Tennessee Valley Railroad Museum Rail Camp
|
|
- Robert Pierce
- 6 years ago
- Views:
Transcription
1 Tennessee Valley Railroad Museum Rail Camp Please complete ALL information and return by May 1st. Incomplete forms will not be processed. Camper Name: Preferred Name: (First Name) (Middle Initial) (Last Name) Birthdate: Gender: (MM/DD/YEAR) Address: City: State: Zip Code: Home Phone: Cell Phone: Camper s Address: Grade in fall of 2018: School attending in fall: Camp Session (please circle): Session 1 - May 29-June 2 Session 4 - June (Day Camp, 7-9 years old) (Overnight, years old) Session 2 - June 4-9 Session 5 - June (Day Camp, years old) (Overnight, years old) Session 3 - June (Day Camp, years old) Circle summers child has attended TVRM Rail Camp: TVRM Member: No Yes (please circle one Student, Individual, or Family) 1st Parent/Guardian s Name: Preferred Phone: Address (if different from camper) Address:
2 2nd Parent/Guardian s Name: Preferred Phone: Address (if different from camper) Address: Camper resides with: 1st Parent/Guardian 2nd Parent/Guardian Both Joint Custody Check here if there are special custody circumstances (restricted parental access, lives with other than legal parent/guardian, etc.) Please include copies of all appropriate legal forms with application. Please include any additional information about campers living situation that may helpful for staff to know (recent move, divorce/death in the family, sibling moving on to college/other, change of school, etc.) Emergency Contact Information Please be sure that this person knows your child well enough to act in your place in the event you cannot be reached in the event of an emergency! Name: Relationship to Applicant: Telephone Number(s): Is there anyone else who is authorized to pick-up this camper? No Yes If yes, please list name and relationship to student: *Any special instructions, such as custody or restraining orders, must be attached to this application and discussed personally with the camp director. All information will be kept confidential.
3 This year we are offering several different options to fine tune camper s experiences at camp! Campers will be placed in Modules as space is available, and at the staff s discretion. Please rank the following Modules in order of your camper's preference (1 = Most Interested in - 10 = least interested in: Locomotive Operations Experience - Shadow our engineers and learn about the skills needed to operate Steam and Diesel locomotives. Passenger Operations Experience - Shadow our conductors and learn about their onboard duties. Shop Work Experience - Spend extended time in our restoration shop, learning about the process of restoring and maintaining vintage railroad equipment. Track-Work Experience - Learn the importance of track work. Ride a velocipede and track speeder! Intro to Railroad Modeling - Learn the skills involved in designing and building model railroads. Intro Pullman Service - Shadow our Dining Car staff and learn how on-board meals are prepared, and how a fine dining experience for our passengers is possible. Photography - Learn to compose, shoot, and edit still and action shots of railroading interest. Blacksmithing - Spend extended hands-on time working in our on-site blacksmith s shop. Chattanooga Railroad History - Learn then history of railroading, specific to the Chattanooga area. Participate in extra field trips to local sites of interest. Rail Fanning - Gain access to local sites to watch, photograph, and film trains.
4 MEDICATION INFORMATION: Camper s Pediatrician: Phone Number: Date of last Physical: (Must be within the past year) Does camper regularly take medications during the school year to aid in focus/attention? No Yes (if so, we encourage continued use during camp session, with physician s approval) Please list all the camper s current medications (regardless of whether it needs to be taken a camp or not): Name of Medication Dosage Additional Information Administered at Camp? (Y/N) Are there any medications that your child will be required to take while at camp? No Yes If yes, please give specifics - names, description of the medication (color of pill/liquid/etc.), when they are to be taken, and if the medications need to be refrigerated. All medications must be provided in daily dose containers, labeled clearly with the camper s first and last name. Name of Medication Dosage Description (color, shape, etc.) Additional Information Please note that there is an extended Medical Form attached with this application that must also be filled out
5 To assist Rail Camp staff in providing the best possible camp experience for your camper, please answer the following questions as carefully and completely as possible: Has your camper been to a day camp before? No Yes Where and for how long? Has your camper been to an overnight camp before? No Yes Where and for how long? Does your camper wear glasses or contact lenses? No Yes Does your camper have any allergies? No Yes If yes, please specify: Does your camper have any dietary needs? No Yes If yes, please specify: Does your camper have any special mobility needs which may require modifications to be made by camp staff? No Yes If yes, please specify: Has your camper been given a Autism Spectrum related diagnosis? No Yes If yes, please explain: Does your camper have any physical, learning, language, developmental, emotional, or behavior difficulties and/or differences which may require modifications to be made by camp staff? No Yes If yes, please specify: Can your camper follow three step instructions without further prompting? No Yes Please describe your camper s fine motor skills: Please describe your camper s gross motor skills: Does your camper make new friends easily? No Yes Does your camper enjoy being outdoors, exercising, and being active? No Yes Does your camper participate in any sports or other outdoor actives (camping, hiking, boating, etc.)? Please list: Does your camper enjoy indoor activities in climate controlled environments? No Yes
6 Does your camper enjoy artistic and/or hands on creative projects (such as drawing, painting, playing musical instrument, woodworking, railroad modeling, etc.)? No Yes Please list: Can your camper walk 1-2 miles on level ground without tiring? No Yes Does your camper swim in water over their head? No Yes Can your camper climb a ladder unassisted? No Yes Is your camper easily embarrassed or upset? No Yes Does your camper become angry or aggressive when challenged by peers? No Yes If yes, please describe: Does your camper exhibit any attention seeking behaviors? No Yes If yes, please describe: Is there anything your camper may be nervous about at camp? No Yes If yes, please specify: Does your camper need any assistance in remembering to perform daily self care (toothbrushing, clean clothing, etc.)? No Yes If yes, please specify: Does your camper exhibit people pleasing behaviors that may require staff to help them stand up for themselves among peers? No Yes If yes, please specify: What is your camper most looking forward to about Rail Camp? Does your camper have any concerns about attending Rail Camp? Is there anything else you can tell us about your camper to help enable Rail Camp staff in providing the most safe, accessible, and enjoyable experience for them?
