This Form cannot be submitted until the missing
fields (labelled below in red) have been filled in
2018 SBW Summer Camp
Please note that all fields followed by an asterisk must be filled in.
First Name*
Last Name*
E-Mail Address*
Street Address*
City*
State/Prov*
Zip/Postal Code*
Cell Phone*
Student's Name*
Age*
School
Please list ADA Accommodations needed (allergies)
Please check the week(s) you wish to participate:*
July 30 - August 3 - COOKING/NUTRITION ($150)
Transportation To and From Camp*
---Select---
Parent Drop off/Pick up
Walker/Biker
Friend
Do you authorize OPMI to use photos of your child on our website and/or promotional material?
YES
NO
Approved Child Pick Up (Please list names, phone number and relation)*
Emergency Contact (Please list names, phone number and relation)*
Payment due the Friday before each week - how will you pay?
Check
Cash
Online
CC
OPMI Payment Policy*
I understand that any portion of the camp that my child cannot attend shall be forfeited without refund or credit. Payments are due before camp starts and any payment made on the first day of camp is subject to late fees.
Statement of Understanding*
By checking this box I accept and understand that there are 8 different weeks of Summer Camp. Camp runs from 9:00am-3:00pm. Any portion of the camp that my child cannot attend shall be forfeited without refund or credit. I also understand that I am responsible for picking up my child from camp on time. If I am more than 10 minutes late, I accept and understand that fees will be applied.
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