2017 Camp Sign Up

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Services
Get Involved
- Donate
- Community Partners
Meet Our Team
Pictures
- Summer Camp 2019
News
- Testimonials
- Awards & Achievements

News

2017 Camp Sign Up

1/1/2016

3 Comments

$5.00 Fee covers cost of T-shirt & Field Trips. Breakfast & Lunch included through USDA summer food program

Child Information:

Name: *

Click or tap below to enter text

Age: *

DOB: *

Sex: *

Home Address: *

Home Phone: *

School Name: *

Grade Next Year: *

Medical or Food Allergies: *

Please explain any medical problems or food allergies here

Emergency Contact #1

Name: *

Relationship to child: *

Email: *

Phone: *

Emergency Contact #2

Name: *

Relationship to child: *

Email: *

Phone: *

Information about child's family:

Family Assistance: check all services child's family receives - Confidential *

Cash Welfare Grant Social Security Food Stamps Free/Reduced Lunch Single Head of Household

Child's Ethnicity: Check one *

Native American Black White Asian/Pacific Islander Hispanic Mixed/Other

Parent Permissions:

I agree that my child can go on field trips (e.g. Tri-Met, school bus, walking field trips).

Parent: *

Date: *

I agree that photos taken can be used for public relations (e.g. brochures, newspaper, web content).

Parent: *

Date: *

Weeks of Camp:

Please check the week for camp (by the grade your child will be in NEXT YEAR) *

Week 1: July 10-13 | Grade: Pre-K to 1st Week 2: July 17-20 | Grade: 2nd to 3rd Week 3: July 24-27 | Grade 4th to 6th

Camp take place at Clarendon Elementary School, located at:
9325 N Van Houten Ave, Portland, OR 97203

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Max file size: 20MB

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fillable_tlc_reg_form_-_english.docx
File Size:	29 kb
File Type:	docx

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new_tlc_form_-_spanish.docx
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3 Comments

theresa porter

5/1/2017 03:34:08 pm

what is it wanting me to upload on the application?

Felicia Capuia

5/1/2017 09:59:00 pm

Charniece Bradley

7/13/2017 11:55:46 am

News

2017 Camp Sign Up

$5.00 Fee covers cost of T-shirt & Field Trips. Breakfast & Lunch included through USDA summer food program

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