7 TVRM RAIL CAMPER S AGREEMENT I understand that I must conduct myself in an appropriate manner both at the Museum and when I am out in public. I will show appropriate respect for camp staff, other campers, as well as Museum staff and guests. I will show respect for Museum property and grounds, as well as any other locations we may visit. If I do behave in any way that camp staff does not believe to be appropriate, my legal guardian will be called and I will be sent home. If this occurs, no refund will be given. I understand that there is a dress code I must follow in order to participate in summer camp. This dress code includes long jeans, and sturdy shoes with good soles (No open toed shoes). I understand that if I do not adhere to this dress code I will have to sit out of certain activities. I understand that The Tennessee Valley Railroad is an operating railroad with running equipment. Therefore during the day I may get dirty, wet, oily, or greasy and I will not wear anything that I do not want ruined. I understand that phone contact with campers is not available with campers for the duration of the session. I understand that due to camp rules, and in some cases Federal Regulations, the use of cell phones, pagers, music players, handheld game machines, tablets, laptops, or other electronic devices are not allowed at TVRM Rail Camp. If the camper does bring one of these devices, staff will collect them, at their discretion, for the duration of the camp session. TVRM will not be responsible for any such devices that are lost or damaged. Camper: Date: Legal Guardian: Date:
8 RELEASE/CONSENT/ACKNOWLEDGMENT/ASSUMPTION OF RISK: I/we, the undersigned parent(s) or guardian(s) of the camper named in this application (hereinafter referred as the Child ), acknowledge that we are aware of the types of activities in which the Child will be participating during his attendance at the summer camp session at the Tennessee Valley Railroad Museum, and that we have been given ample opportunity to ask any questions which we may have about the environment at the Museum and the activities in which the Child will participate. I/we are aware of the dangers which are inherent in the operations of any children s camp and in the Child s participation in all camp activities, either on or off the premises of the Museum, which may include use of tools and equipment in shop work; washing, cleaning, and preparing railroad cars for use by the Museum; riding in the cab of a locomotive engine; painting; oiling, greasing, and/or otherwise servicing locomotive engines and rolling stock; engaging in camp activities which involve physical contact with other camp attendees involved in the same activity; as well as vehicular travel. I/we further acknowledge that I/we have given the Tennessee Valley Railroad Museum full disclosure of any pre-existing physical or mental limitations, challenges, or problems of which we are aware. Because of the potential dangers inherent in participating in the activities of any children s camp, I/we recognize the importance of the Child s obeying the instructions of camp employees and abiding by all camp rules and regulations. I/we have instructed the Child to obey all instructions from camp employees and to abide by the rules and regulations of the camp, and I/we do hereby release the Tennessee Valley Railroad Museum and its officers, directors, staff, counselors, and other employees from any liability which they might otherwise incur as a consequence of the failure of the Child to obey said employees and abide by the rules and regulations of the Museum, and from any other liability which the Museum and the individual parties listed above might otherwise incur in incidents involving the Child s negligence or contributory negligence. PHOTOGRAPHS: I/we grant permission to the use of photographs or video that includes pictures of my/our Child for camp advertising and promotion in Museum brochures or on the Museum website. I/we understand that the Museum intends to provide children with cameras to use to photograph and document camp activities during the entire camp session, and I/we acknowledge that the Museum retains all right of ownership to all photographic images generated in this process. I/we also understand that copies of photographs will be given to camp attendees. APPROVAL AND PAYMENT: I/we have read the information in this application and agree to its terms. Not later than May 25, 2018, I/we will send a check for the full summer camp fee. I/we understand that the summer camp fee is non-refundable after payment and that there will be no refund for cancellations occurring after May 25, Date: Signature of Parent/Legal Guardian Date: Signature of Parent/Legal Guardian If only one parent/legal guardian has signed, the Tennessee Valley Railroad Museum will presume full parental consent unless the Museum is expressly instructed otherwise.
9 CAMPER HEALTH HISTORY FORM1 Developed and reviewed by: American Camp Association, American Academy of Pediatrics Council on School Health, & Association of Camp Nurses Mail this form to the address below by (date) Camper Home Address: Street Address City State Zip Code Parent/guardian with legal custody to be contacted in case of illness or injury: Relationship Name: to Camper: Preferred Phones: ( ) ( ) Home Address: (If different from above) Street Address City State Zip Code Second parent/guardian or other emergency contact: Relationship Name: to Camper: Preferred Phones: ( ) ( ) Additional contact in event parent(s)/guardian(s) can not be reached: Relationship Name: to Camper: Preferred Phones: ( ) ( ) Allergies: No known allergies. This camper is allergic to: Food Medicine The environment (insect stings, hay fever, etc.) Other (Please describe below what the camper is allergic to and the reaction seen.) Diet, Nutrition: Restrictions: Medical Insurance Information: This camper eats a regular diet. This camper eats a regular vegetarian diet. This camper is lactose intolerant. This camper is gluten intolerant. Other, please explain in space. I have reviewed the program and activities of the camp and feel the camper can participate without restrictions. I have reviewed the program and activities of the camp and feel the camper can participate with the following restrictions or adaptations. (Please describe below.) This camper is covered by family medical/hospital insurance Yes No Include a copy of your insurance card if appropriate; copy both sides of the card so information is readable. Insurance Company Subscriber Parent/Guardian Authorization for Health Care: Dates will attend camp: from to Camper Name: First Middle Last Male Female Birth Date Age on arrival at camp: To Parent(s)/Guardian(s): Please follow the instructions below. Attach additional information if needed. 1) Complete pages 1, 2 and 3 of this form (FORM 1) and make a copy. 2) Send the original, signed FORM 1 to camp by the requested date. 3) Complete the top of FORM 2 (CAMPER HEALTH-CARE RECOMMENDATIONS) and provide the copy of FORM 1 with FORM 2 to your child s health-care provider for review and completion. 