2024 Summer Adventure Camp Camper information
Completion of this form is required prior to student participation in the SAC. If you have any questions or difficulties completing this form, call 541-966-0228. 
Sign in to Google to save your progress. Learn more
Child Name *
2024-2025 school year grade *
Primary Guardian name *
Primary Guardian phone number *
Primary Guardian email address *
Secondary Contact name (different than Primary Guardian) *
Secondary Contact phone number 
 *
Please list ALL authorized persons able to pick up your child from the summer camp. Include name and phone number. Anyone not listed will NOT be allowed to pick up your child. (Primary and secondary contacts are automatically authorized to pick up) *
My child MAY sign themselves in/out and ride their bike or walk.  *
If yes, what time are they permitted to sign OUT from camp? Must be by 3:00pm
Time
:
Will your child need to have medications administered at the program? We require documentation for any medicine given. This includes prescribed medications AND over the counter.  *
Does your child have allergies? *
If yes, please explain (include medical information required for Summer camp staff ie: epi pen, food restriction requirement, etc)
Is there anything else we should know about your child that would help them be successful at our program? *
Electronic Signature *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms