2023 Summer Day Camp Registration Please enable JavaScript in your browser to complete this form.Participant Name *FirstLastAge *Please note that children must have completed kindergarten or be similarly aged to attend camp.Date of Birth *More than one child in our family will be participating:YesNoParticipant Name 2FirstLastAgeDate of BirthParticipant Name 3FirstLastAgeDate of BirthName of Parent/Guardian *FirstLastWhat is your relationship to the participant?Is this your first time registering for Funhouse programs?YesNoCell Phone *Home PhoneEmail *Physical Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeOn-Island Emergency Contact *FirstLastEmergency Contact Phone *Please check the boxes beside each camp week you would like to attend. Week 1: June 26th -June 30thWeek 2: July 10th - July 14thWeek 3: July 17th -July 21stWeek 4: July 24th - July 28thWeek 5: July 31st- August 4thWeek 6: August 14th- August 18thWeek 7: August 21st- August 25thPlease list the first and last names of anyone who has permission to pick up your child from The Funhouse:If there is anyone who is specifically NOT ALLOWED to pick up your child, please list their names here:This information is kept confidential.Does your child have any allergies?Is there anything else you would like us to know?By signing this form, I declare that I am the legal parent/guardian of the minor child listed above and authorized to grant such permission. I agree to hold harmless The Funhouse, its employees, volunteers, or anyone connected with the Funhouse organization for any injury or other problems arising from participation in this program. I understand that photographs/videos taken of The Funhouse Commons activities may be used by The Funhouse Commons for promoting our programs, classes, events, in print, TV, social media or on the website. *I agreeCompleting this form puts your child on the camp waitlist, and does not automatically enroll your child in the program. A Funhouse staff member will contact you within 5 business days to confirm availability for the weeks you would like to register.Signature *Clear SignaturePhoneSubmit
