2017 Summer Camp Registration

Parent or Legal Guardian
Apartment Number, PO Box Number

Provide phone numbers where we can reach you both day and night

Child
If your child will be bringing his/her mobile phone to the camp, please provide the number
It is not required. This helps to place campers that know each other.
If yes, list the medications and any instructions
As part of the Power to Choose program, there is a possibility that your child may be photographed, interviewed and/or videotaped by the media. In order to protect your child’s privacy under the Freedom of Information and Protection of Privacy Act, your consent is necessary for involvement in this media coverage. Photographs, interviews and videotapes will help us to evaluate the program, promote the program through the media, and let other interested groups know more about Power to Choose. Additionally, we may use the above in displays, presentations, on our website, and in written reports.