2023 Camp Milestone Information Form
Greetings Parents and Guardians,

Thank you for your interest in the 2023 Camp Milestone Summer Camp.  We are excited about your attendance, and we look forward to working with you and your child this summer.  Below, you will find the registration form. Please be advised that the non-refundable registration fee must be paid with the submission of this form in order for your child to be enrolled at Camp Milestone. 

The first weekly payment is due Friday, June 2, 2023. Thereafter, please pay the Friday before each upcoming week of camp. Label all payment with your child's name. Be sure to fill out a separate form for each child. We look forward to camping out with you and your child/ren at Camp Milestone.

Fondly,

Ms. Travie Thomas 
Founder & Director of Camp Milestone
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Email *
1. Today's date *
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2. Child's Last Name *
3.  Child's First Name *
4. Child's Date of Birth (mm/dd/yyyy) *
5. Child's Age on June 5, 2023 *
6. Mother's/Guardian First and Last Name *
7. Mother's/Guardian's Phone Number *
8. Father's/Guardian's First and Last Name
9. Father's/Guardian's Phone Number
10. Child's Address as of June 5th: City, State, Zip Code *
11. Child Lives with *
12. Other than Parents, Please List Emergency Contact #1  Name and Relationship to child. *
13. List the Phone Number for Emergency Contact #1. *
14. List 2nd Emergency Contact Name and Relationship to Child. *
15. List the Phone Number for Emergency Contact #2.  *
16. Other than emergency contacts, who else is allowed to receive your child from camp? (List each name, relationship to child and number.)
17. Last school attended *
18. Rising grade in the 2023-2024 school year *
19. List Your Child's Academic Strengths & Challenges.
20. Please List any Medical Conditions and Medications. *
21. Food Restrictions/Allergies. *
22. List any other important information (Academic, Social, Personal, etc. that you think we should be aware of). *
23. Please provide a copy of your child's final report card and Spring Star Report. In the event the final report card and Star report are not submitted, you give Camp Milestone permission to secure the documents on your behalf.
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24. Will you need aftercare? Aftercare cost is an additional $35 per child, per week. It ends at 5:00 p.m., Monday through Friday. *
25. The only fee that is actually REQUIRED today (if today's date is prior to June 5, 2023) is $145 for REGISTRATION. This will secure your child's enrollment. However, you have the option to pay registration, the initial week fee, and after care cost today. Which fees are you paying today? *
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26. Which method will you use to make today's payment? Be sure to indicate your child's name and the service for which you are paying (i.e., registration/week 1 camp fee for Jane Doe, etc.). *
27. What is the total amount of today's payment? *
28. How did you hear about Camp Milestone? *
29. A Virtual Parent Orientation is scheduled for Saturday, June 3, 2023 @ 12 noon. Please ensure that you have Zoom access. You will receive a text or email with the link to join the meeting. Be sure to log on by 11:45 a.m., June 5, 2023.  *
30. In the Fall of 2023, Camp Milestone will launch a fee based After School Program on the campus of Macedonia Baptist Church. Would you be interested in enrolling your child/ren? Transportation for pick up from your child's school to the after school site will be provided. More information is forthcoming. *
Parent's Signature (Type first and last name, then Initial.)
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