I made my purchase through Green Lake Moms *
Signed up for: *
Child's Name *
Child's Name
Emergency Contact Information
Primary Class-Time Contact *
Primary Class-Time Contact
Phone Number *
Phone Number
Secondary Class-Time Contact *
Secondary Class-Time Contact
Phone Number *
Phone Number
Please share any notes about others who have permission to pick up your child, or if there is anyone who should never pick up your child.
Medical Information
Physician's Phone Number
Physician's Phone Number
Additional Information
For the following week(s) of camp:
Week 2: June 29th - July 3rd Week 3: August 24th - 28th Week 4: August 31st - September 4
Permission Waivers
We may take a walk over to the park if the weather permits, but we will mostly be playing at the Phinney Neighborhood Center Playground. We are happy to honor your wishes to stay on campus, and will plan curriculum depending on whether we have permission from all families.
I understand that sunscreen must be applied before coming to camp, and will not be applied at camp. *
By typing my name below, I am confirming that all the information above is correct.