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Northwest Girlchoir Summer Sing Day Camp Registration
Monday, July 31 - Friday, August 4, 2017
9:30am - 3:30pm
I am signing up for:
I will also need:
Please tell us how you heard about Summer Sing Day Camp:
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CAMPER INFORMATION
First Name
Your answer
Last Name
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Home Phone
Your answer
Grade Level (Fall 2017)
T-shirt Size
Northwest Girlchoir places campers in groups based on their grade level. If your camper would like to be placed in a group with another camper who is also in her grade, please type their name below. We will do our best to accomodate your request, but we cannot guarantee that they will be placed in the same group.
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Music experience
For non-Northwest Girlchoir choristers only: Please tell us a little about your camper's musical background (classes/lessons, instruments played, choir experience, camps, etc).
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PARENT/GUARDIAN INFORMATION
Parent/Guardian 1
Parent/Guardian living at same address as camper.
First Name
Your answer
Last Name
Your answer
Email
Your answer
Work Phone
Your answer
Cell Phone
Your answer
Parent/Guardian 2
First Name
Your answer
Last Name
Your answer
Street Address (if different from camper address above)
Your answer
City (if different from camper address above)
Your answer
State (if different from camper address above)
Your answer
Zip Code (if different from camper address above)
Your answer
Email
Your answer
Work Phone
Your answer
Cell Phone
Your answer
EMERGENCY CONTACTS
Please provide two emergency contacts other than the parents/guardians listed above.
Emergency Contact 1
(Not a parent/guardian listed above)
Name
Your answer
Relationship to Camper
Your answer
Daytime Phone
Your answer
Alternate Phone
Your answer
Emergency Contact 2
(Not a parent/guardian listed above)
Name
Your answer
Relationship to Camper
Your answer
Daytime Phone
Your answer
Alternate Phone
Your answer
CAMPER MEDICAL INFORMATION
Physician Name
Your answer
Physician Phone
Your answer
Medical Insurance Company Name
Your answer
Subscriber Name
Your answer
Subscriber ID #
Your answer
Group #
Your answer
Please list any allergies, reaction, and required treatment:
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Please provide any additional information regarding your camper's physical and mental health (including learning issues):
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EMERGENCY TREATMENT CONSENT: In case of medical or surgical necessity or emergency, by typing my name below, I hereby give permission to the physician and/or medical facility selected by Northwest Girlchoir staff or chaperones to provide medical or surgical treatment they deem necessary or reasonable.
Please type your full, legal name in the space below to give consent.
Your answer
Publicity Release
PUBLICITY RELEASE: I consent to the use of my chorister’s first name, photographs and quotations in Northwest Girlchoir brochures, advertisements, web pages and other print, audio and video media approved by the Northwest Girlchoir staff.
Please type your full, legal name in the space below to give consent.
Your answer
Behavior Expectations
Campers are expected to behave under the following Northwest Girlchoir behavior guidelines (followed by all participants): kindness, safety, respect, responsibility, and contributing positively. Campers are expected to follow directions given by counselors and directors, to participate in all activities, and to not impede the activities of teachers, counselors, and other campers. Behaviors that will not be tolerated at Northwest Girlchoir include: bullying; disruptive or disrespectful conduct toward campers or staff; verbal abuse or harassment; racial or sexual harassment; fighting or physical attacks on campers or staff; and criminal behavior (e.g. theft, drug use, destruction of property, firearms possession). If a camper chooses behavior in conflict with Northwest Girlchoir rules, the staff may intervene in the following ways: camper will be asked to change/improve her behavior; camper may be removed from activity; counselor will contact parents by phone; and counselor and Camp Director/Artistic Director will meet with camper and/or parents. Serious or repeated misconduct will result in a camper being dismissed from the duration of camp.
Please type your full, legal name to indicate that you have read and agree to these guidelines.
Your answer
Haller Lake Excursion & Movie Night
On Wednesday, August 2, from 3:30pm-8:15pm, there will be an optional excursion to Haller Lake for swimming and games, followed by pizza and a G-rated movie at our facility at North Seattle Alliance Church. Campers will be accompanied by Northwest Girlchoir staff, counselors, and parent volunteers, and there will be a lifeguard on site. There is no additional charge for this event.
Required
PERMISSION TO ATTEND: My camper has my permission to participate in the optional Summer Sing Day Camp Haller Lake Excursion & Movie Night on Wednesday, August 2, 2017, from 3:30pm to 8:15pm.
Please type your full, legal name in the space below to give consent.
Your answer
If attending, please indicate your camper's swimming level:
Which category or categories below represent your camper's ethnic background? Please select all that apply. (Optional)
Additional Information
If you have any additional comments or concerns, please contact the Northwest Girlchoir office at 206-527-2900 or info@northwestgirlchoir.org.
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