STRONG WINGS SUMMER CAMPS

2008 REGISTRATION

Please fill in all fields.
After printing, please sign where indicated and return with deposit and medical forms.
 

PLEASE READ THE REGISTRATION & CAMP POLICIES

   


Child's Name


Age


DOB

M/F

Grade 9/1/08

Guardian(s) Name
 

Mailing Address   (Street)

(PO Box)

(City)

(State)

(Zip)

Island Address (if different from above)

Home Phone

Work (Cell) Phone

Local Phone


Email
 

Family Physician   (Name & Phone)

Dentist   (Name & Phone)
Dates of Immunizations  (must attach certificate of immunization)

Child's Allergies

Medicines Child is Taking

Special Conditions

Health Insurance

Address/Phone

Subscriber
Certificate #
Group #

In case of emergency I/we can be contacted at one of these numbers:

#1     #2     #3
 

Please note that all students must supply a certificate of immunization.
Please include with completed registration form.

Students will not be enrolled until these records have been received.

 

I hereby give my consent for my child to participate in Strong Wings Summer Camps 2008 and further give my authorization to the Staff of Strong Wings, Inc. to arrange for routine or emergency medical care and treatment necessary to preserve the health of my child. I acknowledge that I am responsible for all reasonable charges in connection with care and treatment rendered and agree not to hold Strong Wings, Inc. or any member of their staff responsible in the unlikely event of an accident.

I have read all camp and registration policies,
understand them, and agree to adhere to them.


Signed _______________________________________  Dated _________________
 


Strong Wings may use my child's unidentified photo in their brochures and literature, including their website.  yes  no

CHECK ALL THAT APPLY


Please specify camp and week(s) of enrollment:

First Explorers      9:30-3:30    AM 9:00-12:00    PM 1:00-4:00                
young Explorers              
extreme Explorers           
warrior camp

wk1   wk2   wk3 wk4   wk5   wk6 wk7   wk8   wk9
 

Members receive significant discounts on programs and events throughout the year.
Memberships are annual and run from September 1 thru August 31.

Please begin or renew my Strong Wings Membership   
$50 Single Membership    $100 Family Membership

Method of Payment:  Check      Visa       MasterCard

Amount Enclosed    (Thank You)

 

Credit Card #    Exp Date

Signature________________________________________  Date________________

CAMP RATES AND SCHEDULE
 

Mail or Fax to:  Strong Wings . PO Box 2884 . Nantucket . MA . 02584    (508) 228-6348

© Strong Wings 2000-2008