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campregistration

 
Town of Stony Point Camps
Please check appropriate program:
Child's Name:
Sex:
Shirt sizes:
Address:
DOB:
Age:
Grade:
Parents Names:
Telephone:
Cell:
Email:
Emergency Contact:
Phone:
Family Doctor:
Telephone:
I agree.
(by not agreeing you will not be permitted to register for the Town’s Camp Programs):
PLEASE MAKE CHECKS PAYABLE TO: Town of Stony Point
** I hereby give consent for my child to participate in the program indicated.
I give Permission for pictures to be taken of my child:
In the event a parent cannot be reached I authorize my child to be treated by either an EMT, Physician or other medical staff:
Please Note: Our programs are licensed by the NYS Dept. of Health and requires two inspections yearly. Inspection reports concerning the camps are filed in the Directors offices.
Medical History
Child's Name:
List any chronic illnesses:
List any special needs, allergies, diets, other restrictions:
List any medications or treatments:
List any other conditions that we should be aware of
PLEASE SUPPLY A COPY OF CURRENT IMMUNIZATION RECORDS.
NO CHILD CAN ATTEND THE PLAYGROUND OR DAY CAMP PROGRAMS WITHOUT A COPY OF IMMUNIZATION RECORDS ON FILE.
To the best of my knowledge the above information is correct.
Registrations are limited to 60 children for Playground Program and 375 children for Day Camp Program.
Parent/Guardian Signature:
NO REFUNDS OR PRO-RATED FEES
** Proof of residency and payment must be provided to secure your child's spot. Only 375 campers will be registered.

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