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2010 Fire Museum of Texas Summer Fire Safety Camp
Campers Needed, Volunteers Welcome!
Questions? Call us at 409-880-3927
Please print and complete the form below. Mail it with your $60 check payable to the Fire Museum of Texas and mail to 400 Walnut St, Beaumont, TX 77701
Please note: Space is limited to 20-22 children per session on a first come basis, pre-registration only please...no walk-ins. (You can Postdate a check to June 1, 2010 to save your spot) We are offering one session for 4-6 year olds and 1 session for 7-10 year olds. Camp is held daily from 9:00 am until noon at the Fire Museum of Texas with the exception of the last day. A morning snack and juice is provided. On Friday we visit Station 1 with the younger children and go to the Training Grounds with the older children. Friday is the only day we serve lunch. You will receive a personal invitation and a map to join us for the party on Friday. Please discuss any concerns you may have in advance with the Museum Director before enrolling your child. The FMOT reserves the right to ask a parent to pick up their child and leave camp if safety rules and regulations are not followed. A pre-rated refund may apply. Please do not drop children earlier than 8:45 and please plan to have them picked up by noon.
Registration Form
Choose One: Each Camp is $60 per child
Session I _______June 21-25, 2010 4-6 yrs old Time: 9:00 am- noon
Session II ______June 28-July 2, 2010 7-10 yrs old Time: 9:00 a.m.- noon
Camper’s Name: _________________________________________
Camper’s Address: _______________________________________
City: _______________________Zip: _______________
Camper’s Phone Number: _______________________
Parent’s Name: _______________________________
e-mail________________________________________
Parent’s Phone Numbers: Home _____________________________
Work _____________________________
Cell/Mobil - _________________________
Place of Employment: ______________________________________
In case of emergency contact:
Name:_________________________________
Contact Number: _______________________or _________________
Known Allergies: __________________________________
Medication currently taking___________________________
T-shirt size of Child: youth sizes - small(6-8) medium(10-12) large(14-16)adult sizes - small -medium -large
My child can only be picked up by:
Name: _____________________________
Telephone Number: ______________________
My child ______________________ has my permission to attend the Fire Safety Camp at the Fire Museum of Texas in Beaumont. In consideration of the Fire Museum of Texas allowing my child to attend the Fire Safety Camp, I voluntarily assume all risk of loss, damage, or injury and release the museum from any claim because of loss, damage, or injury of any kind sustained because of such activity. By signing here I also voluntarily give the Museum permission to obtain any medical treatment as might be deemed necessary for him/her in the event of a medical emergency. I agree to pick up my child immediately should he/she not follow the safety rules and regulations as directed by the Camp Staff.
________________________ ________________
Parent’s Signature Date
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