Summer Camp Registration Form

After purchasing, please fill out the following form in order to complete registration for our DelMNS Summer Camp programming. Campers may not attend camp until registration is confirmed by DelMNS staff. Only one set of forms is required per camper, regardless of how many camps that child is registered for.

This required form, and all additional requirements herein, must be completed, submitted and received by DelMNS staff a minimum of THREE WEEKS prior to the start of your child’s first camp date. If these conditions are not met by that date, your camp registration will be cancelled, as per our cancellation policy. If you have any questions, please contact us at camps@delmnhs.org.

Summer Camp Registration

Parent/Guardian Information

First
Last
Address *
Address
City
State/Province
Zip/Postal
Country

Child Information

Weeks attending camp (check all that apply)
Immunization Records
Allergies & Medication *
Epi-Pen/Auvi-Q – If the child listed above has been prescribed an Epi-Pen/Auvi-Q, please include a FARE Emergency Care Plan with your Epi-Pen/Auvi-Q. The auto-injector must be with the child at all times and they must know how to self-administer.
Delaware Museum of Nature and Science has a Medical Response Team, however they are not permitted to administer medication under current Delaware law.

Physician and Insurance Information

Emergency Contacts & Authorized Adults

Please include below at least THREE contacts (INCLUDING PARENTS) in order of whom we should contact in regards to the child listed above. Please include anyone that has permission to pick up the child, as they will only be released to the individuals listed below. Any adult picking-up the child from a program, MUST be listed below, and will be required to provide photo I.D.
First
Last
First
Last
First
Last

Additional Emergency Contacts

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Last