4) After it has been completed and signed by your child s health-care provider, return FORM 2 to camp by the requested date. Policy Number InsuranceCompany Phone Number ( ) This health history is correct and accurately reflects the health status of the camper to whom it pertains. The person described has permission to participate in all camp activities except as noted by me and/or an examining physician. I give permission to the physician selected by the camp to order x-rays, routine tests, and treatment related to the health of my child for both routine health care and in emergency situations. If I cannot be reached in an emergency, I give my permission to the physician to hospitalize, secure proper treatment for, and order injection, anesthesia, or surgery for this child. I understand the information on this form will be shared on a need to know basis with camp staff. I give permission to photocopy this form. In addition, the camp has permission to obtain a copy of my child s health record from providers who treat my child and these providers may talk with the program s staff about my child s health status. Signature of Custodial Relationship Parent/Guardian Date: to Camper: If for religious or other Summer reasons Camp you cannot Application sign - this, 2018contact the camp for a legal waiver which must be signed for attendance. Page 1/4 First Middle Last Camper Name (For Camp Use) Cabin or Group (For Camp Use) Session Code(s):
10 CAMPER HEALTH HISTORY FORM 1 Developed and reviewed by: American Camp Association, American Academy of Pediatrics Council on School Health, & Association of Camp Nurses Camper Name: First Middle Last Birth Date: Immunization History: Provide the month and year for each immunization. Starred ( ) immunizations must include date to meet ACA Standard. Copies of immunization forms from health-care providers or state or local government are acceptable; please attach to this form. Immunization Dose 1 Month/Year Diptheria, tetanus, pertussis (DTaP) or (TdaP) Tetanus booster (dt) or (TdaP) Mumps, measles, rubella (MMR) Polio (IPV) Haemophilus influenzae type B (HIB) Pneumococcal (PCV) Hepatitis B Dose 2 Month/Year Dose 3 Month/Year Dose 4 Month/Year Dose 5 Month/Year Most Recent Dose Month/Year Hepatitis A Varicella (chicken pox) Meningococcal meningitis (MCV4) Had chicken pox Date: Tuberculosis (TB) test Date: Negative Positive If your camper has not been fully immunized, please sign the following statement: I understand and accept the risks to my child from not being fully immunized. Signature of Custodial Relationship Parent/Guardian: Date: to Camper: Medication: This camper will not take any daily medications while attending camp. This camper will take the following daily medication(s) while at camp: Medication is any substance a person takes to maintain and/or improve their health. This includes vitamins & natural remedies. Please review camp instructions about required packaging/containers. Many states require original pharmacy containers with labels which show the camper s name and how the medication should be given. Provide enough of each medication to last the entire time the camper will be at camp. Name of medication Date started Reason for taking it When it is given Amount or dose given How it is given Breakfast Lunch Dinner Bedtime Other time: Breakfast Lunch Dinner Bedtime Other time: Breakfast Lunch Dinner Bedtime Other time: Breakfast Lunch Dinner Bedtime Other time: The following non-prescription medications may be stocked in the camp Health Center and are used on an as needed basis to manage illness and injury. Cross out those the camper should not be given. Acetaminophen (Tylenol) Phenylephrine decongestant (Sudafed PE) Antihistamine/allergy medicine Diphenhydramine antihistamine/allergy medicine (Benadryl) Sore throat spray Lice shampoo or cream (Nix or Elimite) Calamine lotion Laxatives for constipation (Ex-Lax) Ibuprofen (Advil, Motrin) Pseudoephedrine decongestant (Sudafed) Guaifenesin cough syrup (Robitussin) Dextromethorphan cough syrup (Robitussin DM) Generic cough drops Antibiotic cream Aloe Bismuth subsalicylate for diarrhea (Kaopectate, Pepto-Bismol) Copyright 2014 by American Camping Association, Inc. Page 2/4 Rev.1/2014 LEE/EAW
11 CAMPER HEALTH HISTORY FORM 1 Developed and reviewed by: American Camp Association, American Academy of Pediatrics Council on School Health, & Association of Camp Nurses Camper Name: First Middle Last Birth Date: General Health History: Check Yes or No for each statement. Explain Yes answers below. Has/does the camper: 1. Ever been hospitalized?... Yes No 11. Had fainting or dizziness?... Yes No 2. Ever had surgery? Yes No 12. Passed out/had chest pain during exercise?.... Yes No 3. Have recurrent/chronic illnesses? Yes No 13. Had mononucleosis ( mono ) during the past 12 months?... Yes No 4. Had a recent infectious disease? Yes No 14. If female, have problems with periods/menstruation?.... Yes No 5. Had a recent injury? Yes No 15. Have problems with falling asleep/sleepwalking?... Yes No 6. Had asthma/wheezing/shortness of breath?... Yes No 16. Ever had back/joint problems? Yes No 7. Have diabetes? Yes No 17. Have a history of bedwetting?.... Yes No 8. Had seizures?... Yes No 18. Have problems with diarrhea/constipation?... Yes No 9. Had headaches?... Yes No 19. Have any skin problems?... Yes No 10. Wear glasses, contacts, or protective eyewear? Yes No 20. Traveled outside the country in the past 9 months?... Yes No Please explain Yes answers in the space below, noting the number of the questions. For travel outside the country, please name countries visited and dates of travel. Mental, Emotional, and Social Health: Check Yes or No for each statement. Has the camper: 1. Ever been treated for attention deficit disorder (ADD) or attention deficit/hyperactivity disorder (AD/HD)?... Yes No 2. Ever been treated for emotional or behavioral difficulties or an eating disorder?... Yes No 3. During the past 12 months, seen a professional to address mental/emotional health concerns?.... Yes No 4. Had a significant life event that continues to affect the camper s life?... Yes No (History of abuse, death of a loved one, family change, adoption, foster care, new sibling, survived a disaster, others) Please explain Yes answers in the space below, noting the number of the questions. The camp may contact you for additional information. Health-Care Providers: Name of camper s primary doctor(s): Name of dentist(s): Name of orthodontist(s): Phone: ( ) Phone: ( ) Phone: ( ) What Have We Forgotten to Ask? Please provide in the space below any additional information about the camper s health that you think important or that may affect the camper s ability to fully participate in the camp program. Attach additional information if needed. Parents/Guardians: STOP here. The rest of this is form is completed when the camper arrives at camp. Keep a copy for your records. Copyright 2014 by American Summer Camping Application Association, Inc. Page 3/4 Rev.1/2014 LEE/EAW
