Summer Camp Registration 
1 FORM PER CHILD! 
Sign in to Google to save your progress. Learn more
Email *
Parent/Guardian FULL Name *
Parent/Guardian Address CITY, STATE & ZIPCODE *
Parent/Guardian PHONE NUMBER *
Childs FULL NAME? *
Childs Grade  (Recently completed) Not going to. *
Childs DOB? *
Childs AGE? *
Any known ALLERGIES? (please list) *
Any Medication? List Medication and Dosage below *

To ensure your child’s comfort and well-being, we request your consent to administer the following over-the-counter (OTC) medications as needed:

Ibuprofen (Advil/Motrin) – for pain/fever relief
Acetaminophen (Tylenol) – for pain/fever relief
Allergy Medication (Benadryl/Zyrtec/Claritin) – for allergy symptoms
Upset Stomach Medication (Tums/Pepto-Bismol) – for minor stomach discomfort

*

We love capturing special moments and would like your permission to photograph and/or record your child during camp activities. These photos/videos may be used for:

✅ Camp newsletters & updates
✅ Social media & website
✅ Promotional materials

*

As part of our camp experience, we will be organizing field trips to fun and educational destinations. Please complete this form to grant permission for your child to participate in camp-sponsored field trips.

✅ Transportation will be provided by Old School Transportation
✅ Camp staff will supervise all campers at all times.
✅ I will be informed in advance of each trip's details (date, time, location, activities).
✅ The camp is not responsible for lost items or personal belongings.

*

Please select your child's t-shirt size for camp activities and events.

*

Emergency Contact Person FULL NAME (NO Nicknames)

*

Emergency Contact Phone Number

*

Add additional contacts for Emergency (if more than 1)

I understand and agree to the following terms regarding summer camp tuition:

Tuition Payments: Weekly payments are due in full before the camper can begin camp.

No Refunds or Reductions: If my child misses camp days for any reason, there will be no reduction in tuition or make-up days provided.

Flat Rate Policy: All camp rates are flat rates, regardless of attendance.

Payment Responsibility: I am responsible for ensuring timely payments. Failure to make payments may result in my child being unable to attend camp.

*

I understand and agree to the following terms regarding summer camp tuition:

Tuition Payments: Weekly payments are due in full before the camper can begin camp.

No Refunds or Reductions: If my child misses camp days for any reason, there will be no reduction in tuition or make-up days provided.

Flat Rate Policy: All camp rates are flat rates, regardless of attendance.

Payment Responsibility: I am responsible for ensuring timely payments. Failure to make payments may result in my child being unable to attend camp.

*

Late Pick-Up Fee: The latest pick-up time is 6:00 PM. A $1 per minute, per child late fee will be charged for any pick-ups after this time.

Late Fee Payment: Late pick-up fees must be paid in full before the camper(s) can return to camp.

Payment Responsibility: I am responsible for ensuring all tuition and late fees are paid on time. Failure to make payments may result in my child being unable to attend camp.

*

As a reminder, while it will be summer weather, we ask that all individuals picking up campers dress appropriately, as this is a children’s day camp with multiple campers in attendance.

🚫 The following attire WILL NOT be permitted inside the building:

Booty shorts (excessively short shorts)
See-through material of any kind
Tank tops that expose breasts/nipples
Bathing suit attire
Men must wear a shirt at all times
Pants/shorts must be worn at the waist (no sagging)

*
What email should we send your invoice for Registration? *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of corydouglasacademy.org.

Does this form look suspicious? Report