper durning camp swim time. *

Child 2 Information

Child 2 Name (First & Last)

Date of Birth

What grade will child be in fall 2024?

Please list any allergies, dietary restrictions, diseases, or medical problems we should be aware of