 Week(s) Attending: (please circle) July 5 - 9 – M, Tu, W, Th, F or full week July 12 - 16 - M, Tu, W, Th, F or full week July 19 - 23 - M, Tu, W, Th, F or full week July 26 - 30 - M, Tu, W, Th, F or full week August 3 - 6 - Tu, W, Th, F or full week August 9 - 13 - M, Tu, W, Th, F or full week August 16 - 20 - M, Tu, W, Th, F or full week August 23 - 27 - M, Tu, W, Th, F or full week NAME OF PERSON OR PERSON(S) WHO WILL BE PICKING YOUR CHILD/CHILDREN UP AT THE END OF THE DAY _______________________________________________________ IF ANY OTHER PERSON WILL BE COMING TO PICK YOUR CHILD/CHILDREN UP PLEASE NOTIFY US. IF WE ARE NOT NOTIFIED EGALACRES FARM CAMP IS NOT RESPONSIBLE FOR THE CAMPER. Signature: _____________________________________ Date: _________________________________________ |