WELCOME TO PARADISE!
City of New Iberia Summer Camp Registration 2024

Please submit this form for each of your campers and make payment at the City Park located at 300 Parkview Drive. Should you have any questions, please call (337)369-2337.
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Camper's Name *
Camper's Age *
Camper's T-Shirt Size *
Camper's Date of Birth *
MM
/
DD
/
YYYY
Address *
Home Phone Number *
Cell Phone Number
Parent Email Address
Parent #1 Name and Work # *
Parent #2 Name and Work #
Emergency Contact (besides parents) *
Name & Phone #
Emergency Contact (besides parents)
 *
Doctor's Name & Phone #
Preferred Hospital
 *
Does your child require special needs? If so, please list.
Who else is allowed to pick up your child? *
Please select the week(s) your child will attend camp? *
Required
Please select the mandatory parent meeting you will attend. Meetings will be held at the SLIMAN THEATRE. *
I acknowledge that payment must be made the WEDNESDAY prior to the session in which my child is enrolled. I also understand that field trip payments are due one (1) week prior to the scheduled field trip.
(please type your name)
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