Seaport Summer Camp Registration
Your kids are going to love this week-long day camp at the Tuckerton Seaport! You can register you child by completing and submitting this form. You will be contacted for payment information once your form has been received and reviewed. I

A limited number of financial hardship scholarships. Please indicate if you are requesting a scholarship on the registration form.

Here are some important bits of information about camp logistics you might find useful:

* Camp runs August 20-24, 2018 from 10:00am - 4:00pm each day.
* Boys and Girls are welcome as long as they are ages 6yrs - 9yrs at the time of the camp.
* All activities and supplies are included in the cost.
* Kids must bring their own snack and lunch.

Please contact Julie Hain, Director of Education, Exhibits, and the Jersey Shore Folklife Center with questions or concerns.
609-296-8868, ext 117 or julieh@tuckertonseaport.org

Email address *
Are you requesting a financial hardship scholarship for the camp? *
How did you hear about the Tuckerton Seaport Summer Camp? *
Your answer
CHILD INFORMATION
Please provide the requested information about the child attending the day camp session.
Child First Name: *
Your answer
Child Last Name *
Your answer
Child Age *
Your answer
Child *
Address *
Your answer
Phone *
Your answer
Child Age *
Your answer
What school does the child attend? *
Your answer
PARENT/GUARDIAN INFORMATION
Please provide the requested information about the parent or guardian of the child attending the day camp session.
Parent/Guardian Name *
Your answer
Parent/Guardian Address *
Your answer
Parent/Guardian Home Phone *
Your answer
Parent/Guardian Cell Phone *
Your answer
Are you members of the Tuckerton Seaport and Baymen's Museum? *
EMERGENCY CONTACT
In the event of an emergency if the parent or guardian is unable to be reached, who should be contacted?
Emergency Contact First Name *
Your answer
Emergency Contact Last Name *
Your answer
Emergency Contact Phone *
Your answer
Emergency Contact Email *
Your answer
Emergency Contact Relation to Child *
Your answer
Please list the names of individuals who are permitted to pick up your child: *
Your answer
Medical Information
Please provide any information related to medical problems or issues we should be aware of during your child's time at the day camp.
Does your child have any medical problems, including any requiring maintenance medication (i.e. Diabetic, Asthma, Seizures) *
If yes, please list all medical problems and any associated information related to the issue.
Your answer
Is your child presently being treated for an injury or sickness, or taking any form of medication for any reason? *
If yes, please explain:
Your answer
Is your child allergic to any type of food, insect, plant, or medication? *
If yes, please explain:
Your answer
You will be contacted in the event of a medical emergency involving your child. In the event you can not be reached, do you authorize the calling of a doctor and the providing of necessary medical services if your child is injured or becomes ill? *
You understand that the Tuckerton Seaport and Baymen's Museum will not be responsible for the medical expenses incurred, but that such expenses are your responsibility as the parent/guardian of the child. *
PHOTO RELEASE
I hereby give permission for my child to be photographed during the Tuckerton Seaport Summer Day Camp. I understand the photos will be used to keep a journal of activities, to share during power point presentations and/or reports to our donors and for promotional purposes including flyers, brochures, newspaper and on the internet. I understand that although my child’s photograph may be used for advertising, his or her identity will not be disclosed, I do not expect compensation and that all photos are the property of Tuckerton Seaport and Baymen's Museum and its affiliates.
Do you agree to this photo release? *
LOST or DAMAGED PROPERTY
The Tuckerton Seaport and Baymen's Museum are not responsible for lost or damaged personal property. All scheduled events are subject to change. I understand that no fees will be refunded or transferred unless a child is unable to participate due to an accident or illness per physician orders. Children's’ photos and quotes may be used for publicity purposes. In case of an emergency, and if a family physician cannot be reached, I hereby authorize my child to be treated by Certified Emergency Personnel (i.e. EMT, First Responder, and/or Physician).
Do you agree to these terms and conditions? If so, please type your full name below to serve as your digital signature. *
Your answer
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