Please complete ALL FIELDS before submitting your registration form. Thanks, and see you at camp!

Participant Name *
Participant Name
Session/s - Select All That Apply *
Segment/s of Session 1
Segment/s of Session 2
Segment/s of Session 3
Segment/s of Session 4
FSBC Member?
Do We Have Your Permission to Apply Sunblock? *
Swim Level *
If camper is on FSBC Swim Team would you like him / her to attend practice during morning session?
Parent/Guardian 1 *
Parent/Guardian 1
Address *
Address
Home Phone
Home Phone
Work Phone
Work Phone
Mobile Phone *
Mobile Phone
Best Number to Reach Parent/Guardian 1 *
Best Number to Reach Parent/Guardian 1
Parent/Guardian 2
Parent/Guardian 2
Address
Address
Home Phone
Home Phone
Work Phone
Work Phone
Mobile Phone
Mobile Phone
Best Number to Reach Parent/Guardian 2
Best Number to Reach Parent/Guardian 2
Emergency Contact (other than parent) *
Emergency Contact (other than parent)
Emergency Contact Phone *
Emergency Contact Phone
Primary Care Doctor Phone Number
Primary Care Doctor Phone Number
By agreeing, you are confirming you have read and concur with the parameters set forth in the Liability Waiver below. This field is required to complete your registration.
Upon submission, you will be guided to our online payment system. *

Liability Waiver:

I am the parent or legal guardian of a minor child, who I am enrolling in the Fry’s Spring Beach Club, Inc.’s, Summer Camp (Camp) for 2019. I understand that the Camp participants will engage in various activities, including water-related, exercise or playground activities. I understand and accept the fact that such activities are potentially dangerous.  I understand that they have inherent and other risks, including, but not limited to, permanent injury, disfigurement or death. Understanding that such activities may be hazardous, I voluntarily and expressly assume for my minor child the risks of injury as a result of any activities.

I further agree to indemnify, hold harmless and defend FSBC and its officers, directors and employees from any liabilities, losses, damages, attorneys’ fees and court costs that may result from any claims or causes of action arising from my child/ward’s participation in Camp activities and of any use of FSBC facilities.