Signup
Child Name
Date of Birth
Age
Mailing Address
Parent/Guardian
Day Phone
Evening Phone
Email
Parent/Guardian
Day Phone
Evening Phone
Email
Emergency Contact
Relationship
Day Phone
Other authorized pick-up
Day Phone
Allergies-Food
Allergies-Medication
Other important notes
Check Requested Dates (no camp July 5th and 19th)
June
16
18
21
23
25
28
30
July
2
7
9
12
14
16
21
23
26
28
30
August
2
4
6
9
11
13
16
18
20
23
Extended Care (stay after 4:30)
Yes
No
Fees: $40.00 per day, $5.00 per day for Extended Care ($200/wk, W/E.C.@$225/wk)
*One time $25.00 Registration Fee per family
Fees are due by Friday prior to attendance. Registration Fee, first and last week's tuition required to confirm reservation. See website for policies.
Parental agreement: I grant permission for my child
to attend Perfect Summer Santa Cruz Camp and to participate in field trips including beach and swimming. Transportation will be on foot, by car, or by city bus. I will support my child to contribute positively to the community and expect them to be nurtured and cared for. I will be reasonable regarding mishaps which may occur due to the playful nature of children as I expect staff to provide safe guidelines and diligent supervision.
Name
© 2010 Perfect Summer Santa Cruz summer camp
Santa Cruz County summer camp based in Scotts Valley
CA License # 444411085
website hosting and design