12 CAMPER HEALTH HISTORY FORM 1 Developed and reviewed by: American Camp Association, American Academy of Pediatrics Council on School Health, & Association of Camp Nurses Camper Name: First Middle Last Birth Date: Individual Health Record (For Camp Use Only) Initial Screening Date/Time: Initials: Screening has been conducted according to camp protocol and significant findings noted as follows: A. Any signs/symptoms of illness or injury upon arrival?... No Yes as noted below B. History of exposure to communicable disease?... No Yes as noted below C. Additions or corrections to information on this health history?... No Yes as noted below D. Medication given to health-care staff?... No Yes as noted below E. Any signs/symptoms of head lice?... No Yes as noted below Provider notes: (date/time/initial all entries) Exit Note: Check one of the following: Left camp this day with no reported illness or injury symptoms. Left camp this day with the following problem/concern: This person was told about the problem and instructed about follow-up as noted above: Date/Time: Initials: Copyright 2014 by American Camping Association, Inc. Page 4/4 Rev.1/2014 LEE/EAW
13 Recommendations for Licensed Medical Personnel FORM 2 Developed and reviewed by: American Camp Association, American Academy of Pediatrics Council on School Health, & Association of Camp Nurses Mail this form to the address below by (date) The following non-prescription medications are commonly stocked in camp Health Centers and are used on an as needed basis to manage illness and injury. Medical personnel: Cross out those items the camper should not be given. Acetaminophen (Tylenol) Ibuprofen (Advil, Motrin) Phenylephrine (Sudafed PE) Pseudoephedrine (Sudafed) Chlorpheneramine maleate Guaifenesin Dextromethorphan Diphenhydramine (Benadryl) Generic cough drops Chloraseptic (Sore throat spray) Lice shampoo or scabies cream (Nix or Elimite) Calamine lotion Bismuth subsalicylate (Pepto-Bismol) Laxatives for constipation (Ex-Lax) Hydrocortisone 1% cream Topical antibiotic cream Calamine lotion Aloe Diet, Nutrition: Eats a regular diet. Has a medically prescribed meal plan or dietary restrictions:(describe below) The camper is undergoing treatment at this time for the following conditions: (describe below) None. Medication: No daily medications. Will take the following prescribed medication(s) while at camp: (name, dose, frequency describe below) Other treatments/therapies to be continued at camp: (describe below) None needed. Do you feel that the camper will require limitations or restrictions to activity while at camp? No Yes If you answered Yes to the question above, what do you recommend? (describe below attach additional information if needed) I have reviewed the CAMPER HEALTH HISTORY FORM (FORM 1), and have discussed the camp program with the camper s parent(s)/guardian(s). It is my opinion that the camper is physically and emotionally fit to participate in an active camp program (except as noted above.) Name of licensed provider (please print): Signature: Title: Office Address Street City State Zip Code Telephone: ( ) Copyright 2014 by American Camping Association, To Parent(s)/Guardian(s): Complete this section and give this form (FORM 2) and a copy of your completed CAMPER HEALTH HISTORY FORM (FORM 1) to your child s health-care provider for review. Dates will attend camp: from to Camper Name: First Middle Last Male Female Birth Date Age on arrival at camp Camper home address: City State Zip Code Custodial parent(s)/guardian(s) phone: ( ) ( ) Parent(s)/guardian(s) stop here. Rest of form to be completed by medical personnel. Medical Personnel: Please review the CAMPER HEALTH HISTORY FORM (FORM 1) and complete all remaining sections of this form (FORM 2). Attach additional information if needed. Physical exam done today: Yes No (If No, date of last physical: ) ACA accreditation standards specify physical exam within the last 12 months. Date: Weight: lbs Height: ft in Blood Pressure / Allergies: No Known Allergies To foods (list): To medications: (list): To the environment (insect stings, hay fever, etc. list): Other allergies: (list): Describe previous reactions: Inc. Rev. 1/14 LEE/EAW First Middle Last Camper Name (For Camp Use) Cabin or Group (For Camp Use) Session Code(s):
14
Dates will attend camp: from to Month/Day/Year Month/Day/Year. Male Female Birth Date Age on arrival at camp Month/Day/Year
CAMPER HEALTH-CARE RECOMMENDATIONS by LICENSED MEDICAL PERSONNEL FORM 2 Developed and reviewed by: American Camp Association, American Academy of Pediatrics Council on School Health, & Association of Camp
More informationCAMPER HEALTH HISTORY FORM 1
CAMPER HEALTH HISTORY FORM 1 Developed and reviewed by: American Camp Association, American Academy of Pediatrics Council on School Health, & Association of Camp Nurses Mail this form to the address below
More informationCAMPER HEALTH HISTORY FORM1
CAMPER HEALTH HISTORY FORM1 Developed and reviewed by: American Camp Association, American Academy of Pediatrics Council on School Health, & Association of Camp Nurses Mail this form to the address below
More informationCAMPER HEALTH HISTORY FORM 1
CAMPER HEALTH HISTORY FORM 1 Developed and reviewed by: American Camp Association, American Academy of Pediatrics Council on School Health, & Association of Camp Nurses Mail this form to the address below
More informationPlease mark which days your camper will be attending. ($15 a day or $70 for all week)
Peterkin Camp and Conference Center A Ministry of the Episcopal Diocese of West Virginia An Accredited American Camp Association Camp Day Camp Registration June 18-22, 2018; Open to youth entering K-6
More informationYMCA Hayo-Went-Ha Camps Instructions for Medical Form
YMCA Hayo-Went-Ha Camps Instructions for Medical Form EFFECTIVE JANUARY 01, 2012, THE AMERICAN CAMPING ASSOCIATION HAS CHANGED THE STANDARD FOR A CAMPER S HEALTH EXAM. CAREFULLY READ THE INFORMATION BELOW!
More informationLake Geneva Youth Camp Health Certificate
Lake Geneva Youth Camp Health Certificate Camp Session This health form must be completed by the parent or legal guardian of the camper, and signed at the bottom. This form must be returned to the Camp
More informationPlease return this form to your hosting branch.
CAMPER HEALTH HISTORY FORM 1 Developed and reviewed by: American Camp Association, American Academy of Pediatrics Council on School Health, & Association of Camp Nurses Please return this form to your
More informationAs the parent/guardian of I choose not to have a medical. Personnel FORM 2.
Star Lake Camp Health Form 2017 All Campers must have a signed CAMPER HEALTHHISTORY FORM 1 on file at camp. Please be sure to send it with them. All campers must have a Recommendations for Licensed Medical
More informationPARENT / GUARDIAN: PLEASE FILL OUT AND SIGN THIS PAGE.
