2022 REGISTRATION FORM At the time of this printing, Sarasota County Parks, Recreation and Natural Resources (PRNR) is planning to operate a full camp program for the summer of 2022. If the situation calls for changes due to COVID-19, PRNR will implement changes while following the current CDC guidelines. This could lead to reduced camp opportunities, limited registration, no off-site activities and possible cancellation of the program(s). Registration begins Monday, March 28, 2022. Do not mail forms prior to Friday, March 25, 2022. Complete both pages of registration form and mail with payment to: Summer in the Parks, 6700 Clark Road, Sarasota, FL 34241 Parent/Guardian name: Address: City: State: Zip: Home phone: Work phone: Cellphone: Email address: Participant’s name
Date of birth M/F
Program name and camp location
Dates
Fee $ $ $ $
DAY CAMP ONLY: If day camp location is full, identify second choice Official Camp T-shirt (for Day Camp and C.I.T. programs only) Child’s name: Child’s name: Child’s name: Child’s name:
YS YS YS YS
YM YM YM YM
YL YL YL YL
AS AS AS AS
AM AM AM AM
AL AL AL AL
AXL AXL AXL AXL
number of additional shirts x $8 number of additional shirts x $8 number of additional shirts x $8 number of additional shirts x $8
Adopt-A-Camper Donation – your donation will be used locally to send children in need to camp.
ADDITIONAL REGISTRATION INFORMATION:
$ $ $ $ $
Total $
Child’s name
Grade Child’s EIN Fall 2022 Student Number
Allergies
Swimming ability ESE Assessment? Walk/Bike home? (N,B,U,A)* Yes / No** Yes / No / Time
* (N) Non-swimmer, (B) Basic skills, (U) Swim unassisted, (A) Advanced swimmer. ** Has your child received an ESE assessment through his/her school? If yes, please explain:
EMERGENCY / PICK-UP INFORMATION (other than parent/guardian listed above): Name: Phone: Phone: Name: Phone: Phone: Name: Phone: Phone:
Register at scgov.net/parks.
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