2024 Hambright Garden Camp

Name *

First Name

Last Name

Parent/Guardian Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####

Physician Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Physician Phone *

(###)

###

####

Should a paramedic be called?

Yes

No

Allergies *

Is your child allergic to any type of food or medication?

Yes

No

My child has permission to walk home from camp independently. *

Yes

No

I give The Edible Classroom permission to use photographs of the registrant for publicity and promotional purposes. *

Yes

No

Behavior Policy *

I have read and agree with the terms outlined in the Behavior Policy (link at top of this page).

Scholarship

If this box is checked, please complete the Statement of Need below, and do not proceed to the payment screen after registering. An Edible Classroom staff member will notify you of your scholarship status.

I would like to be considered for a scholarship.

Date

MM

DD

YYYY