Online Camp Registration


1st Child Name *
1st Child Name
Date of Birth *
Date of Birth
Address *
Address
Phone *
Phone
2nd Child Name
2nd Child Name
Date of Birth
Date of Birth
3rd Child
3rd Child
Date of Birth
Date of Birth
Mother Name
Mother Name
 

Parent/Guardian Agreement

I give permission for my child/children, listed above, to participate in the Summer Playground Program sponsored by Wenham Village Improvement Society (WVIS) and to travel by private car or chartered bus as necessary during program activities or in case of an emergency. I agree and hold harmless WVIS, its members, committees, board, officers, agents, and employees from any and all liability for personal injuries of any extent to my child/children or others or damages to persons or property that might result in any way from my child/ children’s participation in this WVIS Summer Playground Program. I hereby authorize necessary medical treatment for my child/children.