All Sports Camp Registration 09
By completing this form, I hereby give my child(ren) permission to participate in Brandywine Country Club's 09 All Sports Camp.  I certify that my child is physically fit and that Brandywine Country Club, its' Directors, Mangers, Employees and Coaches will not be held responsible for any accidents or injury during the course of the program.  If any emergency care is required, I give my permission to Brandywine Country Club to administer first stage emergency treatment.

Main Information
First Name
Last Name
Phone Number
Email
Address
City
State
Zip Code

* Camper's Name
* Birthdate
* Gender
Female
Male

* Parent/Guardian Name
* Emergency Contact Name
* Emergency Contact Telephone Number
* Any special needs/allergies that we should be aware of?
* Will the Camper be attending Swim Practice?
Attending Week 1- June 15th thru June 19th?
9am-1pm
9am-3pm
9am-5pm

Attending Week 2- June 22nd thru June 26th?
9am-1pm
9am-3pm
9am-5pm

Attending Week 3- June29th thru July 3rd?
9am-1pm
9am-3pm
9am-5pm

Attending Week 4- July 6th thru July 10th?
9am-1pm
9am-3pm
9am-5pm

Attending Week 5- July 13th thru July17th?
9am-1pm
9am-3pm
9am-5pm

Attending Week 6- July 20th thru July 24th?
9am-1pm
9am-3pm
9am-5pm

Attending Week 7- July 27th thru July 31st?
9am-1pm
9am-3pm
9am-5pm

Attending Week 8- Aug 3rd thru Aug 7th?
9am-1pm
9am-3pm
9am-5pm

Attending Week 9- Aug 10th thru Aug 14th?
9am-1pm
9am-3pm
9am-5pm

* Required Fields
Cancel