Registration
Welcome to the New Era Vacation DayCamp Medical Forms must be sent to neweragymoffice@gmail.com in a ONE file pdf if we do not already have one less than 3 years old. It can be the attached medical form or any one the Dr. gives you (the one you use for school). Almost all scanner apps can accomplish this (I use Adobe Scan on my phone). If there are any medications, they MUST be in a labeled zip locked bag with the attached Admin of Meds signed by the Dr. included and a plan of Care form in medication bag if necessary. All forms can be found on the camp page of our website. All lunches must be NUT FREE and will be refrigerated. When you come in, put bags in a cubby and bring the lunch into the camp room and put it on the table near the refrigerator. Please do not arrive more than 5 or 10 minutes early, or be picked up more than 10 minutes late. There are no water games during Vacation Day Camps and we only go outside weather permitting. Thomas
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Additional Contact phone #
 
 
Students entered below will be added to your family's account
 
Additional Information:
 
Assumption of Risk
  (Show-Hide Details)
I've read the above and agree.
 
Release of Liability
  (Show-Hide Details)
I've read the above and agree.
 
Enter your Full Name: *   
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*