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Giving
Please fill out the form below to register your child for day camp. Up to four children per form.
Parent or Guardian First and Last Name
Email Address
How did you hear about Maywood's Day Camp?
I grant permission for the children listed to participate in Maywood's Day Camp on the dates selected below. I understand that by allowing my child to participate in this event I am also giving permission for my child’s image to be used in Maywood publications, including on the web, fliers, etc., unless a written request stating otherwise is submitted. I understand that sufficient adult supervision will be provided and I acknowledge that I have submitted a 2022-2023 Medical Release Form, providing information to be used in the event any emergency medical decisions need to be made.
I also do hereby grant permission for Maywood Staff or Volunteers to dispense medication, as indicated below to said camper(s) on the dates selected below. Other over-the-counter medication approved by Maywood Staff or Volunteers may be distributed (following dosage and directions on medical packaging) if considered necessary in the opinion of Maywood Staff and Volunteers. Ex. Creams for various rashes, Tums for upset stomach, child-safe Motrin for headaches, etc.
Child #1
Child's First and Last Name
Gender
Girl
Boy
Birthdate
Grade for 2022-2023 School Year
T-Shirt Size
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Child is bringing Medications
No
Yes
Name of medication
Dosage
Frequency (including time of day to administer)
Other medical concerns/conditions/allergies for this child
Dates Attending
Week 1: Pre K-5th | July 10-14 (9am - 3pm)
Week 2: Pre K-5th | July 17-21 (9am - 3pm)
You may attend more than one week.
Child #2
Child's First and Last Name
Gender
Girl
Boy
Birthdate
Grade for 2022-2023 School Year
T-Shirt Size
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Child is bringing Medications
No
Yes
Name of medication
Dosage
Frequency (including time of day to administer)
Other medical concerns/conditions/allergies for this child
Dates Attending
Week 1: Pre K-5th | July 10-14 (9am - 3pm)
Week 2: Pre K-5th | July 17-21 (9am - 3pm)
You may attend more than one week.
Child #3
Child's First and Last Name
Gender
Girl
Boy
Birthdate
Grade for 2022-2023 School Year
T-Shirt Size
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Child is bringing Medications
No
Yes
Name of medication
Dosage
Frequency (including time of day to administer)
Other medical concerns/conditions/allergies for this child
Dates Attending
Week 1: Pre K-5th | July 10-14 (9am - 3pm)
Week 2: Pre K-5th | July 17-21 (9am - 3pm)
You may attend more than one week.
Child #4
Child's First and Last Name
Gender
Girl
Boy
Birthdate
Grade for 2022-2023 School Year
T-Shirt Size
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Child is bringing Medications
No
Yes
Name of medication
Dosage
Frequency (including time of day to administer)
Other medical concerns/conditions/allergies for this child
Dates Attending
Week 1: Pre K-5th | July 10-14 (9am - 3pm)
Week 2: Pre K-5th | July 17-21 (9am - 3pm)
You may attend more than one week.
Enter Code
Submit
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Maywood Free Church