Camp Registration - Town of Bristol, Rhode Island

2023 Bristol Parks & Recreation Summer Camp Registration

Pre-App

Camper Info

Contact Info

Alternate Contacts

Review & Sign

Pick-Up Form

Busing Form

Uploads

Pay

Bristol Parks & Recreation Summer Camp 2023

Location: Bristol Town Beach & Sports Complex (50 Asylum Rd. Bristol, RI)

Camp Dates: June 21, 2023 – August 4, 2023 (No Camp on July 3rd, 4th or 5th)

Camp Hours: 9:00am – 3:00pm

Ages: Bristol Residents 6-14yo. (must be 6yo. by the first day of camp)

Fee: $300 per camp (includes lunch and busing* if needed) and $250 for each additional sibling

To apply, please complete this online registration form.

Required Registration Attachments
• Two (2) proof of Bristol residency documents (Example: utility bills, property tax bills, etc.)
• Child's birth certificate (1st year at Camp Poppasquaw only)
• $300 camp fee ($250 sibling fee)

Please Note: Registrations are not considered complete until all requested forms and payment in full have been received.

Disclaimers
• The Town will dismiss a child from Bristol Parks & Recreation Summer Camp with forfeiture of payment if it is determined at a later date that any information provided on the registration form was misleading or falsified.
• The Bristol Parks & Recreation Department reserves the right to close out the camp registrations before or after the posted deadline.
• Bristol Parks & Recreation Summer Camp Parent Handbook, Bus Schedule, Drop-Off/ Pick-Up Locations, and any additional information will be sent out prior to the start of Camp.

*Busing Pick-up/Drop-off Locations: Town Common, Vets Park, Coelho Park, Sowams Park, Cedar Crest Park & Rockwell School)

Please call us with any questions at 401-253-1611.

Child's First Name*

Child's Last Name*

Child's Date of Birth*

Please click the text field to use the built-in calendar or type the camper's DOB manually. Please ensure the correct year is inputted.

Please select

Please select
Rockwell Elementary
Colt Andrews Elementary
Guiteras Elementary School
Our Lady of Mount Carmel
Kickemuit Middle School
Mt. Hope High School
Home Schooling
Other

Child's School*

Please select

Please select
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
Other

What grade is your child going into?

Please select

Please select
Male
Female

Child's Gender*

Child's Eye Color*

Child's Hair Color*

Child's Height*

Child's Weight*

Please select

Please select
Youth Small (YS)
Youth Medium (YM)
Youth Large (YL)
Youth Extra Large (YXL)
Adult Small (AS)
Adult Medium (AM)
Adult Large (AL)
Adult Extra Large (AXL)

Child's Shirt Size*

Primary Address*

Sibling(s) in Camp

Please provide the full name(s) and age(s) of the sibling(s) also in camp. Please Note: A separate application is required for each camper.

Emotional/Behavioral Issues

Child's Medication

Please Note: Medications are not dispensed by staff.

Allergies

Food Allergies

Child's Health Insurance Carrier*

If your child does not have health insurance, please put 'N/A'.

Child's Health Insurance Policy Number*

Other Important Health Information

Other Information

Please provide any additional information that should be known by Camp Poppasquaw staff.

Parent/Guardian 1 First Name*

Parent/Guardian 1 Last Name*

Parent/Guardian 1 Address*

Parent/Guardian 1 Town*

Parent/Guardian 1 State*

Parent/Guardian 1 Zip Code*

Parent/Guardian 1 Email Address*

Mobile Phone*

Home Phone

Work Phone

Parent/Guardian 2 First Name

Parent/Guardian 2 Last Name

Parent/Guardian 2 Address

Parent/Guardian 2 Town

Parent/Guardian 2 State

Parent/Guardian 2 Zip Code

Parent/Guardian 2 Email Address

Mobile Phone

Home Phone

Work Phone

Please provide two (2) emergency contacts other than a parent/guardian.

Emergency Contact 1 First Name*

Emergency Contact 1 Last Name*

Emergency Contact 1 Address*

Preferred Phone*

Relationship*

Emergency Contact 2 First Name*

Emergency Contact 2 Last Name*

Emergency Contact 2 Address*

Preferred Phone*

Relationship*

In Case of Emergency:*

I understand every effort will be made to contact parents/guardians of campers. In the event that I cannot be reached, I hereby give my permission for the following: The Camp Director may secure proper treatment which may include hospitalization and x-rays if deemed medically necessary by him/her for my child.

Parent/Guardian Signature*

Date*

Photographs/Publicity:

I hereby give permission for photos of the above enrolled child to be used for publicity purposes, public relations and/or camp promotion materials.

Parent/Guardian Signature

Date

Liability Waiver:*

I realize injuries can occur from participation in sports and other activities. I hereby waive, release, absolve, indemnify and agree to hold harmless the Town of Bristol, Department of Parks & Recreation, their Directors, Instructors or Assignee from any claim arising out of injury to my child or myself.

Parent/Guardian Signature*

Date*

Child's Full Name

List up to five (5) people who are authorized to pick up your child from camp.

Please include the first name, last name, and contact phone number of the person(s) authorized to pick up your camper. In addition, please provide your relationship to them.

• Persons picking up your child must present a state-issued driver’s license or photo identification card before the child is released from the camp.
• Only the persons listed above will be able to pick your child up from camp.
• Person picking up your child must remain in their vehicle at the designated pick-up location (you will receive designated drop-off/pick-up locations in your Parent Handbook prior to the start of the camp season.
• If the child is being picked up before the end of the camp day, please call our office at 401-253-1611 to alert our staff of the early pickup.

By signing below, I acknowledge that I have read and understand all of the terms listed above.

Parent/Guardian Signature

Parent/Guardian Printed Name

Date

Busing will return to Camp Poppasquaw for the 2022 camp season.

The bus schedule will be sent with the Camp Poppasquaw Parent Handbook ahead of the start of camp on Wednesday, June 22nd, 2022.

There will be supervision on the bus, but not at the bus stops. Supervision begins once your child enters the bus. In the case that there may need to be (2) bus pick-ups at a location, a staff member will remain at that location in between the first and second bus trips.

Please select

Please select
Town Common (at the corner of Church St. & High St.)
Veteran’s Park
Rockwell School
Cedar Crest Park
Sowams Park
Coelho Park
My camper will not be taking the bus.

Bus Pick-Up/Drop-Off Locations*

Proof of Residency 1*

Upload

*(i.e. tax bill, utility bill, bank statement, cell phone bill, etc.)

Proof of Residency 2*

Upload

Birth Certificate of Camper

Upload

*Required for 1st Year Campers Only

Registration Fee*

If paying by credit card, a 3.1% processing fee will be charged at the time of purchase.

Payment Method*

Credit Card

Check

Checks should be made payable to 'Town of Bristol'. The camper's name(s) should be listed on the memo line.

Pay with Credit Card: Users will be prompted to enter their credit card information after clicking the 'Submit' button below. A non-refunable registration fee of $300 and processing fee of 3.1% ($9.30) will be charged to the credit card used. Following a review of the camp application, users will receive a confirmation of their child's acceptance by a Bristol Parks & Recreation employee.

Pay with Check: Checks can be dropped off at 101 Asylum Road, Bristol, RI 02809 during business hours M-F, 8:00 AM-4:00 PM, or by using the front door dropbox.

For additional questions, please contact the Bristol Parks & Recreation Department at 401-253-1611.