Summer Camp Registration Form 2019

2019 Asbury Preschool Summer Camp FOR AGES 2 – 5

Registration Form Name:______________________ Age:___ Birthdate:________ Address:_____________________________________________ Parent / Guardian Names:________________________________ Best Contact # :_______-________-____________ Email:_______________________________________________________ Any allergies or other important info: ________________________________________________________

_____________________________________________________ Names of people authorized to pick child up: ______________________________________________________ _ Parental consent to participate in summer camp activities – I give consent for my child to participate in all camp activities including, but not limited to water play, outside play, and bounce house. I understand that I am responsible for applying sunscreen daily to my child and administering any medicines at home (as we can not give any medicines). I understand that my child will be well supervised at all times, but that accidents do sometimes occur and I will not hold Asbury UMC or its camp teachers liable. I will provide a healthy lunch for my child. Parent Signature__________________________________________________________ Camp Information Monday – Thursday 9:00 – 1:00 (except wk-1, wk-5) $100/ week (if paid in advance) OR $30/day, Space is limited. Circle weeks and days your child plans to attend: May 28-30 June 10-13 June 17-20 June 24-27 July 1-3 July 8-11 July 15-18 July 22-25 T,W,Th M,T,W,Th M,T,W,Th M,T,W,Th M,T,W M,T,W,Th M,T,W,Th M,T,W,Th