Science Olympiad Camp

Camper name
First Name:
Last Name:
Present Grade
5
6
7
8
Are you signing up for the full day or half day?
full
half
Parent/Guardian Name #1
First Name:
Last Name:
Parent/Guardian Name #2
First Name:
Last Name:
Address
Street:
City:
State:
Zip:
Preferred phone

Alternate Phone

Alternate Phone 2

Email

Emergency Contact name

Emergency Contact Relationship

Contact Preferred Phone

Contact alternate Phone

Please write the full names and phone numbers of AUTHORIZED persons allowed to pick up your child

Please write the full names of persons NOT AUTHORIZED or allowed to pick up your child

List any allergies, food, medication or otherwise

Is your child currently on medication?
yes
no
Will child bring medication to camp? If so be sure to complete the medication policy form in person at the Plainsboro Township Department of Recreation and Community Services
yes
no
Should staff be aware of any physical disabilities, limitations, or restrictions that would affect participation in general camp activities?
yes
no
If so, please describe

Is your child arriving from pre camp care?
yes
no
Is your child arriving from pre camp care every day?
yes
no
Please list the days your child is arriving from pre camp care

Will your child be going to post camp care?
yes
no
Photos may be taken to be used by Plainsboro Township, Plainsboro Academic Camps LLC, or invited media, in print and/or electronic media. I give permission for such photos of my child to be used
yes
no
Does your child wear a youth or adult sized T-Shirt?
youth
adult
Please check size
X-small
Small
Medium
Large
X-large
Summer Camp Waiver
I have read and agree to the above waiver
yes