S'more Fun Summer Day Camp Registration Form
Thank you for your interest in SU 989-Freedom day camp. You may register your camper using this online form. After this form is submitted, you will receive an email confirmation. Make sure that the email address associated with your camper’s account is a parent’s email address that is checked often. We will contact you regarding form submissions, final payment, and other parent information using the email address associated with your camper’s account. Within a month after payment is received, you will receive a Confirmation Packet by email with additional information to help you and your camper prepare for Day Camp. This will include an important parent information packet, health forms and camper's code of conduct agreement.

If you have any questions, please contact us at SmoreFunDayCamp@gmail.com

Email address
Camper's name
Last, First
Your answer
Address
Street, City, Zip Code
Your answer
Parent/Guardian Name
Last, First
Your answer
Custodial Care
Day Phone
Your answer
Night Phone
Your answer
Emergency Contact:
(Person not living with camper that can be contacted during the hours of 9am and 4:30pm) -Name and Phone#:
Your answer
Camp Path 1st Choice
Camp Path 2nd Choice
Grade
Fall 2017
Is your Camper A Registered Girl Scout?
( must be a registered scout before July 20th to be able to attend)
Required
Troop and Service Unit
Your answer
Referred by:
Your answer
Special Dietary Need
Please list all dietary need and food allergies
Your answer
Are you interested in volunteering?
MUST be a registered Adult with Clearance on File with GSWPA by June 15th (If you volunteer at camp the entire week your child will attend camp for free)
Required
Permission
My camper has permission to attend S'more Fun Day Camp 2017
Media Permission
When participating in Girl Scout activities the registrant may be photographed for print, videotaped, or electronically imaged. Images may be used in promotional materials, news releases, and other published formats for either the local Girl Scout Councils or Girl Scouts of the USA. The images will be the sole property of either the local Girl Scout Council or Girl Scouts of the USA
My camper has permission to be picked up by following adults
(please list all possible adults that may pick your child up without a pick-up card. Photo ID will be REQUIRED)
Your answer
Parent or Guardian signature
By typing your name and submitting this form, you are giving permission for your camper to attend S'more Fun Day Camp and agree to all items indicated on this form
Your answer
Payment
Payment must be made by check or money order made out to "Girl Scout SU 1640" and mailed to: Christin Trapp, 340 Springer Rd, Freedom, PA 15042 within 7 days after submitting this form. Camp choice will not be assigned until payment is received.

Girl Scout Bucks will be accepted, at face value, for whole or partial payment for any camper registered before July 1st. Please submit camp fee minus Girl Bucks being used within 7 days.

Camp Fee
Required
Camp t-shirt (Included in camp fee)
Please choose size. Size cannot be guaranteed for campers registered after July 1st . T-shirts to be worn daily- (additional t-shirt $10)
Required
Additional t-shirt
( $10 same size will be order unless otherwised noted)
Total Camp Fee:
Send this total by check or money order made payable to: "GS SU1640" mailed to: Christin Trapp, 340 Springer Rd, Freedom, PA 15042 within 7 days after submitting this form. Camp choice will not be assigned until payment is received.
Special notes
Use to clarify any answer from above questions. Not to be used for health concerns.
Your answer
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms