2020 Camp Curiosity - Let's Camp Out!
Date: June 1-19
Time: 8:00 A.M. to 4:30 P.M. (this year we are doing an extended day again)
Please fill out additional forms for any additional children.

Event travel costs will be $60.00. The Camp shirt is included in that cost. Please remit cash or check to the PES or PPC office.

You may also pay incrementally to reserve a spot as enrollment is first come, first serve and space may be limited. 1st payment of $20 is due by Friday, March 27. 2nd payment of $20 is due by Friday, April 17, and the third payment of $20 is due by Friday, May 8. If payments are not received in a timely manner, the space may be opened up to other enrollees.

Deadline to register is May 8, 2020.

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E-mailadres *
Student's Last Name *
Student's First Name *
Sex
Selectie wissen
Date of Birth *
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/
DD
/
JJJJ
Current Grade *
Address *
City *
State *
Phone Number *
Current school *
Teacher's Name
Family Doctor *
Child's dentist *
If your child takes medication, please list:
Dosage - meds
Times meds are given
Does your child have allergies? *
List allergies
Does your child have an IEP or special need we need to be aware of? If so please list.
Do you have a CURRENT Perry Park Center Pass?  (NOT required to attend) *
Perry Park Center pass #
Does the child attend Adventure Club (must be officially enrolled)? *
Parent #1 Name *
Parent #1 Phone *
Parent #2 Name
Parent #2 Phone
Emergency Contact #1 Name *
Emergency contact #1 phone *
Emergency Contact #1 Relationship to child *
Emergency Contact #2 Name
Emergency Contact #2 phone
Emergency Contact #2 Relationship to student
Child's T-shirt Size - included in field trip fee (if any extra shirts are desired, message office in the space below - $10 each) *
Shirt Design
Message to Office (can include requests for additional shirts to be purchased)
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