2018 Summer Camp Registration K

2020 Summer Camp Registration

Rising Kindergarten Through Rising 4th Graders
We are so happy you have chosen The Honor Roll School's Summer Camp for your Child!

We have an AMAZING SUMMER planned!

Once you have successfully completed this registration form, you will receive an email registration confirmation with includes links to sign up for specific weeks of camp, Specialty Camps and Extended Day.

If you have any questions about registration or need more information, please email us at cinnamon.baldwin@thehonorrollschool.com or call us at (281) 265 - 7888.
Registration is not complete until you have submitted your $25 Registration Fee and Deposit for One Week of Summer Camp - Payment can be accepted by credit card or check. Spaces are limited.

Once your registration is received, we will contact you to secure your registration and deposit fees. We are offering a RISK FREE SUMMER CAMP THIS YEAR. If we are unable to offer camp, or your child will not be attending, we will refund your application fee and deposit two weeks prior to camp starting.
Camper's Information
Camper's Name *

First Name Last Name
Date of Birth *

Month Day Year
Gender *

Male Female
Child's T- Shirt Size
Grade in the Fall *
Is the camper a current THRS student? *

Yes No
Home Address *

Street Address

Street Address Line 2

City State

Zip Code Country
Will the camper have siblings attending camp? *

Yes No
Please list the name of all siblings attending THRS camp:
Parents' Information
Parent/Guardian 1 *

First Name Last Name
Gender *

Male Female
Cell Phone Number *

Area Code Phone Number
Home Phone Number *

Area Code Phone Number
Email *
example@example.com
Parent/Guardian 2

First Name Last Name
Gender

Male Female
Cell Phone Number *

Area Code Phone Number
Home Phone Number *

Area Code Phone Number
Email
example@example.com
Child in custody of: *

Both Parents Mother Father Other
If other, please specify:
Child lives with: *

Both Parents Mother Father Other
If other, please specify:
Does your child know how to swim? *

Yes No
Do you give permission for your child to swim in THRS Summer Camp programs? *

Yes No
Do you give permission for your child to attend and participate in all activities in THRS Summer Camp field trips? *

Yes No
Medical Information
Physician's Name
Phone Number
Address
Dentist/Orthodontist Name
Phone Number
Address
Medical/Hospital Insurance Carrier
Please upload a copy of your insurance card.
Does your child have allergies or other medical conditions? *

Yes No
Does your child require an Epipen? If so, please see the Coordinator of Student Activities to fill out the required authorization form.

Yes No
List ALL allergies and / or medical conditions
Operations, serious injuries, diseases, or restrictions on physical activity:
Any prescription medication that needs to be administered during camp hours must be submitted to the Coordinator of Student Activities along with the Medication Administration form. This form will be available online click here.
Behavioral concerns or problems of which camp staff should be aware:
In addition to Parent/Guardian names listed above, these persons have permission to pick up my child from Summer Camp. I understand that my child will not be allowed to leave with any person without authorization from Parent/Guardian and that the person picking up my child will need to show identification.
List all authorized person's Name, Last Name, Phone Number, Relationship to student, Driver's License #
Parent Authorization/Medical Release: The information provided is correct to the best of my knowledge, and the person described has my permission to engage in all prescribed camp activities, except if noted by me. In the case of sickness or accident, I hereby give permission to the medical personnel selected by the camp representatives to order x-rays, routine tests, treatment, dental work, and necessary transportation for the recipient at my expense. In the event that I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp representative to secure and administer treatment, including hospitalization, for my child as named above. This form may be photocopied for use away from the main program site. I authorize The Honor Roll School staff to apply sunscreen to my child’s exposed skin on an as needed basis – if child needs assistance. All photos that are taken of my child may be used for promotional purposes.
Parent/Guardian Signature. *

Clear
Date *

Month Day Year
Should be Empty:

2020 Summer Camp Registration

Registration is not complete until you have submitted your $25 Registration Fee and Deposit for One Week of Summer Camp - Payment can be accepted by credit card or check. Spaces are limited.