| |
What dates do you want? Would you like AM (8:30-12:00), PM (1:00-4:30) or ALL day. Also, you want full week or single days. Please, be specific.
* | |
What Camp theme would you like? * | |
What is your Credit Card Bill Address* | |
Was this Camp registration reservation completed while inside the GymStars Facility?* | |
Is the participating child a GymStars Stockton Member?* | |
What is your school & grade? | |
Emergency Contact- other than parent's* | |
Has your child attend Day Camps before?* | |
If your child were to appear in a photo or video taken at our functions are we free to use it for marketing and advertising?* | |
Please, list those adults to whom your child may be release to and picked up by. Photo ID will be required for anyone signing out your child.* | |
Please, list anyone who does NOT have permission to child up your child. | |
Please, list any friends your child would like to be placed with | |
Are there any GymStars classes that we need to take your child to during or after camp?* | |
If yes, please list Day, Time, Coach | |
Are there any medical conditions to which we should be alerted. If so, please list. If not, type "No"* | |
Any use of the following: (contacts, glasses, hearing aids, etc."? If so, please list. If not, type "No".* | |
Does your child have any medication allergies or sensitivities? If so, please list. If not, type "No".* | |
Is your allergic to anything? (example: Bee stings, peanuts, tree nuts, dairy, sun screen, etc) If so, please list. If not, type "No". | |
Will your child be taking any medications while at camp or need an inhaler or epi-pen?* | |
Is an epi-pen needed for any of the allergies listed? If so, please list. If not, type "No". | |
If you child will be taking any medications during camp hours, please list the Medicine, time dosage, if refrigeration is required and if there are any special instructions. | |
Is there anything that your child does not eat to which we should be alerted? If so, please list. If not, type "No". | |
Has your child been exposed to or had the following: Rheumatic Fever, Chicken Pox, Measles, Rubella, Mumps, COVID-19 or other? If so, please list. If not, type "No".* | |
Doctor's Name and Phone Number* | |
Dentist's Name and Phone Number* | |
Insurance Company and Policy #* | |
Parent or Legal Guardian Name* | |