TLC TNT: Summer Camp Registration
Tender Love & Care, Think 'N' Try is a non-profit grass root organization. We promote self-esteem and focus on the prevention of gang violence by engaging in active recreation, physical activity, educational activity, and social interaction to proactively promote leadership.
Donation of 5 dollar covers T-shirts, field trips, supplies, etc.
Email address *
Child's First & Last Name *
Your answer
*
Birthday
MM
/
DD
/
YYYY
Age
Your answer
Parent/Gardian Name
Your answer
Email
Your answer
Address
Your answer
Phone (home)
Your answer
Phone (cell)
Your answer
School
Your answer
School Grade Next Year
Your answer
Emergency Contact Name other then parent already listed
Your answer
Emergency Contact Phone Number
Your answer
Medical Problems / Food Allergies (Please Explain)
Your answer
Family Assistance (check any services your family receives) Confidencial
Ethic Group
I agree that my child can go on field trips (tri-met, school bus, walking field trips) *
I agree that photos taken can be used for public relations *
Newspaper, website, brochures
Please check the dates you child will attend camp by the grade your child will be next year:
Contact Information
Please contact Faye Palmerton with any questions or concerns
503-970-4324
fpalmerton@aol.com
Visit our website: www.tlctnt.org
And like us on Facebook: www.facebook.com/TLC-TnT-152132838154430/
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