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Summer Camp Registration 2019
Summer Camp Registration Form 2019
Please email Karen if you would like to be added to a camp waiting list - first come, first served. We sometimes have spots open at the last minute (or before!)
Second Parent Name
Select Camp (hold down Cntrl key to select multiples):
July 8th - 12th
August 5 - 9
August 19 - 23
If your child wants to be a junior camp helper (age 11 and up) please call or email us to request this.
Child's Home Address
Address Line 2
District of Columbia
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Phone: Day time best number
Phone: Day time best number second parent
Second Child's Name
Second Child's Age:
Please explain any custody issues we should be aware of:
Emergency Contact Person Name:
Relationship to Child:
Any Extra Information about Emergency Contact Person:
School your child(ren) attend(s), or mark Home schooled:
Dietary Restricions for your child(ren):
Allergies, either known or suspected:
Medications child(ren) will be taking:
If this information changes, please notify us before camp begins. We should oversee or administer all medications.
Any physical ailments or restrictions on activities we should be aware of:
Please let us know anything else we should know for your child to be sucessful in our camps:
Persons Authorized to pick up your child other than parents listed on this form, and their cell phone numbers:
Refund/ Cancellation Policy: • There is a $30.00 cancellation fee per registration • Up to 14 days before the first day of the program you may cancel your child’s enrollment and receive your money back (minus the $30 cancellation fee). • Cancellations made less than 14 days before the first day of the program will not be refunded. • Registrations and fees are non-transferable.
Children attending camp may be in photographs/videos of activities happening at camp, taken by camp counselors or other parents, but we will not identify your child by name on our website or in printed materials unless we receive explicit permission from you.
I understand and consent
I release Singing Creek Educational Center and it's staff, volunteers, and Board Members from any liability resulting from accident or injury to myself or my family members, including children, due to any reason including negligence.
Sign this form by typing your name below:
Full Price One Child
One Summer Camp Registration
All siblings must be enrolled in the same camp for the discount. $190 each for both (or all) kids.
Junior Helper Price
For ages 11 and up who have been to my camps before. Check availability with us before signing up for this. Only one junior helper per camp.
Donation to our Scholarship Fund for low-income families (optional)
If you have a coupon you can enter it here.