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Get Insurance Information Chatham Music And Arts Day Camp Coll - Chatham

Urned to camp by June 1, 2012 in order for your camper to attend camp. Primary Caregiver I Primary Caregiver II Address Address City/State/Zip: City/State/Zip: Phone (H) (W) Phone (H) (W) Cell Phone Email Cell Phone Email If the above cannot be reached, in case of emergency, please contact: Name Relationship: Address Home Phone ( ) City/State/Zip Work Phone ( ) INSURANCE INFORMATION I authorize Chatham s Day Camp, or its authorized representatives, to take whatever actio.

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