CAMPER HEALTH Attending: 1st Session 2nd Session (Circle one) HISTORY FORM 2015 Camper Name: Developed and reviewed by: American Camp Association, First Middle American Academy of Pediatrics Council on
More informationCAMP JEANNE D ARC Medical Information Instructions for Parents/Guardians
CAMP JEANNE D ARC 2018 Medical Forms 2017 Medical Information Instructions for Parents/Guardians DUE to bybunk1 MAY or 1, mail 2017to our office by May 1st Please complete and upload Complete online: Registration
More informationMARYLAND 4-H CAMPS HEALTH FORM
MARYLAND 4-H CAMPS HEALTH FORM Camper s Name: _ Last First MI Nickname Current Photo Of Camper Male Female Age at Camp Arrival: Birthdate: Dates will attend Camp: to Street Address City State ZIP County
More informationCamper Name: Male Female First M.I. Last Camper T-shirt Size: Grade in Fall 18. Date of Birth (MM/DD/YY): Age at Camp: Name to go by at camp:
Peterkin Camp and Conference Center A Ministry of the Episcopal Diocese of West Virginia Overnight Youth Camp Registration 2018 Please complete one form per camper per camp. Check which camp your camper
More informationPeterkin Camp and Conference Center
Camper Information Peterkin Camp and Conference Center A Ministry of the Episcopal Diocese of West Virginia Summer Camp Registration Please complete one form per camper per camp. Check which camp your
More informationWinter Resident Camp December Winter Day Camp at Immokalee December :30am - 6:30pm
Winter Resident Camp December 26-30 Winter Day Camp at Immokalee December 27-29 6:30am - 6:30pm CAMP IMMOKALEE Program Handbook Staff Our Camp Immokalee staff is dedicated to making your child s Winter
More informationCompleted Packet due by May 19th 2017! Please return ALL PAPERWORK by mail, , or fax to:
Hear Indiana Listening and Spoken Language Camp 2017 Hello 2017 campers! We are thrilled to announce that our 2017 Listening and Spoken Language Camp will be held at Happy Hollow Children s Camp, in Nashville,
More informationYMCA Resident Camp Enrollment Form
YMCA Resident Camp Enrollment Form DAXKO: Staff Use Only T-Shirt: Child s First Name: Last: Child's Gender: Male Female (Please Circle) D.O.B: Age: Grade in Fall 2018 Address: City: Zip: Home Phone #:
More informationMARYLAND 4-H CAMPS HEALTH FORM
MARYLAND 4-H CAMPS HEALTH FORM Last First MI Nickname Current Photo Of Camper Male Female Home Address: Age at Camp Arrival: Birthdate: MM/DD/YYYY Dates will attend Camp: to MM/DD/YYYY MM/DD/YYYY Street
More informationCamp Fire Georgia / Camp Fire Camp Toccoa Camper Medical and Health History
First Name: _ Last Name: Camp Fire Georgia / Camp Fire Camp Toccoa Camper Medical and Health History Attending Camp Session(s) 1 2 3 4 5 6 7 8 LIT CIT Intern Staff The information on this form is not part
More informationCAMPER HEALTH HISTORY FORM1
Camper Name First Middle Last (For Camp Use) Cabin or Group (For Camp Use) Session Code(s): CAMPER HEALTH HISTORY FORM1 Developed and reviewed by: American Camp Association, American Academy of Pediatrics
More informationYouth Safety and Leadership Camp Junior. Sponsored by Campus Police and Security Services
Youth Safety and Leadership Camp Junior Sponsored by Campus Police and Security Services Youth Safety and Leadership Camp The Mission of the Youth Safety and Leadership Camp will provide an environment
More informationHAPPY HOLLOW CHILDREN S CAMP KEEP THIS INFORMATION FOLDER
HAPPY HOLLOW CHILDREN S CAMP FOUNDED IN 1951 615 N. Alabama Street, Ground Floor Suite C, Indianapolis, IN 46204 (317) 638-3849 FAX (317) 686-0195 e-mail: info@happyhollowcamp.net www.happyhollowcamp.net
More informationDate Camper Name: LAST, FIRST (Please print) Medical Form
Date Camper Name: LAST, FIRST (Please print) Medical Form Medical information must be provided for you or your child to attend camp. To ensure the health and safety of our volunteer staff, adult and youth
More informationCamp Celo. Medical Form Package Instructions:
Camp Celo 775 Hannah Branch Road Burnsville, NC 28714 828-675-4323 Medical Form Package Instructions: These forms are required of all campers. Please complete and return by May 15. 1. Complete and sign
More informationCamper Information. Street Address Apartment/Unit # City State ZIP Code. Parent/Guardian Information. Last First M.I. City State ZIP Code
Health History Form Parents / Guardians must complete all sections of this form apart from the final section which should be completed by the campers physician or a licensed medical personnel. Camper Information
More information2018 LMTI FALL LEADERSHIP CONFERENCE YAC APPLICATION PAGE 1 OF 6
2018 LMTI FALL LEADERSHIP CONFERENCE YAC APPLICATION PAGE 1 OF 6 1. Personal Information First Name: Name I Prefer to Be Called (We'll use this for your nametag): Address: Completed application can be
More informationCamper Health History form must be on file prior to arrival at NEMC
Dear NEMC Parent: Camper Health Form It is our privilege to care for your child while they are at camp. In order to do so safely and effectively, we ask that you use the checklist below to assure that
More informationSUMMER AT THE YMCA 2019 Health History Form
SUMMER AT THE YMCA 2019 Health History Form This form must be filled out completely, signed by the camper s parent/guardian, and returned with requested documentation to the camp office or YMCA Branch
More information2017 LMTI SUMMER LEADERSHIP CONFERENCE YAC APPLICATION PAGE 1 OF 7
2017 LMTI SUMMER LEADERSHIP CONFERENCE YAC APPLICATION PAGE 1 OF 7 Checks can be made out to "LMTI" or "Lindsey Meyer Teen Institute" 1. Personal Information Completed application can be sent to: LMTI,
More informationCAMP DATES ARE SUNDAY AUGUST 19 to FRIDAY AUGUST 24, 2018
Dear Parent or Guardian and Camper: Welcome to the opportunity to participate in the Amazing Grace Program at Camp Burgess. Please complete all the forms in this packet. We ask for a lot of information
More informationTODAY S CAMPERS TOMORROW S LEADERS
TODAY S CAMPERS TOMORROW S LEADERS YMCA Camp Whittle Parent s Guide TORRANCE-SOUTH BAY YMCA Congratulations on signing your child up for the experience of a lifetime! Camp Whittle is an amazing place where
More informationSUMMER AT THE YMCA 2018 Health History Form
SUMMER AT THE YMCA 2018 Health History Form This form must be filled out completely, signed by the camper s parent/guardian, and returned with requested documentation to the camp office or YMCA Branch
More informationGirl Scouts of Western Washington Community Camper Health History & Consent to Treat
