Camper Name *

First Name

Last Name

Session Selection: Full-day

Full-day camp 9am-3:30pm Ages 6-11 *select all that apply

June 23-27

July 21-25

August 25-29

Session Selection: Half-day

Half day camp 9am-12:30pm Ages 4-6 *select all that apply

June 23-27

July 21-25

August 25-29

Parent/Guardian Name *

First Name

Last Name

Parent/Guardian Primary Phone # *

(###)

###

####

Parent/Guardian Secondary Phone

(###)

###

####

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone # *

(###)

###

####

Who else is authorized to pick up you child?

First Name

Last Name

Up to date on vaccinations? *

Yes

No

Almost

If yes, please select reaction:

ANAPHYLACTIC REACTION: systemic, difficulty breathing, REQUIRED EPI-PEN

LOCALIZED REACTION: Pronounced swelling at the site of the sting, REQUIRED BENADRYL

Minimal localized reaction, did not require treatment

I agree to the TERMS and CONDITIONS above *

Yes

PHOTO/VIDEO Release *

I AGREE to the PHOTO/VIDEO release

I DO NOT AGREE to the PHOTO/VIDEO release

Donation

An important part of our mission with OYNA is to make sure money is not a barrier for those who want to pursue this kind of experience for their kiddos. With help from those who are able to donate monetarily, we can offer support for those in need through full or partial scholarships. Any type of donation helps greatly! Material: Part of our mission with OYNA is to be sure that we're reducing waste and sourcing as much re-usable materials as possible. We're always in need of a certain number of items: cardboard boxes!! tape! duct tape, masking tape fabric! old, but clean bedsheets, curtains, etc large plastic tubs (just tops are good too) Other materials: kitchen tools! muffin tins, measuring cups, large spoons, wooden spoons, etc rope pvc pipes carpet rolls (the cardboard part) tools! hammers, box cutters, hand saws, screw drivers, etc paint brushes- any size craft materials-scissors, paper, markers, stickers etc anything that can be rolled, piled, added to one another to make something new ; ) corn starch (for making non-toxic paint) food coloring! tape more tape What kind of donation are you able to make at this time? If you'd like to make a donation, we will coordinate details over email.

Monetary donation to support camper!

Donate material!

Would really love to, but we're unable to at this time.

Donate? No way, Rosé, all day