Please
complete and print this form and mail with payment to: South Shore Natural Science Center
Attn: Camp
P.O. Box 429
Norwell, MA 02061
781-659-2559
Child's name:
DOB:
Grade 9/08: Sex:
Parents' names:
Address:
City:
State: Zip:
Phone:
Home:
Work/Cell Mother: Work/Cell
Father:
Email:
Member Status:
Non-Member;
Member; Business
Member; Expiration Date:
Check all that apply:
This
is a new camper.This is a returning
camper.
Please include me on a
carpool list.Send me a
financial aid application.
Send me a current
program brochure.
Please place
this camper with a friend:
Please Check the Groups, times, and sessions for which you are
registering
Permission Form: IMPORTANT – MUST BE SIGNED FOR ALL CAMPERS My child
has my permission to attend field trips as part of the Nature
Adventures Summer Day Camp at the South Shore Natural Science
Center. I understand that camper groups may walk off Center
property to nearby sites such as Jacobs Pond.
Children in 1st
grade and up may travel by bus to other
field trip locations. I will not hold SSNSC,
its staff, agents or volunteers responsible for any injuries
or accidents during these activities. The
SSNSC and/or authorized parties also has my permission to
reproduce my child's image for publicity purposes.