F.O.C.U.O.S.

Home

Summer Takeover Camp Registration Form

Parent/Guardian Full Name

Relationship to Child

Phone *

Email *

Home Address

Address

Street Address

City

State

Country

Enter your country

Postal Code

Child Information

Child Full Name

Date Of Birth *

Age

Gender

Grade

Emergency Contact

Emergency Contact Name

Relationship to Youth

Emergency Phone Number

Medical Information

Does your child have any allergies?

If yes, please explain

Does your child have any medical conditions?

Yes

No

If yes to medical conditions, please explain:

Is your child currently taking medication?

Yes

No

If yes child currently taking medication, please explain:

Program Interests

Which activities interest your child?

Sports & Fitness

Financial Literacy

Leadership Development

STEM Activities

Arts & Crafts

Reading & Academic Enrichment

Entrepreneurship

Team Building

Permissions

I authorize F.O.C.U.O.S. to photograph and/or record my child during program activities for educational, promotional, and program-related purposes.

I understand transportation is not provided unless otherwise specified by F.O.C.U.O.S.

Program Agreement

I understand that participation in the Summer Takeover Camp requires adherence to all program rules and expectations.

Parent Signature

Privacy Policy | Terms of Service