WADSWORTH SAFETY FORCES CAMP APPLICATION
DATE: JUNE 11TH - JUNE 15TH, 2018
TIME: 8:30 A.M. - 1:30 P.M.
WHERE: WADSWORTH MIDDLE SCHOOL (150 SILVERCREEK RD.)
WHO: OPEN TO KIDS COMPLETING 4TH, 5TH, 6TH AND 7TH GRADES
QUESTIONS: CONTACT PTL. INNOCENTI, WADSWORTH POLICE 330-334-1511

Please complete the information below to submit an application for your child to attend the 2018 Wadsworth Safety Forces Camp.

This form will allow you to submit ONE APPLICATION PER CHILD. After you submit this form, you will be directed to another page with a link to submit another application.

Email address *
FIRST NAME *
Provide the first name of the child who will be attending the camp.
Your answer
LAST NAME *
Provide the last name of the child who will be attending the camp.
Your answer
BOY OR GIRL? *
Please indicate the gender of the child who will be attending the camp.
GRADE JUST COMPLETED *
Which grade will the child be completing this school year which ends in May, 2018?
DATE OF BIRTH *
What is the date of birth of the child who will be attending the camp?
MM
/
DD
/
YYYY
RESIDENCE ADDRESS *
Specify the house number, street name, and apartment number (if applicable) where the child resides.
Your answer
CITY/ZIP *
Specify the city and zip code where the child resides.
Your answer
MAILING ADDRESS (If different from above)
Provide the address where you receive mail IF it is different from the residence address.
Your answer
PARENT/GUARDIAN NAME *
Your answer
PARENT/GUARDIAN PHONE NUMBER *
Your answer
ABSENCES DURING CAMP? *
If your child will have any planned absences during the week of the camp, please click "yes" and provide date/time details in the next question.
IF YOU ANSWERED 'YES' TO THE PREVIOUS QUESTION, PROVIDE THE DETAILS BELOW.
If your child will have any planned absences during the week of the camp, provide the exact days and times of the absences below.
Your answer
T-SHIRT SIZE *
Specify the child's t-shirt size.
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