Please print and mail application to:

• All Nations Center
• P.O. Box 187  
• Wapato, WA  98951

(You may also bring it to the office)

All Nations Center Day Camp

AGES 6 - 17

Parent/Guardian Name

Address

Phone

Child’s Name                          Age         Gender       Allergy, yes or no

Child’s Name                          Age         Gender       Allergy, yes or no

Child’s Name                          Age         Gender       Allergy, yes or no

Child’s Name                         Age         Gender       Allergy, yes or no

      Spiritual lessons, Crafts, Health, Swimming, Water Fight/Games, Hiking, Community Outreach

Breakfast, Lunch and a Snack Included

Permission For Off-Site Activities

I, ______________________

give permission for my child,

 _______________________

to travel to the off-site activities under the supervision of the All Nations Center Day Camp Staff.

Signed                                                                                                                                  Date

Are you willing to have your children’s’ images shared in advertising?

Yes_______

No_______