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First child
Child's name: * Month Day Year
Day of Birth: *
Gender: *  Female   Male
Does your child have any medical conditions the staff should be aware of (i.e. allergies)?
Indicate any special medical attention your child may require:
Swimming ability: Does your child require a life jacket in shallow water? * Yes   No
For possible future advertising we need consent from parent to include photographs and video of children * Yes   No
Is your child allowed to go on the waterslides? * Yes   No
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Chipper's Day Camp
(Ages 6 - 12)
Chipper's Jr. Day Camp
(Ages 4 - 5)
MVP Sports Camp  
Chef Camp    
Eco-Explorers Camp  
Paintball Camp     
Camp Couture (Fashion Camp)          
Bowling Camp        
MineCraft Camp    
Arts Camp        
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Emergency contact information
Contact name(s): * Home phone: * Work phone: