PVSD Summer Camp 2018
Student #1 First Name
Your answer
Student #1 Last Name
Your answer
Student #1 Gender
Student #1 Birthday
MM
/
DD
/
YYYY
Student #1 Grade
2017-2018 School Year
Student #1 Current School
Student #1: Are there any special conditions which we need to be aware of when providing care for your child?
If Yes, Click Other and please explain
Student #1: Does your child take medication daily or on an as needed basis (i.e. inhaler for asthma, Benadryl for allergies, etc)?
If Yes, Click Other and please explain
Student #1: Select all weeks Student #1 will be attending camp
The weeks that are not listed above are now full. If you would like Student #1 to be placed on the waitlist for these weeks, please select the weeks below.
#1 Will you be enrolling another student in the PVSD Summer Camp? *
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