Summer Camps Registration

Parent/Guardian First name

Parent/Guardian Last name

Email

Phone

Address

Emergency Contact First and Last Name

Emergency Contact Phone

Camper First and Last Name

Camper Age

Camper Gender

Girl

Boy

Child's Doctor

Doctor's Phone

My signature below certifies that my child's age appropriate mandatory state required vaccinations are current and up to date. *Signature

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Medical power of attorney. I authorize that any staff member of New Beginnings Summer Camp may order any and all forms of emergency medical treatment for my child due to injury or illness while at camp. Signature

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I am registering my child for the following camps.

Camp 1— Rain Forrest Valls June 8-11 (VBS) No Fee

Camp 2 — June 22-25 Heaven's Kitchen $150

Camp 3 — JuLY 6-9 DISNEY DAYS! $150

Camp 4 — JuLY 15 Community Heroes Day!🚨 $50

Camp 5 — JuLY 20-23 MAD SCIENCE!🦠 $150

Camp 6 — August 12 Aloha Summer!🏝 $50