2018 CAMP FIRECRACKER REGISTRATION
Please use the following form to register for CAMP FIRECRACKER at Camp Fletcher. PLEASE COMPLETE ALL RELEVANT FIELDS. Incomplete forms will not be processed. NOTE: Every query and topic included in this registration is intended to equip staff to provide a meaningful and successful camp experience for your child.

Registration will be on a first come first served basis until sessions are full, with an option to be placed on a wait list. The form must be completed in one session; you will not be able to save and return to your registration at a later time. You will need the following information in order to complete the registration form:
 Medical Insurance Information
 Emergency Contact Information (MUST match I.D for verification)

You will also be required to submit the following documents:

 Written notice from your child’s doctor listing ADHD as his/her primary diagnosis
 A copy of your child's most recent immunization record (blue form)
 A copy of your child’s most recent report card with attendance information
 A completed copy of the teacher feedback form (Please decide which teacher at your child's school needs to complete this form)

Note: Once you complete the registration form online, you must submit the documents listed above by doing one of the following:

1: Scan and Email to: admindesk@campfire-al.org
2: Mail to: 5150 Fletcher Road, Bessemer, AL 35022
3: Drop off at the Camp Fletcher office.

All registrations are subject to a $50 registration fee. Applications will not be processed until the registration form and fee has been received (to hold your spot). The program fee for this session is $300.00. Currently, we have two payment options available. After you submit your registration form: (1) The camp registrar will contact you by phone to collect payment with a credit card OR (2) You can stop by the camp office to pay with cash, check or credit card.

Once registration form and fee have been submitted, you will receive a confirmation email from the Camp office. You have until July, 9th to submit the additional supporting documents.

If you have any questions, please feel free to contact us at (205) 428.1059

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