Girl Scouts of Western Washington Community Camper Health History & Consent to Treat Camper s Full Name: Date of Birth: Girl Scout Camp Attending: Camp Lyle McLeod Camp St Albans Northern Property Community
More informationOvernight Camp 2018 Camper Information and Medical Form
Overnight Camp 2018 Camper Information and Medical Form Day camper medical form, other registration forms and/or online registration are available at www.circlerranch.ca This form must be submitted to
More informationCamp Group Leaders Packet
Camp Group Leaders Packet Leaders Checklist: Contract & Deposit Return the contract along with a deposit of $50 per camp spot (campers and adult counselors are the same fee) before March 1 for June camps,
More informationCamper Application. Legal Guardian #1 Information. Legal Guardian #2 Information: Family Status: Mailing Address: Address: City: State: Zip:
Camper Application Legal Guardian #1 Information First Name: Last Name: Relationship to Camper: Home Phone: Cell Phone: Work Phone: E-mail: Legal Guardian #2 Information: First Name: Last Name: Relationship
More informationCamp St. Charles ANNUAL HEALTH FORM CHECKLIST
Camp St. Charles ANNUAL HEALTH FORM CHECKLIST Parents, please use this handy checklist to help you organize your child s health information and prepare everything that needs to be mailed to Camp. HEALTH
More information2017 Medical Form Carolina Raptor Center Summer Camp
2017 Medical Form Carolina Raptor Center Summer Camp Health Information, Form 1 Camper s Name: Birthdate: Sex: Street Address: City State Zip _ 1st Parent/Guardian: Mobile Phone: Home Phone: Work Phone
More information14248 F Manchester Road, PMB #310 Manchester, MO 63011
February 15, 2014 Dear Parents and Campers, Gateway Hemophilia Association is excited to announce Camp Notaclotamongus 2014, for children with bleeding disorders! Camp will be held Wednesday, June 4 th
More informationRelease Consent Form YMCA STORER CAMPS
Release Consent Form YMCA STORER CAMPS Michigan Youth Camp Safety Laws require licensed camps to get authorization from parent/guardians for the release of their child to specific individuals. Please indicate
More informationPages 2-3 Registration Parent/Guardian complete for Please be sure to complete section in blue regarding All Camper s camper family picnic on Sunday
CAMP CELEBRATE 2018! Dear Camper s and Parents, It is once again time for Camp Celebrate and we are super excited! You will find the Registration Packet attached to this letter. There are a number of pages,
More informationCAMP MCCUMBER. Overnight Camp. Camp Dates: Session I: July 8-July 14, 2018 Session II: July 29- August 4, 2018 Expedition Camp Theme
CAMP MCCUMBER Overnight Camp Going into 3rd -9th Grade Camp Dates: Session I: July 8-July 14, 2018 Session II: July 29- August 4, 2018 Expedition Camp Theme 2018 OVERNIGHT CAMP YMCA Camp McCumber Registration
More informationCamp Zanika Required Camper Forms
Camp Zanika Required Camper Forms Every camper attending Camp Zanika must have a copy of the required forms. Forms can be found on our website, emailed, or mailed. All forms need to be returned to the
More informationCamp Catalina White's Landing
Camp Catalina White's Landing Torrance-South Bay YMCA Parent s Guide Your camper is going to have an amazing week at Camp Catalina White s Landing this summer! Inside this guide is everything that you
More information2018 Medical Waiver and Release
2018 Medical Waiver and Release I hereby give my consent to the Summer Camps at Avon Old Farms School personnel to provide, through a medical staff of its choice, customary medical attention and emergency
More informationDay Camp Health Form and Waiver Packet
Day Camp Health Form and Waiver Packet Camper Name: Session Group: Date: Completion Checklist: Completed Health Form Signed Waivers Physical and Immunization Record Insurance Card Allergy, Asthma or Diabetes
More informationPage
Page 1 Page 2 Page 3 Page 4 WE ARE ACA ACCREDITED! (AND PROUD!) Page 5 Page 6 º º º º Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 º Page 18 Page 19 Page 20 Page
More informationDHAC School Vacation Camp
DHAC School Vacation Camp Required Camper Paperwork Please complete all forms and return prior to attending camp. Dedham Health & Athletic Complex 200 Providence Hwy Dedham, MA 02026 781-326-2900 www.dedhamhealth.com
More informationTorrance-South Bay YMCA Parent s Guide
Camp Round Meadow Torrance-South Bay YMCA Parent s Guide Your camper is going to have an amazing week at Camp Round Meadow this summer! Inside this guide is everything that you need for your child to have
More informationGARAYWA CAMP & CONFERENCE CENTER 2019 Summer Missions Day Camp Registration Form
GARAYWA CAMP & CONFERENCE CENTER 2019 Summer Missions Day Camp Registration Form REGISTRATION OPENS JANUARY 3, 2019 A FULL PAYMENT OF $25 PER CAMPER PER DAY MUST BE MAILED WITH THIS COMPLETED REGISTRATION
More informationDay Daily Them Subject Bible Study Focus Objective Craft focus (additional) John the Baptist calling out, prepare the way!
What Time is it? Summer 2014 overview Ecclesiastes 3:1 For everything there is a season, and a time for every matter under heaven. Day Daily Them Subject Bible Study Focus Objective Craft focus (additional)
More informationCAMP WHITTLE. Torrance-South Bay YMCA Parent s Guide
CAMP WHITTLE Torrance-South Bay YMCA Parent s Guide Your camper is going to have an amazing week at Camp Whittle this summer! Inside this guide is everything that you need for your child to have a successful
More informationMedical History Form
Medical History Form Childs Name: Age: Date of Birth: Weeks Attending: Gender: M F Parent/Guardian: Address: Home Phone #: Work Phone #: Cell Phone #: E-Mail: Emergency Contact Information: Name: Relationship
More informationSummer 2017 Health Form Break Down
Summer 2017 Health Form Break Down The health and safety of campers are our primary concern. As such, we review and update our Health Forms each year to reflect changes made in Maryland State Youth Camp
More informationDay and Resident Camp
Day and Resident Camp CAMPER NAME: BIRTHDAY: / / AGE AT CAMP: GENDER: M F ADDRESS: CITY: STATE: ZIP: PARENT/GUARDIAN S NAME: HOME/WORK/CELL PHONE: EMAIL: COUNTY: ETHNICITY: TRANSPORTATION/BUS SITES Car
More informationYMCA CAMP CHANDLER Ranger & Specialty Camps Parent Packet 2018
Ranger & Specialty Camps Parent Packet 2018 ALL FORMS must be returned to the camp office by the Monday before your child's session starts. Be sure to include the following items when you return your child
More informationSunday, August 12 Saturday, August 18, 2018 We welcome campers entering grades 3 ~ 12!
