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Gentopia Application Confirmation

Gentopia Application Confirmation

    Personal Information:
    Child's Full Name: *
     
    Child's Age: *
    Child's Date of Birth: *
    Parent Full Name: *
    Parent Contact Number: *
    Parent Email Address: *
    Home Address: *
    Emergency Contact Information:
    Emergency Contact Name: *
    Emergency Contact Relationship to Child: *
    Emergency Contact Phone Number:*
    Medical Information:
    Does your child have any allergies? If yes, please specify.
    Does your child have any medical conditions or take any medications? If yes, please provide details.
    Does your child have any dietary restrictions? If yes, please specify.
    Camp Preferences:
    What are your child's favorite activities? (e.g., sports, arts and crafts, swimming, etc.)
    Are there any activities your child should avoid? If yes, please specify.
    Additional Information:
    Does your child have any previous camp experience? If yes, please specify.
    How did you hear about our summer camp?
    Week requested:
    Who will Pick up your child?
    Name
    Phone number
    Relation to child