Marcus Whitfield Youth Camp Hosted by GCSO
Sign up with this form for summer camp July 6-10 2026
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Email *
Child's Name *
Gender *
Date of Birth *
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Shirt Size (Adult Sizes) *
School Attending *
Grade *
Child's Resource Officer (if known) *
Parent or Legal Guardian *
Street Address *
City *
State *
Zip Code *
Daytime Phone Number *
Emergency Contact *
Emergency Contact Phone Number *
I will be dropping off and picking my child up at Berea High School
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Your child needs to be picked up at an optional location at 7:30 a.m. and dropped off at 4:30 p.m.  Please select your site below
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Who will be picking up your camper at school or drop off location *
Is anyone NOT allowed to pick up your camper?  If so, provide the name or names.   *
Is you child taking medication? *
Will medication need to be given to your child during camp? *
If so, please provide medication information and dosage instructions.  
Any known allergies especially food allergies? *
Camp is physically demanding.  Does your child have any physical limitations that we should be aware of? *
If your child does have physical limitations (asthma, diabetes, etc, please list below.  
Insurance Policy Name and Number or Medicaid number (please specify) *
Date of last tetanus shot *
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How do you think your child might benefit from the camp? *
Camp Rules are on the website you visited to register for camp.  Do you agree to abide by those rules for the Camp? *
Does your child agree to abide by the rules? *
The Permission and Liability Form is also on the website you visited.  By typing your name below you are consenting to allow your child to participate in camp under the terms established in that form.   *
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