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Registration

Parent/Guardian Information
Phone *
Phone
Address *
Address
Camper One
Name *
Name
mm/dd/yyyy
Please describe any allergies, medical conditions, emotional conditions, disabilities, special needs, or family changes that may affect your camper's experience at camp.
Camper Two
Name
Name
mm/dd/yyyy
Please describe any allergies, medical conditions, emotional conditions, disabilities, special needs, or family changes that may impact your camper's experience at camp.
Camper Three
Name
Name
mm/dd/yyyy
Please describe any allergies, medical conditions, emotional conditions, disabilities, special needs, or family changes that may affect your camper's experience at camp.
Emergency Information
Doctor's Name
Doctor's Name
Doctor's Phone Number
Doctor's Phone Number
Permission for Field Trips
I give my permission for my child to go on field trips and on BART or other public transportation. My child will be with staff at all times. I have provided the camp with emergency contact information, which will be taken on all field trips.
Authorization to Treat Minor *
The health history provided is correct and complete as far as I know, and the person herein described has permission to engage in all camp activities except as noted. In consideration of acceptance of this authorization, intending to be legally bound, hereby, for ourselves, our heirs, executors and administrators, waive and release all rights and claims that may arise against Abundant Beginnings, and persons affiliated with this camp. I hereby give permission to Abundant Beginnings to provide routine health care, administer prescribed medications, and seek emergency medical treatment including ordering x-rays or routine tests. I agree to the release of any records necessary for insurance purposes. I give permission to Abundant Beginnings to arrange necessary related transportation for my child. In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp to secure and administer treatment, including hospitalization, for the person named above.
Full name(s) and phone numbers. Note only legal guardians and people on this list can pick up your child. If other arrangements need to be made, you must let us know in person or in advance.
We respect everyone's right to digital privacy. No names will ever be used online or on promotional materials (unless specifically requested).