Sunday, August 12 Saturday, August 18, 2018 We welcome campers entering grades 3 ~ 12! We expect every space to be filled up, so get your application in early! Deadline Date: June 30, 2018 After June 30th,
More informationOvernight Camp Registration
over ---> Summer 2019 Overnight Camp Registration Additional registration forms and/or online registration available at www.circlerranch.ca Camper Information: Male New Camper (Camper s last name) (Given
More informationWelcome Camp Northwoods Families,
Welcome Camp Northwoods Families, First, we'd like to send you our appreciation and excitement for deciding to join us for a fun-filled and memorable summer at Skidmore's Camp Northwoods. The summer of
More information2019 Registration Form
Please include a $50 NONREFUNDABLE DEPOSIT for each camp. Please complete a separate form for each camper. For Office Use Only Please Print Legibly Parent/Guardian Information Relationship to Camper Relationship
More informationCAMP I BELIEVE: CAMPER APPLICATION Camp Baldwin Elberta, AL Saturday, September 12 th -Sunday, September 13 th, 2015
CAMP I BELIEVE: CAMPER APPLICATION Camp Baldwin Elberta, AL Saturday, September 12 th -Sunday, September 13 th, 2015 CAMPER INFORMATION Last First Middle Nickname _ Street Apt# City State Zip DOB Age Grade
More informationYMCA CAMP LETTS 2018 OVERNIGHT CAMP General Information
YMCA CAMP LETTS General Information Camper Last Name: Camper First Name: Session(s): Male: Female: Grade Entering in Fall: Birth / / Age at Camp: Street Address: Town/City: State and Zip: All individuals
More informationOverview. Camper Confirmation Packet Easter Seals Washington Camp Stand By Me
Camper Confirmation Packet 2015 Email: campadmin@wa.easterseals.com Overview Welcome to the 2015 Season at Easter Seals Camp Stand by Me! This packet includes important paperwork that we need on file here
More informationJEDI Camp Information July 7 to July 12, 2019
JEDI Camp Information July 7 to July 12, 2019 This year at JEDI Camp we are purposfully training and equipping our campers with God's personalized weaponry: PRAYER! So to get into the spirit of our theme,
More information2015 Camper Health Form
2015 Camper Health Form Camp Frederick PO Box 258, 6996 Millrock Road, Rogers, OH 44455 Email: info@campfrederickohio.com Phone: 330-227-3633 FAX: 330-227-9005 Camp Frederick requires the following information
More informationRegistration Information and Fees
South Shore Day Camp 2015 Registration Information and Fees Parent Information Name: Address: Town: Zip: Home Phone: Work Phone: Cell Phone: Parent s Email address: Parent s Email address: Please circle
More informationSouth Shore Stars 2015 Summer Camp and Fall Enrollment
My child is in the grade, and attends After School Program. South Shore Stars 2015 Summer Camp and Fall Enrollment Child s Name(s) Parent s/guardian s Name Home Phone Work Phone Email Address Your child
More informationUSGTC Summer Camps. Family Information Resident Health Form
USGTC Summer Camps 2017 Resident Health Form Return by June 1 to USGTC Summer Camp PO Box 4088 Tequesta, FL 33469 Completed form must be in our office (address above) at least four weeks before the camper
More informationCamper Authorization for Medical Treatment and Authorization to Pick-up Camper
Camper Authorization for Medical Treatment and Authorization to Pick-up Camper Please return all 5 forms at least week before your first day of camp to: Inside the Outdoors, 200 Kalmus Dr., Costa Mesa,
More informationCamper Forms Checklist-Camp Menzies
Camper Forms Checklist-Camp Menzies If you have difficulty opening the forms, contact customer care at 916.452.9181/800.322.4475 or customercare@ Forms Tips Use the following checklist and review the information
More informationAmerican Indian/Alaskan Native Black or African American Hispanic/Latino Asian or Pacific Islander Caucasian/White Mix Other
For Official Use Only: Branch: Camp Site: Camp Group: CHILD S FIRST & LAST NAME ADDRESS (Street Address, Apt#, City, Zip Code) DATE OF BIRTH (Month/Day/Year) CHILD S DISMISSAL [ ] BE PICKED UP [ ]WALK
More information2013 BFA Jr. Balloonist Hot Air Balloon Camp Camp Registration Form Reno, Nevada
2013 BFA High Sierra Balloon Camp Western States Region Balloon Federation of America Jeff Haliczer, Director 15225 Pinion Dr. Reno, Nevada 89521-8841 Home Phone: (775)853-4109 Camp E-mail: Renoballooncamp@sbcglobal.net
More informationPlease circle shirt size and check Youth or Adult: Shirt Size S M L XL XXL 3XL other: 4-H Member is active in 4H Online:
2019 4-H Special Clovers Registration Packet March 23 & 24, 2019 DEADLINE: Registration is due in the State Office February 1 st Camp is limited to the 1 st 15 paid 4-H members Date: / / 2019 FOIC USE
More informationEastman Area 4-H Summer Camp
Eastman Area 4-H Summer Camp It s not too soon to be thinking about summer camp! Eastman Area will once again be holding a summer camp for Junior and Intermediate members, from August 25 th -30 th at beautiful
More informationCamp Hope Camper Health Information YEAR: 2017
Camp Hope Camper Health Information YEAR: 2017 PLEASE COMPLETE AND RETURN TO: Camp Magruder 17450 Old Pacific Hwy Rockaway Beach, OR 97136 PLEASE NOTE: Completely fill out, sign and date where requested.
More informationForms A-C must be completed and sent to the Camp Floyd Rogers office and postmarked by June 1 st. Camp Floyd Rogers PO BOX Omaha, NE 68154
Forms A-C must be completed and sent to the Camp Floyd Rogers office and postmarked by June 1 st. Camp Floyd Rogers PO BOX 541058 Omaha, NE 68154 NOTE! The forms typically require $.70 postage in a standard
More information2019 FAMILY CAMP Camper and Adult Registration
2019 FAMILY CAMP Camper and Adult Registration Christian Church (Disciples of Christ) in Florida RETURN COMPLETED FORMS AND PAYMENT TO The Retreat at Silver Springs, 6455 E. Silver Springs Blvd., Silver
More informationIMPORTANT NEMC CAMP FORMS
IMPORTANT NEMC CAMP FORMS Please print this page, read the Parent/Camper Handbook, complete the checklist of forms, and mail to the camp address or email office@nemusiccamp.com by June 1 st. Travel Form
More informationNebraska-Iowa Kiwanis District Foundation
Nebraska-Iowa Kiwanis District Foundation 2007 Camp OK Information and Forms This e-mail mailing is a way to save a lot of postage. Please print and use the forms provided here. February 1, 2007 Dear Kiwanian:
More informationCAMPER REGISTRATION FORM, SUMMER CAMP, 2015
CAMPER REGISTRATION FORM, SUMMER CAMP, 2015 FOR GRADES 3-12 (separate forms for Uno & Family Camps) Christian Church (Disciples of Christ) in Florida RETURN COMPLETED FORMS AND PAYMENT TO The Retreat at
More informationAll forms and the $25.00 registration fee must be completed and returned to us in order to start the enrollment process.
