Camp Waitlist

Camp(Required)

To be added to the correct waitlist, please select the appropriate camp session.

Child's Full Name(Required)

Child's Date of Birth(Required)

Childs Shirt Size(Required)

Does your child wear glasses or contact lenses?(Required)

Does your child have any known allergies?(Required)

If yes, please list known allergies:

Does your child have any physical or behavioral conditions that could restrict activities or require special accomodation? (Examples: epilepsy, diabetes, ADHD, ASD, etc.)(Required)

If yes, please explain:

NOTE: Museum staff is not allowed to administer any medication. If your child needs medication during the program, you or someone you designate in writing must administer that medication. Selecting "Yes" signifies your consent that you recieved this notice.(Required)

Photo/Image Waiver and Release: I authorize and give consent to the usage of photographs or other images of my child by the Witte Museum, or any of its affiliated organizations and sponsors, for publicity, advertising, or any other legitimate business purposes.(Required)

Parent/Guardian Full Name(Required)

Parent/Guardian Home Phone(Required)

Parent/Guardian Cell Phone(Required)

Parent/Guardian email(Required)

Name(Required)

Address:(Required)

City(Required)

Country(Required)

Zip Code(Required)

Emergency Contact 1, Name and Phone Number(Required)

Emergency Contact 2, Name and Phone Number(Required)

Consent is hereby given for the applicant to attend the Witte Museum Camp program and permission is given for all emergency medical treatments, operation, or anesthesia, which might become necessary.(Required)

By signing electronically, with initial and date, you agree to all that is above.

Camp Waitlist

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