Busy Bees Summer Camp Registration - Abbeville Presbyterian Church

Child's Name*

First Middle Last

Name Called*

Gender*

Male
Female

Age at the time of camp*

Child's Birthday*

T-shirt Size*

Camp(s) attending

Note: Children can attend both camps! Check all that apply. You will receive a discount for signing up for both camps!

Oh, A Camping We Will Go!
June 7-11, 9:00 to Noon, Ages 1 – 6
Blast Off to Space!
July 19-23, 9:00 to Noon, Ages 1 – 6

Parents' Names

Preferred Phone Number*

Alternate Phone Number

Primary Email*

This is the email we will use for billing information including a PayPal invoice to collect applicable camp fees.

Address*

Street Address City State ZIP Code

Does your child have any allergies?*

No
Yes

Please list your child's allergies.

In the event of an allergic reaction, are there any specific immediate actions that our staff should perform? (medication, inhalers, epi pens, etc.):

Emergency Contacts

Emergency Contact 1 Name*

First Last

Emergency Contact 1 Phone*

Emergency Contact 2 Name

First Last

Emergency Contact 2 Phone

Emergency Contact 3 Name

First Last

Emergency Contact 3 Phone

Name(s) of people who have permission to pick up your child from camp:

The Camp fee is $125 per child per camp. If you register for both camps at the same time you will receive a discount of $25.00 on the July Camp. A PayPal invoice will be emailed to you once the registration form is received.

A camp t-shirt and goodie bag is included in your camp fee.

Photo Release

We will be taking many pictures of our Campers having fun throughout the week. These pictures will be used for our Facebook page, website, and local newspapers. Please choose from the following:*

YES, I give permission for my child’s photograph/video to be posted on the Busy Bees website and/or Facebook page and local newspaper.
NO, I do not give permission for my child’s photograph/video to be posted on the Busy Bees website and/or Facebook page or local newspaper.

Authorization*

By checking this box, I (the child's parent or legal guardian) agree to hold harmless Busy Bees Preschool, its staff and volunteers, along with Abbeville Presbyterian Church, from any liability arising from injury, illness, or other damage your child may sustain while attending summer camp. Camp staff and volunteers will make every effort to keep all children safe from harm while in their care but cannot prevent accidental injuries.

Today's Date*

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