Camp Registration

BOYS AND GIRLS
AGES 3 YEARS-ENTERING 5TH GRADE*
*Please note that group for boys entering 3rd grade and up will only be open for the 1st and 2nd Sessions.

DATES AND PRICES
1st SESSION: JUNE 17-JUNE 21 (ONE WEEK)
Price per child: $180 Members | $200 Non-members

2nd SESSION: JUNE 24-JULY 5 (TWO WEEKS)
Price per child: $360 Members | $400 Non-members

3rd SESSION: JULY 8-JULY 19 (TWO WEEKS)
Price per child: $360 Members | $400 Non-members

A $25 REGISTRATION FEE IS REQUIRED FOR ALL CAMPERS

TIMES
9:00am-3:00pm

DEADLINE FOR REGISTERING IS WEDNESDAY, MAY 15, 2024.
REGISTRATIONS WILL NOT BE ACCEPTED AFTERWARDS.

ALL PAYMENTS MUST BE PAID IN FULL BY THURSDAY, MAY 30, 2024.

CLICK HERE TO DOWNLOAD THE REGISTRATION FORM
IF YOU WOULD LIKE TO EMAIL IT OR BRING IT TO THE OFFICE.

Any and all Camp Sheves Achim payments are 100% non-refundable.

* Your Email address

* Father's Name

* Father's Daytime Phone Number

* Father's Email Address

* Mother's Name

* Mother's Daytime Phone Number

* Mother's Email Address

* Child's Full Name

* Current Grade

* Date of Birth

* Emergency Contact

For your child's safety, please include name, address, and all phone numbers of someone other than a parent in case of an emergency.

* Child's Physician In Case Of Emergency (Name And Phone Number)

* Please List Any Known Allergies

Please include any helpful information for dealing with potential hazards, reactions and health concerns.

* Please List Any Ongoing Medications:

When listing medications, if they must be administered during camp hours please describe the dosage and specific instructions (with/without food etc.)

* I give permission to apply one or more of the following topical ointments/preparations to my child in accordance with the directions on the label of the container (please check all as applicable):

* If I cannot be reached, or when delay would be dangerous to my child’s health, I hereby authorize the staff to give my child the following medications (please check all as applicable):

IbuprofenTylenolBenadryl

* Child's T-shirt Sleeve style

Please Select OneLong SleeveShort Sleeve

MEMBERS ONLY: Number of Sessions

Session 1Session 2Session 3

NON-MEMBERS: Number of Sessions

Session 1Session 2Session 3

* I ACCEPT THE $25 REGISTRATION FEE FOR THIS CHILD

I ACCEPT THE $25 REGISTRATION FEE FOR THIS CHILD

Total Amount Due

* Would you be interested in volunteering to drive for field trips?

YesNoI need more informationNot me but someone I know may/is interested

* Signature:

Submitting parent's/guardian's name below constitutes a binding digital signature.

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