Traditional Camp (ages 5-11 years) Check the date(s) you wish to attend.

All days are 9:30am to 2:30pm except Sunday* which is 12pm to 5:00pm  

Mon., March 22___  Tues., March 23___  Wed., March 24___  Thurs., March 25___  Fri., March 26___  Sat., March 27___ 

Sun., March 28*___   Mon., March 29___  Tues., March 30___  Wed., March 31___

Youth Camp (ages 12-15 years)

Tues., March 30___

Please print the following information:

Child's name (nickname?)_______________________________________________________________________

   

Name of parent(s) or guardian(s)_________________________________________________

Address:_______________________________________________________________

                       (# and Street)                                                                   (City, State)                                     (Zip)

Home Phone _____________________________    Work phone _________________________________

 

Cell Phone _____________________________     Email________________________________________

 

Child’s grade: _____________ Child’s age: _____________      Child’s date of birth: ____________________

In case of emergency we call the above phone numbers OR: (please list an alternate)

 

 Name:______________________________________________     Phone:________________________________

Physician's Name:_________________________________           Phone:__________________________________ 

Does the child have allergies, special needs, or other restrictions?        Yes         No

If “yes”, what are they?___________________________________________________________________________

(If needed, please use the back of this registration form to describe the restrictions.)

 

Sunrock Farm reserves the right (1) to refuse registration for health reasons. For example, the farm environment may not be good for children with severe hay allergies;  (2) to cancel camp days due to insufficient registration or extreme weather conditions (with full refund).  A confirmation will be sent to acknowledge your registration.

Camp fee is $50 per day.  Please send check/money order (sorry no charge cards) along with this form to:

Sunrock Farm, 103 Gibson Lane, Wilder, KY  41076       Phone: 859-781-5502   Fax:  859-572-0260

Refund Policy:  There will be a $15 per camper non-refundable processing fee charged for cancellations. The balance of the fee is refundable ONLY in the case of serious illness or accident (with a physician’s statement), or death in the immediate family.

 

"I give my child permission to attend spring break camp.  I agree not to send my child to camp unless she/he is in good physical condition and has not been exposed to a communicable disease.  My child has permission to receive emergency medical care.  I understand that photos of camp activities my be taken during the course of spring camp and used in advertising Sunrock Farm".

Signature of parent/guardian________________________________________________  Date_________________

Comments/special requests_______________________________________________________________________

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For office use only:  Date registration form received at Sunrock____________ 

Check amount__________________________  Check number and date____________________________