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Happy Kids Camp Registration Form 2024
Please complete one form per child
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* Indicates required question
Email
*
Your email
Primary Contact Full Name:
(This is the person who will be picking the child up)
*
Your answer
Primary Contact Number:
*
Your answer
Primary Contact relationship to child:
*
Mother
Father
Grandparent
Other:
Child's Last Name
*
Your answer
Child's First Name
*
Your answer
Child's Gender:
*
Male
Female
Child's Date of Birth
*
MM
/
DD
/
YYYY
What grade will your child be in as of September 2024?
*
Your answer
Which Session are you Registering for?
*
Session 1: July 8 - 12
Session 2: July 15-19
Both Sessions
Does this child have Allergies?
*
Yes, not requiring an Epipen
Yes, requiring an Epipen
No
If you answered yes above, please list the allergies
Your answer
Emergency Contact Name:
*
Your answer
Emergency Contact Number:
*
Your answer
Emergency Contact relationship to child:
*
Your answer
Name of any other adults picking up the child
*
Your answer
Will you be signing up an additional child?
*
Yes
No
A copy of your responses will be emailed to the address you provided.
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