UAU PS53 Camp Registration
Please enter your child's name. *
Your answer
Please enter the name of the child's parent or guardian. *
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Please enter your child's date of birth *
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DD
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YYYY
Please enter the grade your child will be in as of September 2018. *
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Please enter your address and zip code. *
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Please enter the best number to contact you. *
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Who should we contact in the event of an emergency? *
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What number can we reach them at? *
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Please provide an additional contact that you want to leave on file in the case your emergency contact cannot be reached? *
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Please provide phone number for your additional contact? *
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What is the best email address to send all camp related correspondences? *
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If none of the above can be reached by phone, what do you want the camp to do in case your child is sick of injured? *
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Are their any activities that your child should be restricted from participating in. If yes, please describe below. *
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It is understood that the final disposition in an emergency case, the judgement of the camp authorities will prevail. The recommendation of the parent as indicated above will be respected as far as possible. If at any time the above information must be changed, I will notify the United Activities Unlimited in writing. I understand my application is not complete until I bring a copy of a birth certificate and a completed medical on the first day of camp. I also understand my child will not be permitted to attend camp until I bring these documents to the Program Directors on the first day of camp. Please re-enter you name below to provide a digital signature that you understand and agree to this process. *
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