EmailMe Form - Spring Break Camp 2025

PARENTS INFORMATION

Mothers Name *

Fathers Name *

Cell Phone Number #1 *

### - ### - ####

Cell Phone Number #2

### - ### - ####

Email #1 *

Email #2

CAMPER(S)

How Many Children are you Registering? *

CHILD #1 INFORMATION

#1: Child's Full Name *

#1: Date of Birth *

CHILD #2 INFORMATION

#2: Child's Full Name

#2: Date of Birth

CHILD #3 INFORMATION

#3: Child's Full Name

#3: Date of Birth

PROGRAM & PAYMENTS

(1 Child) Week or Daily.

1 Child: ALM Camp All 5 Days (7:30am-6pm) ($130)

-- or Selected days--

1 Child: Monday March 24th ($35)

1 Child: Tuesday March 25th ($35)

1 Child: Wednesday March 26th ($35)

1 Child: Thursday March 27th ($35)

1 Child: Friday March 29th ($35)

(2 Children) Week or Daily.

2 Children: ALM Camp All 5 Days (7:30am-6pm) ($250)

-- or Selected days--

2 Children: Monday March 24th ($70)

2 Children: Tuesday March 25th ($70)

2 Children: Wednesday March 26th ($70)

2 Children: Thursday March 27th ($70)

2 Children: Friday March 29th ($70)

(3 Children) Week or Daily.

3 Children: ALM Camp All 5 Days (7:30am-6pm) ($370)

-- or Selected days--

3 Children: Monday March 24th ($105)

3 Children: Tuesday March 25th ($105)

3 Children: Wednesday March 26th ($105)

3 Children: Thursday March 27th ($105)

3 Children: Friday March 29th ($105)

INSURANCE

Does your Family need our Insurance? *

$0 if you have your insurance as a Primary
$10 for the 5 days for our partnered ALM Insurance as a primary at PSN Park

Primary Insurance Details
(your childs insurance carrier and policy number)

Please list the people that will collect your child at the end of the day. *

(Name / Phone number / Relation to your child)
PLEASE NOTE: the above listed people will need to provide ID

Medical Concerns

Food Allergies

REFERRALS

How did you hear about this Camp?

Be sure to let Others know about the Camp

TERMS & CONDITIONS

I have read and agree to the Terms of Service *

Yes, I agree.

If your child is covered by a private insurance, you must provide us with proof of your child’s insurance coverage. If your child is not We offer this through our Partners ALM Sports Insurers at a cost of $10.00 for up to 5 days during the Winter Break camp. I give consent for my child to take part in the activity and consent to emergency treatment as necessary. I accept that the organizers and their employees are not under any liability whatsoever in respect of injury, loss or damage whilst on the course, other than imposed by law. I also allow ALM to take photos for advertising and promoting purposes only; if you do not want your child's photo to be taken please email almsportsteam@gmail.com. I confirm that my personal insurance is correct and bears responsibility in case of accidents. I confirm that I am legally entitled to give this consent and understand all payments received are non-refundable.

I agree and understand that all payments are non-refundable *

Yes, I agree.