Camper Information Child’s Name: Birthday: Age: Gender: T-Shirt Size: Parent/Guardian Information Parent’s Name: Address: City: State: Zip: Home Phone: Email: Camp Details Which week or weeks will your child attend Camp? Full Day or Half Day? Full DayHalf Day Parent Employment Info Mother’s Place of Employment Phone: Mother’s Cell Phone: Father’s Place of Employment Phone: Father’s Cell Phone: Emergency + Additional Info Emergency Contact and Phone Number: Are you carpooling with another camper? List Names: School Attended: Pick up Policy Notification in writing must be given if someone other than parent is picking up. Special Needs or Comments Please list if your child has any type of allergies or has any special needs Menagerie Farms may need to know. Δ
