CURRENT HOURS: Open for classes & special events only • Touring season resumes in May 2022

Participant Info, Health, & Consent Form

  • Registration for day camp is not considered complete until we receive this form.
  • One form for each child participating in day camp must be completed, and submitted to Living History Farms within 5 business days of paying for camp.  Failure to fill out and return the form will result in your payment being canceled.
  • Children registered for day camp must have a health form completed by a parent or guardian regarding allergies, chronic illnesses or medications.
  • Camper and Parent Information

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    MM slash DD slash YYYY
  • Hidden
    Which camp are you attending?
  • Please enter a valid email address where all camp-related emails will be sent.
  • Please provide any other information we need to make camp successful for your child (for example, a request to place your child in the same session as a friend).
  • They must present a photo ID at pick up.
  • Policies

  • Emergency Contact and Health Information

  • (other than parent/s, within a 30 minute drive)
  • If different from number above.
  • Please bring a daily dosage of medication. Counselors are not authorized to dispense or to monitor the taking of medications, but will remind campers to take them.
  • This question is required by the American Camp Association as part of Living History Farms' accreditation.
  • This question is included as part of Living History Farms' accreditation by the American Camp Association.
  • This question is included as part of Living History Farms' accreditation by the American Camp Association.
  • This question is included as part of Living History Farms' accreditation by the American Camp Association.
  • This question is required by the American Camp Association as part of Living History Farms' accreditation.
  • Authorization for Treatment

    I hereby give my permission to the medical personnel selected by the Day Camp Coordinator to order x-rays, routine tests, treatments, and necessary transportation for the child named above. In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by the Day Camp Coordinator to secure and administer treatment, including hospitalization, for the child named above.
  • Signature typed here constitutes a legal and binding signature.
  • MM slash DD slash YYYY
  • American Camp Association Accredited
    Living History Farms Day Camp program is accredited by the American Camp Association, the only nationwide organization that accredits all types of organized camps.
  • This field is for validation purposes and should be left unchanged.

 

  • This field is for validation purposes and should be left unchanged.