AVP Camp 2017 Parent Form

Summer 2017 AVP Teen Leadership Day Camp. Please fill out a separate form for each youth attending from your family.

Please complete the form below

*Required

Name of Parent or Guardian *
Name of Parent or Guardian
Name of Teen Attending the Camp *
Name of Teen Attending the Camp
Daytime Phone for Parent or Guardian *
Daytime Phone for Parent or Guardian
Evening Phone for Parent or Guardian *
Evening Phone for Parent or Guardian
Is there a phone you use for text messages?
Is there a phone you use for text messages?
If yes, enter the phone number below.
Transportation *
Day camp will be at the Quaker Meetinghouse in Chatham Township on 158 Southern Boulevard near Lafayette Street.
Light breakfast, lunch and snacks will be served.
Is your child currently under the care of a physician or health professional? *
In some situations we may need additional approval or information from the treating health professional. We will send you a consent form for you to sign if this is necessary.
I approve of my child’s participation in the AVP Teen Leadership Summer Day Camp. I understand that he/she must attend all 8 days of camp, must be on time, and I will make sure he/she does. *
I understand that there will be followup meetings during the following school year. *
Do you need scholarship help for your child to attend this camp? *
The subsidized cost of the camp is $500 per child. We do not want anyone to be excluded for financial reasons. Scholarship money is available.