Camp Registration

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Spring Animal Camp 2012 Registration

Child's Name:
Grade:
Date of Birth:
Gender:	Female Male
Week 1: April 2-6 FULL	No
Week 2: April 9-13 FULL	No
Please list any medical concerns (allergies, physical limitations:
Please list any behavioral/special supervision needs:
How did you hear about camp:	Other:
Parent/Gardian Name:
Mailing Address:
City/State:
Zip Code:
Email Address:
Home Phone:
Work Phone:
Cell Phone:
Emergency Contact (aside from parent):
Relationship:
Emergency Phone:
After you have reviewed your registration please type RCHS into the box for security purposes:

All fees must be paid at time of registration. Due to space limitations all camp fees are non-refundable.

In case of accident or serious illness, I request that RCHS contact me. If RCHS is unable to reach me or my emergency contact, I authorize RCHS to make whatever arrangement deemed necessary. I agree to allow RCHS to use any photos or videos of my child for use in PR efforts without compensation or notification. If you feel your registration is complete, click on the button marked Submit Registration.