Camp TULIP Spring 2020 Registration Form
Monday - Friday: 9:00-4:00 --with optional additional times (see below)
Half day and Full day options
Address: 2840 Franklin Street, Suite F, Avondale Estates, GA 30002
Contact us at (404) 444-9815 or atlTULIP@gmail.com
Email address *
Welcome!
How did you hear about us? *
Please mark all that apply
Required
Parent/Guardian Information
Please list ALL parents, guardians, and/or caregivers below
Parent/Guardian #1: Name *
Your answer
Parent/Guardian #1: Relationship (i.e. mother, father, grandmother, guardian, etc.) *
Your answer
Address *
Your answer
Cell Phone *
Your answer
Home, work, or alternative phone (optional)
Your answer
Parent/Guardian #2: Name
Your answer
Parent/Guardian #2: Relationship (i.e. mother, father, grandmother, guardian, etc.)
Your answer
Address
Your answer
Cell Phone
Your answer
Home, work, or alternative phone (optional)
Your answer
Additional email address (if different than above):
Your answer
Name of additional parent/guardian/caregiver not listed above (if needed):
Your answer
Relationship of additional parent/guardian (i.e. mother, father, grandmother, guardian, sitter, etc.)
Your answer
Emergency Contact:
Please provide a contact that is NOT already listed.
Emergency Contact NAME (not already listed) *
Your answer
Emergency Contact PHONE (not already listed) *
Your answer
Camper ONE Information
Camper ONE Name: *
Your answer
Camper ONE Date of Birth *
Your answer
Camper ONE Grade for 2019-2020: *
Your answer
Camper ONE School (attending 2019-2020): *
Your answer
What camp is Camper ONE attending? *
Required
Camper ONE Allergies: (please list all below or none) *
Your answer
Camper ONE: please list any medical/physical challenges or special care that you know the camper may require: (PLEASE NOTE: TULIP is not equipped for all special needs. If your child has special needs, please contact us at atlTULIP@gmail.com to inquire if we can accommodate.) **n/a if not applicable** *
Your answer
Camper TWO Information
Camper TWO Name:
Your answer
Camper TWO Date of Birth
Your answer
Camper TWO Grade for 2019-2020:
Your answer
Camper TWO School (attending 2019-2020):
Your answer
What camp is Camper TWO attending?
Camper TWO Allergies: (please list all below or none)
Your answer
Camper TWO: please list any medical/physical challenges or special care that you know the camper may require: (PLEASE NOTE: TULIP is not equipped for all special needs. If your child has special needs, please contact us at atlTULIP@gmail.com to inquire if we can accommodate.) **n/a if not applicable**
Your answer
Camper Pick-up/Release Approval List:
Please list any adults allowed to pick-up camper (other than parents listed) below
List here or n/a: *
Your answer
Preferred method of payment: *
Is there anything else you'd like us to know?
Your answer
I understand that this form does not guarantee enrollment. *
Required
I understand that should camper be accepted into the camp, additional signed forms are required. (i.e. Medical release, photo release, handbook acceptance, etc.) *
Required
I understand that TULIP is exempted from state licensure by the Georgia Department of Early Care and Learning. (enter name below) *
Your answer
I understand that TULIP carries limited liability insurance. (enter name below) *
Your answer
Registration fees, deposits and tuition balances will be invoiced to the email address above. Registration will not be considered until registration fees and deposits are paid.
Thank you!
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