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 HowGathered Oak Farm Summer Camp
Please fill out the following information for your child before attending summer camp.
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Email *
Child's First Name
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Child's Last Name
Child's Age
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Child's Birthday
 *
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Select the Summer Camps you would like to sign up for: *
Required
Parent Name *
Parent Email Preferred for Communication
 *
Parent Phone Number Preferred for Communication. Please include the name of the person the phone number belongs to.
*
Home Address: City, State, Zip Code
 *
Emergency Information: In case you cannot be located, list the names and phone numbers of TWO people who are authorized to take responsibility for your child:
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Please list the names of all people who are authorized to drop off and pick up your child.
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Please list any allergies your child has, including food. (For the safety of everyone, if we have anyone with severe allergic reactions to certain foods, we will not allow that food item to be brought to classes by anyone.)
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Is your child currently taking any medication? If yes, what is it and what is it for?
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Is there anything we should know about your child that would help us meet their needs?
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Please sign the Gathered Oak Release Form HERE before submitting your registration. Please verify below that you have signed the release form.
 *
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