Bowen Park Rangers Registration Form

WAUKEGAN PARK DISTRICT All forms Checked__________ Manager Reviewing _______ 2019 Summer Day Camp Registration Form Special needs reviewed_______ Date of Final Review______ Medications reviewed________ Bowen Park Rangers Camp (5-13 years) Final Payments... More

WAUKEGAN PARK DISTRICT All forms Checked__________ Manager Reviewing _______ 2019 Summer Day Camp Registration Form Special needs reviewed_______ Date of Final Review______ Medications reviewed________ Bowen Park Rangers Camp (5-13 years) Final Payments made (Initial next to section) _________ *Must have completed Kindergarten Camper Information Camper’s Name: Home Phone: Address: City: State: ZIP: Child’s Birth Date: _______/_______/_______ Child’s Age: _______ Sex: _______M _______F Parent/Guardian Information #1 Parent/Guardian Information #2  Ms.  Mr.  Ms.  Mr. First & Last Name: First & Last Name: Home Address: Home Address: City, State, Zip: City, State, Zip: Home Phone: Work Phone: Home Phone: Work Phone: Email Address for Confirmation: Email Address for Confirmation: Emergency Contact Name: ________________________________________________ Emergency Contact Phone #: In an emergency situation, every effort will be made to reach a parent first. The ____________________________ Less