FSBC Membership Status

Are you an active FSBC member?

Camper Information

Last Name

First Name

Date of Birth

Grade in 2026-2027 School Year

Please choose the grade that your child will be entering next school year. Camp enrollment is open to rising kindergartens - rising 6th graders.

With which gender does your child most identify?

Allergies or Medications

If your child has severe allergies or medical conditions, please check reach out to FSBC prior to registration so that we can be certain that we are equipped to handle any potential emergencies.

Pediatrician Name

Pediatrician Phone

Do we have your permission to apply sunscreen?

Current Swim Level

If your camper is on the swim team, would you like them to attend AM practice?

Additional Information/Requests

Let us know if there is anything we can do to help your child love camp! If you would like your child placed in a group with another camper, let us know that here as well.

Contact Information

Parent/Guardian 1 Name

Parent/Guardian 1 Email

Parent/Guardian 1 Phone

Please enter as (xxx) xxx-xxxx

Parent/Guardian 2 Name

Parent/Guardian 2 Email

Parent/Guardian 2 Phone

Please enter as (xxx) xxx-xxxx

Emergency Contact Name

Emergency Contact Phone

Please enter as (xxx) xxx-xxxx

Person(s) authorized for camp pick-up (in addition to parents/guardians)

Liability and Release

I am registering the named camper for FSBC Summer Camp. I give permission for the named camper to participate in all aspects of camp. I recognize that camp programs include, but are not limited to, certain physical activities which may pose some risk of injury. I knowingly and freely assume all such risks associated with FSBC Summer Camp, both known and unknown, and assume full responsibility for my child's participation.

I expressly agree to indemnify, hold harmless, defend, and reimburse FSBC, its directors, agents, employees, for any and all losses, damages or injuries arising out of, in connection with, or during the above-named child's participation in FSBC Summer Camp, to include but not limited to attorney’s fees, court costs, and any costs incurred for the rendering of any emergency medical procedures or treatment.

In the event that I cannot be reached in an emergency involving the named camper, I hereby give permission to the appropriate medical personnel, selected by FSBC personnel, to provide medical treatment deemed necessary by such personnel. I agree to be responsible for all charges incurred in the treatment of the participant regardless of whether my insurance covers such charges.

Agreement of Camp Policies

I understand that I will pick up my child as soon as possible, if notified by FSBC that they have become ill while at camp.

The FSBC Camp Director reserves the right to dismiss any camper who violates camp rules or is judged detrimental to the general welfare of the camp or other campers. No refund will be made in case of dismissal.

I understand that camp registration fees are refundable until April 1, 2026 less a $65/session cancellation fee. After April 1, refunds will not be granted.

I understand that if I am more than 5 minutes late to pick up my camper(s) according to the designated pick-up time for my registration, FSBC will charge me $15.00. Pick-up times are 12:30 PM for morning campers, 4:30 PM for afternoon and full-day campers, and 5:00 PM for afternoon and full-day campers who have purchased the extension.

Photo Release

I hereby grant FSBC permission to use my child's likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration.