Application for Summer Camp Northern Lights Summer CampChild's Name: *Date of Birth: *Name of Parent/Guardian: *Email address(es): *Parent/Guardian's Cell: *Secondary Name:Secondary Name's Cell: *Emergency Contact:Emergency Contact Cell: *Health and Allergy InformationPlease provide any special medical or additional information about your child that could be helpful in an emergency (e.g., known medical conditions, skin conditions, vision/hearing difficulties):Does your child have any allergies that are not life-threatening (food or other substance (e.g., latex))? *YesNoIf yes, please provide relevant details, including what your child is allergic to, symptoms of a reaction and treatment:Additional InformationPlease indicate any additional information which is relevant to the care of your child (e.g., prone to colds, frequent shoulder dislocation, etc.):The following non-prescription items may be applied to my child in accordance with the manufacturer’s instructions on the original container (please check off):SunscreenInsect Repellent Lip BalmLotionsRegistering for: *August 10-14August 17-21Application Fee Please submit a non-refundable $50 application fee which will be applied to your week’s fee by sending an e-transfer to [email protected].SUBMIT APPLICATIONPlease do not fill in this field.
