Free Teen Summer Camp Application Form

Please fill out this form to apply for [Your Company Name]’s Teen Summer Camp
Camper Information
Name
Age
Phone Number
Date of Birth
Gender
Male
Female
Address
Parent/Guardian Contact Information
Parent/Guardian Name
Phone Number
Emergency Contact
Emergency Contact Name
Relationship to Camper
Phone Number
Camp Session Preferences
Preferred Camp Session Date
Would you like to participate in overnight sessions?
Health Information
Allergies or Dietary Restrictions
Specify Allergies or Restrictions.
Medical Conditions or Medications
Specify Any Conditions or Medications.
Health Insurance Provider
Insurance Provider Name
Policy Number
Interests and Goals
What are you most excited about for camp?
Briefly describe.
Are there any specific skills or activities you’d like to focus on?
Specify Activities or Goals.
Parent/Guardian Consent
By signing below, I give permission for my child to attend [Your Company Name]’s Teen Summer Camp and participate in all activities, including any necessary medical treatment.
Parent/Guardian Signature
Name:
Date:
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