Educational Concepts and Development Camp Registration Application

Once application is completed and payment is made it becomes a legal binding contract as well as a non-refundable deposit. If the child withdraws the fee is non-refundable.    *Fees must be paid in full, unless previous arrangements are made in writing to the summer camp

* Required fields
Name *
E-mail Address *
Name of child *
Child's Date of Birth *
Child's Grade *
Gender *
Does your child attend school in Maryland, DC, or VA Yes
No
Mailing Address *
Home Telephone Number (include area code) *
Work Telephone Number (include area code) *
Cell Telephone Number (include area code) *
Please describe any medical/physical condition which Educational Concepts and Development should be made aware of. *
Name of child’s physician *
Physican's Telephone Number (include area code) *
Emergency Contact *
Does your child suffer with any of the following (attach copies if necessary) *
If your answer is yes to any of the health issues above, please describe here.
The names listed are the only authorized individuals that are allowed to pick up my child (include their relationship to the child, etc., father, sister, aunt) *
Permission for photographs to be taken throughout camps and workshops to be used in displays, projects, and advertisement purposes only.
My child will be taking public transportation to and from camp. *
My child will be walking to and from camp. *

I have read and agree to the Privacy Policy *

Spam prevention


Please enter the code shown above and click the 'Submit Form' button. This additional step is required to help protect against message spam.

Enter code above:


After you submit  your forn you will be redirected back to this page, at which time you can complete your registration by submitting payment.  Please submit your payment by  clicking here.  Thank you.

   
No material may be reproduced in part or in whole without written consent from holders.
Site designed and maintained by jomarby web design
 
Please send comments and/or questions to Webmaster.
Copyright 2003