Colonial Kids’ Camp 2011 What was it like to be a kid in 18th century colonial Bridgehampton? Come spend five days with us to find out! Tour the Corwith House Museum and see how you would have dressed, played, and lived in Colonial times. Learn to decorate a floor cloth, stencil designs, and how to eat, play and dance like you’re living in 18th century New York! This year’s camp is a collaboration between the Bridgehampton Presbyterian Church and the Bridgehampton Historical Society, but of course a traditional field trip to Splish Splash Water Park in Riverhead will also be included. July 11-15 and August 29-Sept. 2 9am-2pm Children Grades K-6 $140 per child Scholarships and discounts for multiple children available. Snacks, drinks, crafts, and field trips included. Please pack a bag lunch each day. www.bridgehamptonpc.org, [email protected], 631.537.3521 www.bridgehamptonhistoricalsociety.org, [email protected], 631.613.6730 Colonial Kids’ Camp 2011 Registration: Child’s First and Last Name:______________________________________________________ Child’s Age: _______________________ Child’s Birth date: ____________________________ Parent’s Name(s): _______________________________________________________________ Parent’s Email: _________________________________________________________________ Mailing Address: _______________________________________________________________ (Mom) Home Phone: _________________Work: _______________Cell: __________________ (Dad) Home Phone: __________________Work: _______________Cell: __________________ Medical Information: Does your child have any allergies or special needs that we should be aware of? _____________ ______________________________________________________________________________ Emergency Contact, other than parents (name and phone):_______________________________ ______________________________________________________________________________ In case of an Emergency, we the Bridgehampton Historical Society is authorized to seek medical attention from emergency services and/or: Doctor: _____________________________Phone: ____________________________________ Address: ______________________________________________________________________ Dentist: _____________________________Phone: ____________________________________ Address: ______________________________________________________________________ As parent, legal guardian or agency representing the child named above, I hereby give consent to enroll my child in the specified program(s) operated by the Bridgehampton Historical Society (BHHS) and the Bridgehampton Presbyterian Church (BPC). I recognize that my child must follow safety instructions, remain in areas designated by staff, and refrain from behavior that is harmful to him/her or others. Failure to do so will result in dismissal from the program without refund. The BHHS and BPC staff will do its best to ensure a safe experience, however I understand that accidents do occur. I hereby release BHHS and BPC from any and all responsibility and liability of any nature resulting in my child’s participation in any program accident including claims for any injury, illness, death, loss or damage. I have informed camp staff of my child’s medical conditions/needs. All information given is accurate and true to the best of my knowledge. Signature: ______________________________________ Date: _________________________ www.bridgehamptonpc.org, [email protected], 631.537.3521 www.bridgehamptonhistoricalsociety.org, [email protected], 631.613.6730
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