Grace-Village Foundation
A helping hand for families in transition
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Day Camp Application Form
Company Name
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First Name
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Last Name
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Address
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City
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State
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Zip Code
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Primary Phone Number
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Secondary Phone Number
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Age
3-8
9-12
13-17
18-39
40-59
60+
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Gender
Male
Female
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Email Address
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Website
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Emergency Contact
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Contact's Phone Number
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How many are in your party?
1
2
3
4
5
6
7
8
9
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Please list the first and last name as well as the sex and age of each additional member in your party.
Your Parties Information
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Special considerations
Please indicate any special considerations or needs of any Applicants in this party.
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Additional information
Please let us know any other information that may help us serve your family camp experience.
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Disclaimer Grace Village sponsors camping activities for Families. Grace Village does not assume responsibility for any adult or child who attends a Grace Village sponsored event. The Applicant assumes and maintains all responsibility, to include but not limited to the safety, security and conduct of themselves and each person in their party. Applicant is responsible for conformity for themselves and each person in his/her party, to - all Local, State and Federal Laws, Rules and Regulations of all State and National Parks or Private Facilities. Applicant is responsible any required individual permits for themselves and each person in their party. Grace Village only provides accommodations and activities unless otherwise specified in our Programs. Food and Beverage, Clothing, Supervision, Medical Care and all other needs are the responsibility of Applicant. By signing this application, Applicant understands he assumes all responsibility for all needs and activities of all persons in Applicant’s party.
I agree to terms and conditions
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No
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