Porter IN Childcare | Registration at Parents as Teachers of Porter County

Registration

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Child's Name
Parent's Name
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Child's Age
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Medical Conditions
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Emergency Phone
Interested In:	June 17 - 20 "Messy Camp" (9am - 12 noon) 3-6 year olds, $75
	July 8 - 11 "Science Camp" (9am - 12 noon) 3-6 year olds, $75
	July 15 - 18 "Mystery Camp" (9am- 12 noon) 3-6 year olds, $75
Policies:	I give permission to Parents As Teachers of Porter County to take immediate action if my child should need immediate medical attention in the case of an emergency. I understand I must be accessible during camp hours by one of the phone numbers provided. If I am not available I will ensure the emergency contact can be reached if needed.
	I consent to having my child photographed for the purpose of documenting summer camp and for use in publications for the purpose of positive promotion of Parents As Teachers of Porter County and/or Porter County Parks.
	I agree to make immediate payment.
Comments
Notes	You will receive confirmation of your enrollment upon receipt of this form. Please note payment must be made at the time of registration. ONLY PAYMENT WILL SECURE YOUR SPOT. Once paid on our secure payment site, you will receive immediate confirmation of payment. PAYMENT CAN BE MADE BY CREDIT CARD OR ELECTRONIC CHECK. Camp information will be emailed to you two weeks prior to the start of camp. Questions in the meanwhile can be directed to 395-8412 or email to info@patpc.org. 　 ONCE YOU HAVE SUBMITTED THIS FORM YOU WILL BE DIRECTED TO PAYMENT SITE