CAMP F.U.N. 2019 Summer WAITLIST Registration Form
Please complete one form PER CAMPER

Camp Dates are July 1st - August 9th
Hours: Free from 8:30am - 3pm ($25 Early drop off 8am and late pick up 3:30pm)

329 E. WARRINGTON AVE
OFFICE: 412-708-4008

*Transportation will be provided for all field trips and activities BUT NOT TO/FROM CAMP!

For Waitlist applicants, you will be notified when spots are available on a first-come, first-served basis.

Camper's Name (First, Last) *
Your answer
Parent's/Guardian Name (First, Last) *
Your answer
Home Mailing Address (House #, Street, City, State, ZipCode) *
Your answer
Daytime Phone Number *
Your answer
Daytime Email Address
Your answer
Camper's T-Shirt Size (to be worn on every field trip day) *
Emergency Contact Name (First, Last) *
Your answer
Emergency Contact Relationship *
Your answer
Emergency Contact Phone Number (MUST BE DIFFERENT FROM DAYTIME #) *
Your answer
Camper's Birthday *
MM
/
DD
/
YYYY
Gender *
Age *
Grade as of next fall (8/2019) (if there is no space for your child to attend camp, you will be contacted) *
Is your child able to swim? (Mondays are swimming days) *
Allergies, medical problems, physical limitations. (**Insurance information is needed LATER ON for emergency situations as they arise. Insurance information will not be shared with any outside entities and will ONLY be used in medical emergencies.**)
Your answer
Parent/Guardian E-Signature *
Your answer
Date *
MM
/
DD
/
YYYY
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