Awbury Arboretum · Day Off School Camps Spring 2024

Parent/Guardian Name

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First Name

Last Name

Address

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Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Phone Number

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Email

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Verify Email

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Would you like to begin receiving our weekly email newsletter?

Yes

How did you find out about this camp at Awbury?

Scholarships available

If you have already qualified for a scholarship at Awbury within the past year, you may choose the scholarship amount. If not, please contact the camp director at camp@awbury.org or check our scholarship elibility page.

MLK Jr. Day Camp - Monday 1/15/24	Quantity
$50 - Awbury member fee
$60 - Non-member fee
$15 - Scholarship fee

Presidents Day Camp - Monday 2/19/24	Quantity
$50 - Awbury member fee
$60 - Non-member fee
$15 - Scholarship fee

Eid al-Fitr Camp - Wednesday 4/10/24	Quantity
$50 - Awbury member fee
$60 - Non-member fee
$15 - Scholarship fee

Election Day Camp - 4/23/24	Quantity
$50 - Awbury member fee
$60 - Non-member fee
$15 - Scholarship fee

Child 1's Name

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First Name

Last Name

Child 1's Pronouns

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For example: he/him; she/her; they/them

Child 1's age as of Jan 2024

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Child 1 lunch options

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Child 2's Name

First Name

Last Name

Child 2's age

Child 2 lunch options

Child 2's Pronouns

For example: he/him; she/her; they/them

Child 3's Name

First Name

Last Name

Child 3's Pronouns

For example: he/him; she/her; they/them

Child 3's age as of Jan 2024

Child 3 lunch options

Child(ren)'s Physician's Name

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Physician's Phone Number

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Health Insurance Provider

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Health Insurance Policy Number

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Medications Currently Used

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Illnesses, Medical Conditions, or Allergies

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Medical Care Consent

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I do hereby consent to any medical care and the administration of anesthesia determined by a physician to be necessary for the welfare of my child while said child is under the care of Awbury Arboretum and I am not reasonably available by telephone to give consent. I am the lawful guardian of the child listed and there are no court orders now in effect that would prohibit me from conferring the power to consent upon another person.

Agree

Do not agree

Is there anything special about your child(ren)'s learning style or physical abilities that you would like to share with us?

Please list who has permission to pick your child(ren) up:

*

Emergency Contacts - Phone numbers and relation to child(ren):

*

Photo Release

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Photographs taken of my registered child may be used in Awbury exhibits, published in local news outlets and in Awbury publications, or published on the Awbury website or other digital media.

I agree and give photo release permission

I disagree and do not give photo release permission