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First child
Child's Information
Child's name: *
Date 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:
Is your child's immunization up to date? * Yes   No
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
Children must be 48" to ride the waterslides. Do you give permission for your child to ride the waterslides that drop into a pool? * Yes   No
Do you give permission for your child to ride the waterslides that run out and do NOT drop into a pool? * Yes   No
Parent's Information
Parent name: *
Phone: *
Alternate phone:
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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        
Grand Canoe Camp        
Kingpin Cambridge Camp
(Ages 6 - 12)
Kingpin Cambridge Jr. Camp
(Ages 4 - 5)
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Emergency contact information
Contact name(s): * Relationship: * Home phone: * Work phone: