Pre - k Camp ages 3- 5 track 2025

For kids who are 3 (potty trained - entering kindergarten in August 2025) ** $60.00 per child for full day $30.00 for half day option. Please fill out a form for each individual child.

Child Name (first and last)

age

3 4 5 6

T- shirt size

3t 4t 5/6 youth XS

Parent/ Guardian name (first and last)

Primary Email (announcements will be sent here)

This address will receive a confirmation email

Parent/ Guardian Phone Number

Address

Emergency Contact (full name and number)

Backup emergency contact (full name and number)

Please list any known allergies:

Please list any medications , if any, that need to be taken while at camp

Does your child have any game or activity limitations

Other relevant medical information

I give permission for my child to be given sunscreen.

yes no only sunscreen that my child brings

Who will primarily pick up your child from each day? If there is another person please notify staff upon 1st day check - in

Please note if there is a specific person who should in no circumstance pick up your child

In the event of an emergency in which my child is in need of immediate medical attention, hospitalization or surgery, and after reasonable efforts have been made to contact me (parents or guardian) and we cannot be located for the purpose of consenting thereto, consent for the emergency attention may be given to any person standing to loco parentis to my child. I understand my own medical insurance will be the primary coverage. I hereby release Reclamation Church, its staff and volunteers from the liability for injury or damage and assume all risks stemming from my child’s participation in Reclamation Church's RecKIDS Camp Program This release is completed of my own free will for the Reclamation Church PreK Camp 2025 . Granting my permission:

Electronic Signature

*by entering my name in the box above I am providing my elctronic signature

I give RC permission to take pics and or video during camp activities.

yes no

Medical Insurance

Policy #

Please check which option your child will be attending

Full day (9am-2:30pm) Half day (9am- 12pm)

** if your child will not be attending the full day of camp (needing to leave early or come late) or will only be attending certain days, please note below, days and times of occurences.

Please list any other comments in space below or put N/A

How did you hear about us?

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Pre - k Camp ages 3- 5 track 2025

Description

Please Fix the Following