Summer Camp Registration Form

Welcome to Energy’s Summer Camp Registration Form

Please read the following content carefully. By signing below, you confirm that you have reviewed and understood the information provided.

Thank you for your interest in signing your child up for our program. It’s going to be a great summer!

As you complete this online form, you will fill out the following sections:

  • Registration Form
  • Camp Selection Form
  • Medical Information Form
  • Immunication Record and Proof of Physical Exam
    • Must be within 12 months
  • Liability Waiver
  • Camper Release Form

You will also review the following:

  • Pricing Information
  • Policies & Procedures
  • What to Bring to Camp / Typical Daily Schedule
  • Prescreen Your Camper at Home

Registration will not be complete until all required sections have been filled out and submitted. Once your submission has been reviewed and approved, you will receive a confirmation email finalizing your child’s registration. Please note that your child’s registration is not finalized until you receive this confirmation email.

Payment Information:

Payment is due at the time of registration. Prior to June 1st, those paying by credit card will be charged a 50% deposit. The remaining balance is due on June 1st and will be automatically billed to your credit card. For those registering after June 1st, payment in full is due at the time of registration.

Note: Some policies, forms, or immunization requirements may change as a result of local, state, or federal regulations. You will be notified if any updates are required.

Please E-mail or give us a Call should you have any questions that have not been addressed in this form.

We look forward to sharing the summer with your child!

How Did You Hear About Us?

Camper Information

Parent/Guardian Information

Emergency Contact Information

Prescription Drugs: Written physician’s directions should accompany any prescription medicines sent to camp for the staff to dispense, and should be in the original container, labeled by the pharmacist. These directions must include: medication, dosage, frequency, condition being treated, physician’s signature, and DEA Number.

Administration of First Aid: If needed, the Health Care Supervisor will administer basic first aid to your child.

Emergency Protocol: I understand that I will be contacted as soon as possible in the event that my child is brought to Newton Wellesley Hospital for treatment. If I am not available, please provide an alternate contact:

Alternate Emergency Contact

Billing Information