Clone of Winter Wonderland Camp Registration 2024

Winter Wonderland Camp

Discovery Village presents

Winter Wonderland 4 - day camp

Monday, December 29th - Friday, January 2nd

(Thursday, January 1st there will be NO camp)

9:00am - 1:00pm

Ages: 3 - 6

Price: $240 for enrolled students & $250 for general public

We provide a nutritious snack each day. Children with allergies or sensitivities should bring their own snacks.

Lunch is avaliable for $7/day or you can bring a nut free lunch from home.

Enrichment class is available each camp day from 1:00 - 4:30 for $45/day.

There is a 15 day cancellation policy. Discovery Village reserves the right to cancel camps with fewer than 6 registred campers 48 hours prior to the start of camp. No credit will be given for missed days of camp.
Child's Information
First name*
Last name*
M.I.
Date of birth*

MonthDayYear
Date
FemaleMale
Does your child have any food allergies?*

YesNo
Please list any known food allergies
Does your child have any health concerns we need to be aware of?*

YesNo
Please list any medical conditions or health concerns that we need to be aware of
Are you enrolling a second child?

YesNo
Second Child's First name
Second Child's Last name
Date of Birth

MonthDayYear
Date
FemaleMale
Does your child have any food allergies?

YesNo
Please list any known food allergies
Does your child have any health concerns we need to be aware of?

YesNo
Please list any medical conditions or health concerns that we need to be aware of
Parent's Information
Parent's/Guardian's name 1*

First NameLast Name
Cell number 1*
Parent's/Guardian's name 2

First NameLast Name
Cell number 2
Street address*
Street address line 2
City*
State
Zip code*
Billing Email*
EMERGENCY CONTACT
In the event that we are unable to contact you in an emergency
Name*

First NameLast Name
Primary phone number*
Secondary phone number
Consent for Pickup

Enter the names of any adults, other than the listed parent/guardians who you authorize to pick up your child. Teachers will not allow children to be picked up by any unnamed individual.
Name

First NameLast Name
Name

First NameLast Name
Name

First NameLast Name
Name

First NameLast Name
Name

First NameLast Name
PHOTO RELEASE Any photos or videos taken of your child while at Discovery Village may be used for class newsletters, classroom bulletin boards, open house events, class projects and/or in center decorations. (No pictures will ever be sold.)

I hereby give consent to Discovery Village Academy, LLC to use photos and/or videos of my child for promotional purposes.I DO NOT give consent to Discovery Village Academy, LLC to use photos and/or videos of my child.
MEDICAL RELEASE

*Any medication prescribed or over the counter, required to be given to your child during school hours must be handed directly to your child’s teacher or the director with a completed consent to give medicine at school form.

I authorize qualified emergency medical professionals to examine and in the event of injury or serious illness, administer emergency care to the above named child(ren). I understand every effort will be made to contact me to explain the nature of the problem prior to any involved treatment.
In the event it becomes necessary for Discovery Village Academy, LLC to obtain emergency care for my child, neither the staff or Discovery Village Academy, LLC assumes financial liability for expensed incurred because of the accident, injury, illness and/or unforeseen circumstances.
The undersigned client hereby acknowledges that he/she proceeds at the client’s own risk, and indemnifies and holds harmless Discovery Village Academy, LLC, its employees, owners and agents, for any injury, act, or liability, whether intentional or otherwise, that occurs to the client or his/her family as a result of the use of the services and premises provided by Discovery Village Academy, LLC. This includes but is not limited to bodily injury, mental distress, financial loss, loss of personal property and all other forms of loss.
Doctor
Doctor's phone number
Preferred hospital
Signature*

My Products*

Winter Wonderland 4-day camp - Enrolled Families$240.00

Quantity

Winter Wonderland 4-day camp - General$250.00

Quantity

Total $0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Expiration

Should be Empty:

Consent for Pickup