JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Summer Camp Emergency Form 2024
Please complete a form for each child attending camp at York Country Day School.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Untitled Title
Student's Name
*
Your answer
I give my child, listed above, consent to participation in the York Country Day's Summer Camp.
*
No
Yes
My child has the following food and/or drug allergies:
*
Your answer
My child has the following pre-existing illness/health concerns:
*
Your answer
Is your child taking any continuous medicine? if so, please list below.
*
Your answer
In the event of an emergency, we will attempt to contact parents first. Please provide your information below so that we may be able to contact you if an emergency situation arises.
*
Option 1
Guardian 1 Name
*
Your answer
Guardian 1 Daytime/Cell Phone
*
Your answer
Guardian 1 Work Phone
*
Your answer
Guardian 2 Name
*
Your answer
Guardian 2 Daytime/Cell Phone
*
Your answer
Guardian 2 Work Phone
*
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of York Country Day School.
Report Abuse
Forms
