Bradley International Summer Camp                      June 3 - 28, 2019
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Email *
Registration Form
Participant Information
Last Name *
First Name *
Gender *
Age *
School
Grade attended 2018 - 2019 *
Home address *
City *
State *
Telephone *
Cell *
Parent email *
Mother's name *
Mother's day phone *
Mother's cell: *
Father's name *
Father's day phone *
Father's cell *
Person's Authorized to pick up child: *
Other Dismissal Arrangements *
Emergency contact *
Emergency contact relationship *
Specify any of your child's health problems *
Is your child on any medication? *
If so, please specify
Please type first and last name to acknowledge camp payment policy. *
Parent/Legal Guardian name *
Student Allergies *
Student Medical Problems
Doctor/ Phone Number *
Insurance Carrier/ Policy Number *
Who is financially responsible for the student? *
I hereby give permission to Bradley International Summer Camp to photograph and/or videotape the student for educational or promotional purposes. Pictures will not go on the web without express parent permission. *
I hereby state that (camper’s name) ___________________________________________ is in good mental and physical health condition to participate in the activities provided by Bradley Summer Camp, including but not limited to all aspects of cheerleading, tumbling, and dance training, baseball, basketball, soccer and or competition. I am fully aware that any activity involving motion, height or athletic activity creates the possibility of serious injury. I hereby release Bradley Summer Camp, its employees and its staff from liability to the above named camper, of the person claiming through him/her, arising from injury to the person or property of the above named camper occurring in the premises of Bradley Summer Camp. *
Required
I understand that Bradley Summer Camp has the right to deny admittance to any student not meeting the standards of the program as it sees fit. I also agree not to hold these parties responsible in the event that my child engages in inappropriate conduct (including, but not limited to disruptive or volatile behavior in or out of camp, etc.) or becomes involved in any activity or with any persons not associated with Bradley Summer Camp, or its scheduled program and that Bradley Summer Camp, has the right to send him/her home for inappropriate conduct, forfeiting camp fees.  I further attest that the information contained in this application is correct to the best of my knowledge. In addition, I have agreed to the policy and fee statement and agree to comply. *
Required
Week One Camp Choices Kindergarten & 1st Graders
Please pick one choice for morning and afternoon session.
June 3-7, 2019 Kindergarten & First Grade        AM Session
June 3-7, 2019  Kindergarten & First Grade PM Session
Week One Camp Choices 2nd - 5th Graders
Please pick one choice for morning and afternoon session.
June 3-7, 2019 2nd - 5th Graders AM Session
June 3-7, 2019 2nd - 5th Graders PM Session
Morning Stars & After Camp Care
Morning Stars (7:30 - 9:00 am - $6.00 day/$30 week) & After Camp (3:00 - 5:00 pm $10 day/$50 week)
Week One (June 3 - 7)
Monday - Friday
Monday
Tuesday
Wednesday
Thursday
Friday
Morning Stars (7:30 - 9:00 am)
After Camp (3:00 - 5:00 pm)
Clear selection
Week TWO Camp Choices Kindergarten & 1st Graders
Please pick one choice for morning and afternoon session.
June 10 - 14, 2019 Kindergarten & 1st Graders
June 10 - 14, 2019 Kindergarten & First Grade PM Session
Week TWO Camp Choices 2nd - 5th Graders
Please pick one choice for morning and afternoon session.
June 10 - 14, 2019 2nd - 5th Grade AM Session
June 10 - 14, 2019 2nd - 5th Grade PM Session
Morning Stars & After Camp Care
Morning Stars (7:30 - 9:00 am - $6.00 day/$30 week) & After Camp (3:00 - 5:00 pm $10 day/$50 week)
Week Two (June 10 - 14)
Monday - Friday
Monday
Tuesday
Wednesday
Thursday
Friday
Morning Stars (7:30 - 9:00 am)
After Camp (3:00 - 5:00 pm)
Clear selection
Week THREE Camp Choices Kindergarten & 1st Graders
Please pick one choice for morning and afternoon session.
June 17 - 21, 2019 Kindergarten & 1st Graders AM Session
June 17 - 21, 2019 Kindergarten & 1st Graders PM Session
Week THREE Camp Choices 2nd - 5th Graders
Please pick one choice for morning and afternoon session.
June 17 - 21, 2019 2nd - 5th Graders AM Session
June 17 - 21, 2019 2nd - 5th Graders PM Session
Morning Stars & After Camp Care
Morning Stars (7:30 - 9:00 am - $6.00 day/$30 week) & After Camp (3:00 - 5:00 pm $10 day/$50 week)
Week Three (June 17 - 21)
Monday - Friday
Monday
Tuesday
Wednesday
Thursday
Friday
Morning Stars (7:30 - 9:00 am)
After Camp (3:00 - 5:00 pm)
Clear selection
Week FOUR Camp Choices Kindergarten & 1st Graders
Please pick one choice for morning and afternoon session.
June 24 - 28, 2019 Kindergarten & 1st Graders AM Session
June 24 - 28, 2019 Kindergarten & 1st Graders PM Session
Week FOUR Camp Choices 2nd - 5th Graders
Please pick one choice for morning and afternoon session.
June 24 -28, 2019 2nd - 5th Graders AM Session
June 24 - 28, 2019 2nd - 5th PM Session
Morning Stars & After Camp Care
Morning Stars (7:30 - 9:00 am - $6.00 day/$30 week) & After Camp (3:00 - 5:00 pm $10 day/$50 week)
Week Four (June 24 - 28)
Monday - Friday
Monday
Tuesday
Wednesday
Thursday
Friday
Morning Stars (7:30 - 9:00 am)
After Camp (3:00 - 5:00 pm)
Clear selection
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