Summer Camps at Meredith College
Please complete this form to register your child for the camps. Total cost for each camp is $275.00. A non-refundable down payment of $50.00 is due by April 15 2020. The balance for the camps must be paid by May 31, 2020 .
Payment may be made in the form of check or money order made payable to: Meredith College Summer Camps.
Email address *
Which camp session(s) are you planning for your child to attend: *
Required
First and Last Name of student attending the camp *
Your answer
Rising Grade Level 2020 -2021 School Year *
Your answer
Student T-Shirt Size *
First and Last Name of Parent/Guardian *
Your answer
Parent/Guardian Cell Phone Number *
Your answer
Medical Information: I give permission to Meredith College Officials and staff health professionals to view and maintain my child’s medical records during the program and to share them with medical personnel in case of emergency. *
Any medically prescribed meal plan or dietary restrictions:  Explain if applicable *
Your answer
Any allergies (food, drugs, plants, insects, etc.):  Please list any allergies *
Your answer
Any medicine (EpiPen, inhaler, etc.) needed to be brought to camp: Please list medications if applicable *
Your answer
Family Physician Name and Phone Number *
Your answer
PERMISSION FOR EMERGENCY MEDICAL TREATMENT:I am the parent/guardian of the above named child, and give consent for my child to attend and participate in the Meredith College summer camp experiences as a camper.  I understand that my child’s participation will include some physical activity. I acknowledge that injuries may occur as a result from participation in this program, and I assume those risks to the extent allowed by law.  I hereby release and hold harmless Meredith College, its agents and employee from liability in connection with or arising from unavoidable accidents, violations or applicable standards of behavior or rules, and any other cause.  I have completed and signed this form in the event that my child encounters a health emergency requiring hospitalization and/or immediate medical care and treatment during the Program, and in order to prevent dangerous delay in treatment.
Please provide your signature and date that you completed this form: *
Your answer
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