Summer Camps - The Westfield School

1. Camper's Name *

2. Age *

3. Grade Completed *

4. School Currently Attending *

5. Parent/Guardian's Name *

6. Parent Cell Phone *

7. Parent Work Phone *

8. Address *

9. City *

10. State *

11. Emergency Contact Name *

12. Emergency Contact Phone *

13. Please Check Camps Attending * (1 required)

14. Please Select T-Shirt Size * (1 required)

Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large

15. Waiver: I give permission for my child to attend Camp Westfield. I give permission to camp directors/instructors to seek treatment for my child should he/she become injured and I cannot be reached. I release The Westfield School, its staff and the instructors of Camp Westfield from responsibility for any injury. Please print name in box below to sign waiver.

16. Total Amount Due for Payment *

17. Enter Your Email Address: *

18.