Sandlot Camp Westerville - Registration 2020
Email address *
Camper's First Name: *
Your answer
Camper's Last Name: *
Your answer
Week(s) of camp for which your are registering: *
Required
Camper's Grade in School (next year, 2020-2021): *
Camper's Gender: *
Camper's T-shirt Size: *
Medical Alerts, Allergies, Physical Limitations, Health Concerns, etc.: *
Your answer
Will you be leaving any medications or equipment with the camp staff (EpiPens, Auvi-Q, inhaler, medication, etc.)? If so, please list and provide dosage information: *
Your answer
Additional information important/helpful in planning the experience for your camper? *
Your answer
Name(s) of friend(s) your child would like to be teamed with during camp? *
Your answer
I give permission for my child to swim (supervised by BOTH pool AND camp staff): *
I give permission for my child to be photographed for the website and/or Facebook page: *
I understand that Sandlot Westerville is a youth sports/activities camp and participation involves a risk of injury. I am giving my child permission to participate in camp, waiving my right to sue any member of Sandlot Westerville in the unlikely event that my child is injured. *
Required
I understand that I will need to print and complete the emergency medical authorization and release/waiver forms from the Sandlot Westerville website and bring them, along with the confirmation email, on the first day of camp. *
Required
In the event that reasonable attempts to contact parent/guardian have been unsuccessful, I hereby give my consent for the administration of any treatment deemed necessary for the well-being of my child. *
Required
My child is currently covered under a health/medical plan offered by the following insurance provider: *
Your answer
Parent/Guardian #1 - NAME: *
Your answer
Parent/Guardian #1 - PHONE: *
Your answer
Parent/Guardian #1 - EMAIL: *
Your answer
Home Address, City, Zip: *
Your answer
Parent/Guardian #2 - NAME:
Your answer
Parent/Guardian #2 - PHONE:
Your answer
Parent/Guardian #2 - EMAIL:
Your answer
In addition to Parent(s)/Guardian(s) --EMERGENCY CONTACT(s) Name(s) & Phone Number(s) : *
Your answer
Aside from Parents/Guardians, additional name(s) and relationship(s) of specific people authorized to PICK-UP your child at the end of each day (people not on this list MUST be authorized via signed note AND in-person/phone confirmation by a Parent/Guardian listed above): *
Your answer
I understand that I will receive an email (from SandlotWesterville@gmail.com, PLEASE check you spam/junk folder) with more details regarding camp in the weeks leading up to camp. This email will include all important information about your camp week. We are excited to have your child at camp this year and are looking forward to a great summer! *
Required
I understand that payment ($170 per camper, per week) is a separate transaction and I will complete payment (online or check mailed) within 3-days of completing this registration. *
Required
Intended payment method (due within 3-days of completing this registration): *
Add Early Bird Drop-off (as early as 8:00 AM -- extra $25 per child, per week, due in-person on the first day of camp, check or cash only)? *
Required
Add SandlotScuba (must be at least 8-years-old -- extra $40 per 90+ minute experience, due in-person at the time of experience, check or cash only)? *
Required
Camper's School in 2019-2020: *
A copy of your responses will be emailed to the address you provided.
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