Heritage Landing Summer Camp Participant Information and Registration

Child's Name

Child 2 (If Applicable)

Child 3 (If Applicable)

Early Bird Special Expires 4/1 Coupon Code: SUMMER24 (EXPIRED)

Week 1 Camp June 3rd-7th (FULL CLOSED)

Select all that apply:

Week 2 Camp June 10th-14th (FULL CLOSED)

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Week 3 Camp June 17th-21st (FULL CLOSED)

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Week 4 Camp June 24th-28th (FULL CLOSED)

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Week 5 Camp July 1st-5th (Short Holiday Week NO CAMP)

Week 6 Camp July 8th-12th (FULL CLOSED)

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Week 7 Camp July 15th- 19th

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Week 8 Camp July 22nd- 26th (FULL CLOSED)

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Swimming

Our Summer Swimming session is not instructional, just a time for kids to splash around and cool off.  It is also optional if you wish for your child not to particpate they can stay indoors during that time.  Please answer the questions below. 

Please don't forget to enter the coupon code below to get your. EARLY BIRD DISCOUNT (EXPIRED)

Early Bird Special Expires 4/1 Coupon Code: SUMMER24 (EXPIRED)

Current Total:
$0.00

Adult Primary Contact 1

Relationship to Participants: *
 

Adult Primary Contact 2

Relationship to Participants:
 

Emergency Contact

Primary Care Pediatric Contact

Sports and Arts Participation Waiver

Please Sign Below: *
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Sports and Arts Covid Waiver

Signature *
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HERITAGE LANDING Summer Camp Waiver

Signature *
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PRIVACY NOTICE: Under Florida’s Public Records Law, Chapter 119, Florida Statutes, the information you submit
on this form may become part of a public record. This means that, if a citizen makes a public records request, we
may be required to disclose the information you submit to us. Under certain circumstances, we may only be
required to disclose part of the information submitted to us. If you believe that your records may qualify for an
exemption under Chapter 119, Florida Statutes, please notify the District Manager.
NOTE TO STAFF: THIS FORM MAY CONTAIN CONFIDENTIAL INFORMATION. DO NOT DISCLOSE ITS CONTENTS
WITHOUT FIRST CONSULTING THE DISTRICT MANAGER.

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