top of page
Pink Powder

Pink Summer 4 Girls Camp Registration Form Student

Please fill out form and submit to register your child.

Child Resides with

Any special instructions, such as custody or restraining orders must be attached to this application and discussed personally with the camp director.

All Information will remain Confidential.

Student's Medical Information Form

The medical background of each camper is required as part of the camp’s registration process. The camp director must be advised in writing of any condition that would limit the camper’s ability to participate in any program.

Date of Last Physical
Will your child need to take any prescription medications while at camp?
Yes
No
Does your child require an Epi-pen?
Yes
No

If yes, you must provide the camp with an Epi-pen to be kept at camp during your child’s enrollment. Epi-pen must be accompanied with a current prescription and a doctor’s note.

Parent Authorization Form

Pink Summer 4 Girls does not discriminate on the basis of race, color, handicap, religion or national origin. Pink Summer 4 Girls reserves the right at its sole discretion to refuse an application or dismiss a child from camp.

No refund will be made of fees paid before camp start date due to unforeseen circumstances and camper will not attend or if the child has attended any portion of the camping period.


By electronically typing your first and last name you are agreeing that you understand and accept these guidelines.

I give Pink Summer 4 Girls permission to photograph and/or videotape my child for public relations and/or marketing purposes. Photos will remain archived at Pink Summer4 Girls and can be used for promotional purposes without notification.


I give permission for Pink Summer 4 Girls to transport my child off camp property for the purpose of field trips and/or medical care. I understand that a schedule of events will be available to me and that all events are subject to change due to weather and/or scheduling conflicts without notice.


I authorize the camp management to act as the agent of the parents in any emergency situation or to administer basic first aid for the health and welfare of the camper involved. I am responsible for the expenses involved if the services of a physician or hospital are required. Please request a waiver for persons requesting exemption from medical treatment.

By electronically typing your first and last name you are agreeing that you understand and accept these guidelines.

bottom of page