Summer Camp Enrollment -

Playmates Summer Camp 2026

Summer Camp Schedule Printable PDF

Summer Camp Enrollment

Please fill out the following enrollment application and the Center Director will contact you shortly.

Date Enrolled(Required)

Days & Hours Care is Needed(Required)

Please list what days your child will be attending and the approximate times they will arrive and leave.

Center Location(Required)

Child's Full Name(Required)

Full Name

Date of Birth(Required)

Complete Address including Zip Code(Required)

Guardian #1 Full Name(Required)

Full Name

Phone #1(Required)

Phone #2

Guardian #1's Complete Address including Zip Code(Required)

Guardian #2 Full Name(Required)

Full Name

Phone #1(Required)

Phone #2

Guardian #2's Complete Address Including Zip Code(Required)

Emergency Contact #1 Name(Required)

Full Name

Phone #1(Required)

Phone #2

Complete Address including Zip Code(Required)

Relationship to Child(Required)

Emergency Contact #2 Full Name(Required)

Full Name

Phone #1(Required)

Phone #2

Complete Address including Zip Code(Required)

Relationship to Child(Required)

Is there a court order for custody?(Required)

List any people NOT ALLOWED to pick up child(Required)

Physician's Name(Required)

Complete Address including Zip Code(Required)

Phone(Required)

Dentist's Name(Required)

Complete Address including Zip Code(Required)

Phone(Required)

Hospital(Required)

Child's Health Insurance(Required)

Name on Card(Required)

ID#(Required)

Please list any special conditions, disabilities, allergies, dietary needs or medical conditions(Required)

Name(Required)

Parent/Guardian’s Signature

By typing your name above, you are electronically signing this form and affirming that the information provided is accurate and complete to the best of your knowledge.

Date(Required)