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Explosion Elite Allstars Summer Camp Registration
Registration form and a $50 registration fee required for each camper. https://www.paypal.me/ExplosionElite
Email address *
Cheer, Dance and Tumbling Summer Camp
This camp offers campers an opportunity to have an exciting summer filled with tumbling, dance and cheerleading. We will have various activities, arts and crafts and field trips. Campers must bring their own lunch. Please do not bring any nuts or nut product to camp. Spaced is limited to 20 campers per session. Standard camp hours are 9am - 4pm. Before and After care is offered 7am - 9am and 4pm - 6pm for an additional fee. Each two week session is $450.
Camper Information
Please complete for each camper.
Camper's Name
Your answer
Camper's Shirt Size *
Required
Age
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Birthdate
MM
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DD
/
YYYY
Address
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Parent's Name
Your answer
Parent's Contact Information *
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Parent's Contact Information
Your answer
Please mark all sessions you are registering for (each session is 2 weeks)
Emergency Contact Information (1st choice)
Your answer
Emergency Contact Information (2nd choice)
Your answer
Camper Pick-up Information - my camper can be picked up by the following people(include yourself.) *
Your answer
Health Information
If your camper takes medication during camp hours or brings an emergency medical device, such as an epi-pen or asthma inhaler, you child must be able to self administer or require little assistance. You must submit written consent for your camper to take medication during camp hours. Medication must be a prescription with instructions. (not just a pill in a baggie.)
Does your child have health problems of any kind (including physical, psychiatric, behavior) of which we should be aware?
If "yes", Please list and explain below.
Your answer
Are there any medications, dietary restrictions, allergies or special needs that we need to be aware of to ensure your camper has a positive experience.
If "yes", Please list and explain below
Your answer
In the event of an emergency do you give consent for EEA staff/volunteer to obtain medical assistance for your camper at your expense?
Acknowledgement
I hereby acknowledge that all information provided on this form is accurate.

Parent or Legal Guardian Signature: ______________________________________________________

A copy of your responses will be emailed to the address you provided.
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