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2023 Summer Youth Program Registration
Dates: June 12th - 16th
June 19th - 23rd
June 26th - 30th
Time: 9:00am - 3:00pm
Location: Lake City Community School
614 Silver St; Lake City, CO 81235
Contact: Silver Thread Public Health - 970-944-0321
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Email
*
Your email
Child Name (Separate form to be completed for each child)
*
Your answer
Please select dates the child will attend camp
*
June 12th - 16th
June 19th - 23rd
June 26th - 30th
Required
Please select the grade the child will be in for the 2023 - 2024 school year
*
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Required
Age of child
*
Your answer
Parent/Legal Guardian
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Your answer
Local Address
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Your answer
Phone (please indicate cell, work, home)
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Your answer
OK to text?
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No
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Local Emergency Contact
*
Your answer
Emergency Contact Phone
*
Your answer
Allergies and any Pertinent Medical Conditions
*
Your answer
My child has permission to ride their bike or walk home at the end of the camp day
*
Yes
No
**Camp will start at 9:00am sharp and end at 3:00pm sharp each day.**
**Please plan to drop your child off on their first day of camp in order to:
1) Sign paperwork
2) Make payment ($75/week)
3) Meet the camp staff!
**Please send the following items with your child each day:
1) Lunch
2) Water Bottle
3) Sunscreen
**We will provide snacks and lunch on Fridays**
I have read the above information about 1st day drop off and what my child needs to bring to camp each day
*
Yes
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