Sprout Day Camp – July 13-16

Time: 9:00 am-12:00 pm

Who: K5-2nd Grades Completed

Cost: $50

Sprout Day Camp Registration

Parent/Guardian Information

Parent/Guardian Name 1*

First

Last

Parent/Guardian Email 1*

Parent/Guardian Phone 1*

Area Code

 - 

Phone Number

Additional Emergency Contact:*

First

Last

Emergency Contact Number*

Area Code

 - 

Phone Number

Media Release: Do you give permission for your child(ren)’s photos to be taken and used on EPC website, social media, and other media publications?*

Yes

No

Day Camp Participants

6505-Please choose the number of children you wish to register ($50/ea): *

1

2

3

4

Child #1

Name - #1*

First

Last

Gender #1*

Female

Male

Choose Grade Completed #1*

Grade ChoicesK51st2nd

Medical/Allergy Concerns #1*

Child #2

Name - #2*

First

Last

Gender #2*

Female

Male

Choose Grade Completed #2*

Grade ChoicesK51st2nd

Medical/Allergy Concerns #2*

Child #3

Name - #3*

First

Last

Gender #3*

Female

Male

Choose Grade Completed #3*

Grade ChoicesK51st2nd

Medical/Allergy Concerns #3*

Child #4

Name - #4*

First

Last

Gender #4*

Female

Male

Choose Grade Completed #4*

Grade ChoicesK51st2nd

Medical/Allergy Concerns #4*

Total

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