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Sports Camp Registration Form

Register up to three children in the same family.

Camper information

Camper's name
Male Female Age

2nd camper's name
Male Female Age

3rd camper's name
Male Female Age

Parent's name (required)

Street Address

City

State

Zip code

Parent's email (required)

Primary phone (required)

Work phone

Other phone

Emergency contact

Relationship

Phone

Child's primary care physician

Physician's phone number

Summer Camp Sessions

Note: Before signing up, see the Camp Sessions/Schedule page for availability.

Please check desired sessions

Session 1	Session 2	Session 3	Session 4
Session 5	Session 6	Session 7	Session 8

Please check needed extended hours ($60 per week)
8:00 - 9:00 am
4:00 - 6:00 pm

For your records. . .

Required Forms

Download this NYC Health Department medical form. Have it completed by your child's physician and send it to Camp Olympia by June 1, 2010.
Please also download the camp agreement, sign it and return it as soon as possible.

Children will not be allowed to attend Camp without a completed and signed medical form or camp agreement.

Sports Camp Fees
Session 1 is $155, all other sessions are $180.

$100 deposit is to be paid for each camper with completed application. Deposit refundable until May 31, 2010.

No refund after May 31, 2010.

Balance due June 10, 2010.

Make check payable to

Camp Olympia
7304 5th Ave, # 271
Brooklyn, NY 11209