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Program Registration

SUMMER
ENRICHMENT PROGRAM

A 6-week summer camp designed to enrich young minds through literacy,
fitness, life skills, and social-emotional learning.

Camp activities include:

Yoga and hiking for physical well-being

Financial literacy for smart money management
Weekly field trips to museums and nature reserves
Our curriculum features evidence-based programs like Too Good for Drugs, empowering campers with healthy choices and strong decision-making skills.

A summer of growth, discovery, and lifelong lessons!

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Parent/Guardian Information

We're looking forward to an incredible summer! Please take a few minutes to complete each line of the required information below. If registering more than one child, a separate form must be completed for each child.

Parent/Guardian First Name*

Parent/Guardian Last Name*

Relationship to Camper*

Phone Number (Primary)*

Phone Number (Alternate)

Email*

Home Address*

Camper Information

Please complete camper's full name, date of birth, and gender below.

Child's Name*

Child's Gender*

Child's Birthday*

Month

Day

Year

Emergency Contact (Other than Parent/Guardian)

Name*

Phone*

Relationship to Camper*

Medical Information

Allergies (food, medication, environmental)

Medical Conditions or Special Needs

Medications Camper Will Take During Camp

Physician Name & Contact Info

T-Shirt Size (One Camp Shirt Included)*

Consent - Required for Participation

Please review and check each of the boxes below to indicate your understanding and consent. All must be selected to complete registration.

I consent to my child’s participation in BFIT Big Dreams Youth Inc. programs and activities, including on-site and off-site events under the supervision of staff.

I authorize emergency medical treatment for my child in the event of illness or injury when I cannot be reached, including first aid, transport, and any medically necessary procedures deemed appropriate by licensed professionals.

I consent to the collection and secure storage of my child’s data, including demographic information, attendance, and participation records, solely for program management and reporting purposes. I understand that this data will remain confidential and will not be shared without consent.

I consent to my child’s information being used in anonymous, aggregate evaluation and reporting to improve program quality and fulfill grant reporting obligations. No identifying information will be disclosed.

Optional Consent – Not Required for Participation

Please select yes if you consent to the following:

I consent to photographs or video of my child being used in promotional or social media materials for BFIT Big Dreams Youth Inc. *

Yes

No

I consent to receiving periodic program updates via text or email. *

Yes

No

Permission & Waiver

By signing below, I grant permission for my child to participate in all summer enrichment activities and authorize emergency medical care if necessary. I also acknowledge that BFIT Big Dreams Youth, Inc. is not responsible for lost or damaged personal belongings.

Parent/Guardian Signature*

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Date

Month

Day

Year

Big Dreams Summer Enrichment Experience

$250

2.5% Service fee included

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