Personal Info

Child's Name                Grade Completed  Choose One Pre-K K 1 2 3 4 5               Shirt Size  Choose One Youth Small Youth Medium Youth Large Adult Small

Parent / Guardian's Name       Address 

Phone Number(s)       City       State       Zip 

Snacks  Please verify that your child can have the snacks listed below.  Mark any snack(s) your child SHOULD NOT HAVE.

  Nachos - June 17th    (Chips and Cheese with Lemonade)

  S'mores - June 24th    (Graham Crackers, Hershey Chocolate Bar and Marshmallow Cream with Water)

  Hot Dogs - July 1st    (Hot Dog, Buns and Ketchup with Lemonade)

  Popcorn - July 8th    (Popcorn and Popcorn Oil with Lemonade)

  Trail Mix - July 15th    (Peanuts, Sunflower Seeds, Raisins and Chocolate with Water)

Please list any allergies, medical conditions, physical limitations, special needs or behavior that we would need to know.

Notes: 

VOLUNTEER INFO  If you are interested in helping out with summer camp, please complete the contact information below.

Name          Email:       Phone:      

Interests (Choose all that Apply):

  Camp Counselor      Crafts      Games / Recreation      Music      Prize Table      Sign-In Table      Snacks      Sound      Teacher