End of Summer Camp - FriendshipDallas.org

End-of-Summer Camp Registration

August 8, 9 August 15- 16, at the JCC
Hours are from 9:30am-2:30pm. Due to JCC camps going on simultaneously and their own camp drop off, we will begin unloading children from your car at 9:30am. Prompt pickup at 2:30pm is appreciated.

Pick up and drop off is in the front of the JCC. Parents are not allowed in the building, only campers!

Please bring your own lunch. Friendship Circle will provide snacks and water.

Please note: as of now we are planning 4 days of camp. Fewer sign-ups for certain days may result in cancellation. We will work our hardest to avoid this and in the event we must cancel, will give ample time to make other arrangements.

Our camp is heavily subsidized and does not reflect actual cost. As usual, we do not turn anyone away due to lack of funds. Space is limited! Please sign up quickly to gua rantee your spot.

We are still seeking capable staff to join our team. Any ideas are welcome!

If you have any questions filling out this form please email [email protected]
Camper Name*

First Name Last Name
Parent/Legal Guardian 1*

First Name Last Name
Parent/Legal Guardian 1 - Number*

Area Code Phone Number
Parent/Legal Guardian 1 E-mail*
Parent/Legal Guardian 2

First Name Last Name
Parent/Legal Guardian 2 - Number

Area Code Phone Number
Parent/Legal Guardian 2 - E-mail
Additional Emergency Contact*

if Parent/Legal Guardian is not available Name and Relationship
Additional Emergency Contact Number*

Area Code Phone Number
How many Camp Days?*

Monday, August 08- $50 Tuesday, August 09 - $50 Monday, August 15 - $50 Tuesday, August 16- $50 Help Sponsor Camp - $90 Help Sponsor Camp - $180 Help Sponsor Camp - $360
Health Information
It is our policy to contact the parent or guardian as soon as possible in the event of an accident or injury. If the information has changed on the day of registration please let a staff member know. If your child has medication, please bring all medication in ORIGINAL CONTAINER or you will not be allowed to leave the medication or vitamins with us. No exceptions. All prescriptions must be in that campers name and the correct dosage.
All fileds are required below. If nothing applies, please put "NONE" in the box.

Thanks.
Any activity your child should be restricted from?*
Any physical, mental or other condition that would require special attention or medication while at camp?*
Does your child have any specific behaviors that may require an additional shadow? Would providing a shadow/aid be a possibility?*
List any allergies and/or dietary needs: (eg: bees, nuts, dairy)*
Please describe in detail your child's swimming capability:
Camper Release
Camper Release (List anyone, including parents, to whom your child can be released)*
By hitting submit and putting your initials, you agree that you are the parent or legal guardian of the above named camper, and are over the age of 18. In case of medical emergency or general medical care, I give consent for medical teatment for the aboved named camper by authorized personnel. The camp carries insurance. I understand that the above named camper will only be released to the names listed above, an update may be done at registration. I certify that my child has my permission to attend camp and participate in all activities.
Electronic signature, please initial*
I authorize Friendship Circle of Dallas to use my camper's picture, testimony, and video in any promotional material (web, print, or media.)
Electronic signature, please initial*
Double-click toIn the event of a field trip, I authorize my child to be transported to and from the JCC of Dallas, via hired transportation, staff, or adult volunteers. edit this text...
Electronic signature, please initial*

Payment

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Total

$0.00
Should be Empty:

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End-of-Summer Camp Registration

Health Information

Camper Release