Clone of Summer @ Selwyn Registration Form

Summer @ Selwyn Registration THE GREAT OUTDOORS

Jason Kitchen | Rising 3rd - 8th
Child's Name*

First NameLast Name
Grade (August 2025)*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Name*

First NameLast Name
Home Number*
Cell Number*
E-mail*
example@example.com
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe.*
Is the child prescribed a medication that requires delivery while at camp? If yes, please explain any instructions.
Medical Release and Authorization

As Parent and/or Guardian of the named child, I hereby authorize treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is also granted to Selwyn School and its affiliates including Directors, Coaches, and Teachers to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered session.
Date*

MonthDayYear
Date
Signature*

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Fishing

JUNE 8 - 12: Campers will learn how to use different types of rods and reels. The safe use of lures and baits will also be implemented. In addition, anglers will get to practice their fishing skills on our school campus. There will be a “Fishing Field Trip” at the conclusion of the week to a local pond. Each camp participant will get the opportunity to earn prizes during the week.

$240.00 Quantity

Archery

JUNE 16 - 20: Campers will learn how to use different types of bows. The safe use of releasing arrows will also be implemented. In addition, archers will get to practice their targeting skills on our school campus. There will be a “Archery Field Trip” at the conclusion of the week to a local indoor range. Each camp participant will get the opportunity to earn prizes during the week.

$240.00 Quantity

Trail Blazers

JUNE 22 - 26: Campers will backpack and hike on trails in Denton County. Hiking skills include proper food and hydration practice as well as clothing, footwear, map, compass and GPS. Campers will also participate in trail cooking!

$240.00 Quantity

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Summer @ Selwyn Registration THE GREAT OUTDOORS