PineTree oce~ DI SCOVERING A B I L IT I E S TOGE THER Dear Parents and Guardians: Thank you for your interest in having your child attend Camp Pine Cone in 2012. Many of last year's summer staff members
More informationColorful Changes Westminster Girl Scout Community Day Camp
Colorful Changes Westminster Girl Scout Community Day Camp www.angelfire.com/super2/daycamp This is an opportunity for girls to have a safe, fun-filled experience in the outof-doors while making new friends
More information2019 Summer Camp Forms Health History Form
Health History Form An invitation will be sent from CampDoc.com to: Set up a password. Follow instructions to complete your forms. If you are a returning camper, please return to CampDoc.com to: Update
More informationGARAYWA CAMP & CONFERENCE CENTER 2018 Summer Missions Camp Registration Form
GARAYWA CAMP & CONFERENCE CENTER 2018 Summer Missions Camp Registration Form A FULL PAYMENT OF $185 PER CAMPER MUST BE MAILED ON OR AFTER JANUARY 4th WITH THIS COMPLETED REGISTRATION FORM TO Garaywa Camp
More informationMarianne Askew and Sally Joyce
Dear Friend, Thank you for your interest in Camp Hope 2019. Camp Hope s mission is to create a healing environment for those living with cancer by fostering meaningful relationships with others through
More informationHEALTH FORMS PHYSICIAN
HEALTH FORMS PHYSICIAN Form must be completed AND signed by a licensed health-care provider. Please review the HEALTH FORMS and complete all sections of this form. Fax this form, by June 1 st, to (607)
More informationPaulding County 4-H Camp Registration
Paulding County 4-H Camp Registration - 2018 Return to: OSU Extension, 503 Fairground Drive Suite A, Paulding, OH 45879 4-H Camp Date: Monday, July 9 (3:00 pm) through Friday, July 13 (10:30 am) Age Guidelines:
More informationYMCA CAMP PINEWOOD 2014 Summer Camp Registration
YMCA CAMP PINEWOOD 2014 Summer Camp Registration Send completed form to 4230 Obenauf Road, Twin Lake, MI 49457 Fax to 231.821.0487 Email to mmccarthy@ymcachicago.org Call our office at 231.821.2421 with
More informationHEALTH FORMS PHYSICIAN
HEALTH FORMS PHYSICIAN Form must be completed AND signed by a licensed health-care provider. Please review PARENT/GUARDIAN FORMS 1 & 2, and complete all sections of this FORM. CAMPER NAME: Date of Birth:
More informationCamper Registration Form 6/10/14
Camper Registration Form 6/10/14 Camper Name M or F Birthdate Mailing Address City State Zip Parent(s)/Guardian(s) Home Phone ( ) Cell Phone ( ) Work Phone ( ) Parent/Guardian Employer and Street Address
More informationGirl Scouts of Central Texas CAMP HEALTH HISTORY FORM Fill out and bring with you to check in at camp Camper:
CAMP HEALTH HISTORY FORM Fill out and bring with you to check in at camp Camper: Name Last First Middle Birthdate Age Girl Scout Level (Fall of 2018): Daisy Brownie Junior Cadette Senior Ambassador Street
More informationCave Springs Camp Registration Form
Cave Springs Camp Registration Form Camper Information (please use one form per camper) Camper s Name: (Last) (First) Birthday: (D/M/Y) Age: Gender: Does your child require 1:1 support? Yes No (Please
More informationBen Lomond Quaker Center Summer Youth Camps Box 686, Ben Lomond, CA (831) ENROLLMENT FORMS
ENROLLMENT FORMS THESE FORMS MUST BE COMPLETED AND POSTMARKED NO LATER THAN JULY 2ND OR FAXED TO 831-336-0218 EQUIRED EMERGENCY INFORMATION Please PRINT legibly Camper's Name Sex: M F Birth date: / / Social
More informationThere will be no refunds.
Flint Park Day Camp Application- 2015 Camp Dates: July 6 th August 14 th In order for application to be accepted: 1. Application must be completed in its entirety. Immunization Records must be printed
More informationBuilding from the Inside Out...academically, spiritually and physically in the hearts of our students the things the world will never erase.
Cape Christian Academy 10 Oyster Road, Cape May Court House, NJ 08210 Office: (609) 465-4132 Fax: (609) 465-0170 Web: www.capechristianacademy.com Info@CapeChristianAcademy.com Building Students from the
More informationFORM /GUARDIAN PLEASE HEALTH PARTICIPANT PROGRAM PARTICIPANT HEALTH FORM, CONT. TO BE COMPLETED BY PHYSICIAN ARENT/G CAMPER
GLOW YMCA CAMP HOUGH PARTICIPANT HEALTH FORM TO BE COMPLETED BY PARENT ARENT/G /GUARDIAN PLEASE TE THE NEED FOR PHYSICIAN HYSICIAN S S SIGNATURES ON BOTH SIDES OF THIS FORM ORM. T ALL YMCA SUMMER PROGRAMS
More informationSouthern California 401 S. Ivy Street Escondido, CA (P) (F) 2018
= Easterseals Southern California 401 S. Ivy Street Escondido, CA 92025 951.264.4855 (P) 760.406.6048 (F) 2018 www.easterseals.com/southerncal Dear Campers and Parents Easterseals camp will be held August
More informationYMCA of Glendale 2017 Summer Camp Fox Programs
YMCA of Glendale 2017 Summer Camp Fox Programs ACTIVITIES INCLUDE: CAMP FOX, CATALINA ISLAND SWIMMING, KAYAKING, STANDUP PADDLE BOARDING, FISHING, DANCES, CAMPFIRES, ROPES COURSE, ARCHERY, VOLLEYBALL,
More informationMIDWEST DIOCESE CAMP W. Grant Avenue - Third Lake, IL
MIDWEST DIOCESE CAMP 35240 W. Grant Avenue - Third Lake, IL 60046 midwestdiocesecamp@gmail.com Diocesan Kolo of Serbian Sisters Serbian Orthodox Diocese of New Gracanica Midwestern America 1. CAMPER INFORMATION
More informationBorough of Lincoln Park Parks & Recreation 2018 Summer Camp K-6 CAMP / SUMMER TOUR WAIVERS & MEDICAL FORMS
Borough of Lincoln Park Parks & Recreation 2018 Summer Camp K-6 CAMP / SUMMER TOUR WAIVERS & MEDICAL FORMS TO: FROM: RE: Parent, Guardian or Caregiver of a LP Summer Camper: Cathy Adubato, Camp Director
More information