Clone of Summer Camp 2025 Registration

ABC Care Camp Registration - Part 2

Summer 2026
Camper's Information
Which Camp will your child be attending?
Child's Name
Parent/Guardian Name

First NameLast Name
Parent Email
example@example.com
Grade entering in Fall (2026/27) If your child is in 9th grade or above, they will automatically be enrolled in our Counselor In Training (CIT) Program at a reduced rate.
School child will attend in the Fall
If other, Please tell us which school your child attends:
Name of Sibling(s) that will also be attending camp *Please note, you MUST complete a separate registration for each child.
**** Please Note, you MUST complete a separate registration for each child. ****
Is your child receiving intervention services through the school?
Is your child utilizing a one-on-one aide during school?
**If yes to either question, our staff will follow up with you for additional information and to request a copy of IEP/504/BIP Plan via email so the Director of your camp is aware of modifications necessary (All information will remain confidential).
How did you hear about us?
If other or referral, please list name or how you heard about us:

Camp Gear
Each camper will receive one FREE t-shirt. Please choose the size for your child's free camp t-shirt below:

You may also choose to purchase an additional t-shirt for your child for $15.

Rows	Choose Size of the Additional T-shirt you would like to order
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL

PAYMENT INFORMATION
Will parents need separate billing accounts?
If parents are having separate billing accounts, please list parent name and percentage for each parent. (total cost will be split with initial deposit being credited to parent paying on this form)
By signing this registration agreement on behalf of my child, I acknowledge I am financially responsible for the weeks indicated on the registration form. In case of voluntary withdrawal, absenteeism, deduction of weeks or if my child is removed from camps, I understand there will be no refund of camp fees or credit applied to my account. I agree to complete any additional paperwork (medical forms) and submit two weeks prior to start date of the camp week. I have read or will read the 2026 Family Summer Camp Handbook in its entirety and will abide by the requirements and policies as stated.
Signature: (hold down left pointer button on mouse to sign)
Date Signed

MonthDayYear

YOUTH CAMP HEALTH HISTORY
Child's Name

First NameLast Name
Child's Current Address

Street Address

Street Address Line 2

CityState

Zip Code
EMERGENCY CONTACT INFORMATION:
Emergency Contact: (Parent or Legal Guardian)

First NameLast Name
Primary Phone Number
Format: (000) 000-0000.
Emergency Contact: (Other than Parent Above)

First NameLast Name
Primary Phone Number
Format: (000) 000-0000.
Primary Care Physician Name (or other provider of medical care):
Primary Care Physician Phone Number
Format: (000) 000-0000.
HEALTH INFORMATION:
Are there any health problems including physical, psychiatric, or behavioral problems of which we need to be aware?
If yes, please explain, otherwise mark N/A:
Are there any medications, dietary restrictions, allergies, or special needs that we need to be aware of to ensure that your child's camp experience is positive?
If yes, please explain, otherwise mark N/A:
IMMUNIZATION INFORMATION:
For campers who currently reside within the United States, a United States territory, or the District of Columbia: Does the camper have any immunization exemptions because of a parental or guardian objection or medical contraindication?
If yes, LIST, otherwise mark N/A:
For campers who reside outside the United States, a United States territory, or the District of Columbia: Attach record of vaccination or immunity on Department form MDH-896

Upload a File

Cancelof

Will your child need to have medication administered while at camp?
Medication Administration Authorization Form
**If your child uses asthma medication, please print this form, fill it out and return it to us no later than two weeks prior to the beginning of camp. See attached.
Asthma Action Plan & Medication Administration Authorization Form

ACTIVITIES PERMISSION
I give permission for my child to participate in all activities, including:
Child's Name
By signing below, you acknowledge that you have given permission for your child to participate in the activities selected. (hold down left pointer button on mouse to sign)
Date

MonthDayYear
Date
Checkout:
Tuition Deposit:
This field should be $75 per week chosen - if it is not go back to the grid for choosing week and insure the first column is checked in each week you wish to register for
Walk in Fee (if applicable)
Fabulous Friday:
Swim Lessons:
Additional T-Shirt:
SubTotal (Deposit, Fabulous Friday trips, Swim Lessons, walk in fee and additional Shirt):
Coupon Code:
leave blank if you do not have a coupon
Coupon Amount to be applied
Updated SubTotal after Coupon application
Credit Card Processing Fee: (2.85%)
Total to be paid now:

USDDescription

Rows	Check box to choose week. AND pick which days attending that week (You will not be registered for this week if this box is not checked)	Monday	Tuesday	Wednesday	Thursday	Friday
Week 1 (June 15-19)
Week 2 (June 22-26)
Week 3 (June 29-July 2)
Week 4 (July 6-10)
Week 5 (July 13-17)
Week 6 (July 20-24)
Week 7 (July 27-31)
Week 8 (Aug 3-7)
Week 9 (Aug 10-14)
Week 10 (Aug 17-21)

ABC Care Camp Registration - Part 2