Earthworks 2017 Summer Programs


Please fill out this form once for each child you wish to send to camp.

Name(s) and relationship of other people dropping off or picking up your child

Medical Information & Release

I hereby give permission to transport my child by ambulance when urgent medical care is deemed necessary by the EarthWorks staff. I understand that the family is responsible for the cost of this transfer. I hereby give permission for the hospital emergency room staff to render any and all EMERGENCY care before a parent/guardian arrives.

Please note: We publish photographs of camp activities on our website and send to parents by email at the end of every day. We need your permission to include your child's picture in these parent emails.

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