Huntersville Family Fitness & Aquatics


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Are you a HFFA member? Yes_____ No_____ KeyTag#__________________ Child's Name:______________________________________________________________________________________ Date of Birth:_____/____/_______ Age ____________ Rising grade ______________ Mother's Name: ____________________________________________________________________________________ Email:___________________________________________________________ Address_______________________________________________________________________ City:____________________________________________State:_________________________Zip:__________________ Home Phone:_____/_____/ ______Cell Phone:_____/_____/ ________Work Phone:_____/_____/ ______ Father's Name: _____________________________________________________________________________________ Email:____________________________________________________________ Home Phone:_____/_____/ ______Cell Phone:_____/_____/ ________Work Phone:_____/_____/ ______ Does your child have any allergies? ___Yes ____No If yes, what? _______________________________________________________________________________________ ____________________________________________________________________________________________________ Please list any other medical conditions: ____________________________________________________________ ____________________________________________________________________________________________________ Emergency Contacts: (persons allowed to sign your child out of the program): Name: _______________________________Relationship to child: _________Phone # ______/______/__________ Name: _______________________________Relationship to child: _________Phone # ______/______/__________ Week Date Theme Select your desired week(s) 1 June 13-17 High Tide at the Poolside o 2 June 20-24 Future Famous Artist o 3 June 27-July1 Superhero, Super Fun o 4 July 5-8 Fantasy Fun o 5 July 11-15 Space is the Place o 6 July 18-22 Treasure Hunters o 7 July 25-29 Creative Campers o 8 August 1-5 Getting' Dirty, Havin' Fun o 9 August 8-12 Just Clowning Around o 10 August 15-19 The Mighty Jungle o Please complete this application; one application per child. When complete either snap a photo or scan the application and e-mail it to, mail it to HFFA, Attn: Rebecca Taylor, PO Box 1979, Huntersville, NC 28070 or bring it to HFFA Guest Relations Desk. Staff use only: Received:_______ E-mailed:______ Account Confrmed: _______ Billing Confrmation:_______ Preschool - 1/2 Day Camps Registration Form (One Per Child) 2016 SIZZLIN' SUMMER CAMPS R1

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