Camper

1
BOOGIE WOOGIE WITH BAY CAMP SPRING BREAK APRIL
14th 18th 730 a.m.-600 p.m.
Campers Name __________________________________
Age_____________ ( camp is open to ages 5yrs-
13yrs) Address__________________________________
______ City_________________ State_____________
_ Zip_________ Mothers Name___________________
__________DR LIC__________________ Mothers
Phone_____________________Mothers Work
Phone_________________ Fathers
Name______________________________DR
LIC___________________ Fathers
Phone______________________Fathers Work
Phone__________________ Emergency Contact, Other
than parents_____________________________________
_ Emergency Contact Phone________________________
________________________ Person for Pick Up
Authorization_______________________Relationship
__________ Insurance Company______________Policy
Holder_____________I.D. ___________
I give my permission for my son/daughter
___________________________ to participate in
swimming, field trips, and all other activities
related to the Bay Camp program. In case of
emergency, I give permission to Bay Camp to
secure needed medical treatment for my
son/daughter. I also Release and Hold Harmless
Bay Camp. ________________________________________
_ ____________________________ Parents
Signature Date Rates 50.00 Registration Fee
Deadline for Camp Pre-Registration is
APRIL 7TH 150.00 per child
Please note There is a 5.00 late fee for
every fifteen minutes you are late picking up
your child from our program. Children must
register for the entire week, daily rates are not
available. Once you have pre-registered you are
responsible for payment in full . Payments are
Non Refundable or Transferable. (i.e. NSFs/
30.00, Stop Payments will NOT be honored .)
For Registrations and more information you
can go to www.easternshorebaycamp.com or
call 251-752-4897 Registrations may be
mailed to P.O. Box 6 Fairhope, Al. 36533

ATTN Lisa Ledet Bay Camp Make checks
payable to BAY CAMP