Mythology Camp 2019 Registration
Application for Admission to Glencairn Museum's Mythology Camp
Please fill out one application form per child.
Completed registration and payment are due by June 1, 2019.
Limited financial aid available. Contact Glenn Greer at 267-502-2984 or
Name of camper
Gender of camper:
Prefer not to say
Which session will your child be attending?
SESSION ONE: June 17th – 21st, 2019
SESSION TWO: June 24th – 28th, 2019
Home street address, city, state, and zip code
Phone number of parent/guardian
Please provide the best phone number to reach you, and all appropriate alternate phone numbers
Person to notify in case of emergency
Both name AND phone number to reach them
PLEASE NOTE: Glencairn staff is not legally allowed to administer any type of medication, including pain and allergy medication. Please confirm that you grant the Glencairn Mythology camp staff permission to administer/provide basic first aid in case of an injury (i.e. apply ice, disinfect and dress cuts and bee stings).
I grant the Glencairn Mythology camp permission to administer/provide basic first aid in case of an injury.
Allergies and Dietary restrictions (if any)
Special needs (if any)
How did you hear about the Glencairn Mythology Camp?
Please confirm permission for your child to attend this camp
I, the guardian/parent, grant my child permission to attend the Glencairn Mythology Camp via this electronic signature
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