ADVENTURE HIKESOct. 26- 100 Acre WoodsNov. 16 - Arroyo Park11am-3pmIf your child is new to The Play Project or didn’t participate in camp this year, please fill out the registration form below.If your child participated in one of our 2024 summer camps, please fill out the shortened registration form here. REGISTER FOR ADVENTURE HIKES First Child's Name * First Name Last Name Birthday * MM DD YYYY Gender * (Male, Female, Non-Binary) Pronouns * Second Child's Name First Name Last Name Birthday MM DD YYYY Gender (Male, Female, Non-Binary) Pronouns Third child’s information: (please include name, birthday, gender, & pronouns) Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Parent/Guardian Name * First Name Last Name Phone * (###) ### #### Email * Relationship to Child * Address (if different than child’s): Parent/Guardian Name First Name Last Name Phone (###) ### #### Email Relationship to Child Address (if different than child’s): Child's Physician * First Name Last Name Physician Phone * (###) ### #### Physician's Address * Address 1 Address 2 City State/Province Zip/Postal Code Country List all possible allergies (foods, drugs, insects, other) * List all possible reactions List any health conditions and/or concerns (including if s/he sunburns and/or overheats easily) * Name of Health Insurance * Policy # * Person carrying insurance * Relationship to participant * Emergency Contact #1 * Relationship to Child * Cell Phone * (###) ### #### Home/Work Phone (###) ### #### Emergency Contact #2 * Relationship to Child * Cell Phone * (###) ### #### Home/Work Phone (###) ### #### Authorized Pickup Person #1 In addition to parents/guardians, only the following individuals will be permitted to pick-up your child. Please notify us if you would like to add anyone to your pick-up list. Phone (###) ### #### Relationship to Child Authorized Pick-Up Person #2 Phone (###) ### #### Relationship to Child Restrictions * I am aware of the program activities and feel my child can participate without restrictions. I am aware of the program activities and feel my child can participate with the following restrictions or adaptations (please describe below) Please describe restrictions or adaptations needed to ensure our program is accessible for your child To what extent is your child comfortable and confident around water? * The Play Project may use images and sounds of participants and staff to share with enrolled families and/or to promote future programs of The Play Project. Please check the box that is most appropriate: * (Please note: The Play Project does not use social media and no images taken during summer camp programs will be posted on social media). I give permission for The Play Project to use, without limitation or obligation, photographs or other media that may include my child’s image or voice to share with families in the same program and/or to promote the Play Project Programs. I am not comfortable with my or my child’s image or voice being used in promotional materials. I am not comfortable with my or my child’s image or voice being documented in any capacity. Is there anything else about your child that would be helpful for us to know? Please select which Adventure Hike(s) you'd like to register your child for: * (select all that apply) October 26, 100 Acre Woods November 16, Arroyo Park I have read and agree to abide by The Play Project Policies: * Yes Thank you! THANK YOU!
