Registration Forms - A Step Ahead Day Camp

Before you start...

Please have a completed immunization form completed BEFORE you fill out the rest of this form as it's required to complete it. You can upload a copy of your child's MyChart data, retrieve they records off the Wisconsin Immunization Registry website or download the State's Child Care Immunization Record form from our website to complete and upload.

Enter an email address where we'll send a copy of this registration form.*

Camper Information

Camper's Name*

First Last Nickname (if applicable)

Camper's Birthdate*

Please note: your camper MUST be at least 5 years on their first date of camp. (i.e. if they start camp on 7/1/25, they must be 5 by that date.)

Select the grade your child will be in September 2026*

Select your Camper's Shirt Size*

Camper's Address*

Street Address City State ZIP Code

Camper's Parent/Guardian

All parents / guardians are permitted to visit during center hours and are allowed to pick up the child unless access is prohibited or restricted by a court order. Attach court order, if any. If the child resides at multiple locations, the department recommends the provider obtain and attach a schedule.

Parents / Guardians*

Please provide info on ALL PARENTS/GUARDIANS. Include contact information where you will be reachable while your child is at A Step Ahead Day Camp. (Add additional parents/guardians by clicking the plus at the end of each line.)

Name (first and last)

Relationship to Child

Primary Phone Number

Secondary Phone Number

Email

Place of Employment

Does the child live with this person?

Does this person want to receive camp update emails?

Authorized Person(s)

Persons OTHER THAN PARENTS/GUARDIANS LISTED ABOVE who are authorized to pick up the child or accept the child if dropped off. (Add additional authorized persons by clicking the plus at the end of each line.)

Name (first and last)

Relationship to Child

Primary Phone Number

Secondary Phone Number

Email

Place of Employment

Emergency Contact(s)*

Emergency contacts are to help locate the parents, if you would also like to authorize them to also pick-up your child, please add them to the authorized persons section above. (Add additional emergency contacts by clicking the plus at the end of each line.)

Name (first and last)

Relationship to Child

Primary Phone Number

Secondary Phone Number

Email

Place of Employment

Will someone other than parents or authorized people noted above be picking up/dropping off this camper? Do you need to provide special consent for your child to arrive/leave on their own, without parents or with someone NOT on the authorized persons list above?*

i.e. "Camper is allowed to ride their bike to/from camp without supervision".

Alternate Arrival

Please tell us where your child will be coming from, his/her mode of transportation, the time of day and any specific days of the week affected. PLEASE BE AS SPECIFIC AS POSSIBLE.*

(i.e. My son Jack will be riding his bike to Camp every morning by 7:30am.)

My child will arrive from this destination*

Alternate Departure

Please tell us when your child will leave Camp, his/her mode of transportation, the time of day and any specific days of the week affected. PLEASE BE AS SPECIFIC AS POSSIBLE.*

(i.e. My son Jack has my permission to ride home with the Smith family.)

My child will travel to this destination*

Additional Information

Anything else we need to know?

Tell us more about your Camper

Please rate items as to what's most important for THIS CAMPER this year.

How good of a swimmer is THIS CAMPER right now?

Please rate 0 being the lowest, 10 being the highest.

Are there any comments or concerns you have regarding THIS CAMPER swimming at camp this year?

List the activities in which THIS CAMPER excels right now.

What skills or talents would you like to see introduced or stressed this year?

What does THIS CAMPER do in his/her free time?

What are THIS CAMPER's favorite school subjects?

Does THIS CAMPER play a musical instrument? If yes, which one(s)?

Does THIS CAMPER have any siblings or friends who will be at the camp this year? If yes, please list their names/ages.

Please READ AND ACCEPT the following terms and conditions:

A Step Ahead Day Camp LLC Terms & Conditions:*

1. I understand that the A Step Ahead Day Camp (hereafter “Camp”) serves participants between Camp hours specified on the website. It is essential for me to pick-up and drop-off my camper during the times specified. Parents whose children remain past the times specified must pay overtime fees as follows: 5-15 minutes overtime = $25.00 per camper and each additional 1-15 minutes = $25.00 per camper.

2. If any contact information, medical history or emergency contacts change while my camper is attending the Camp, I will notify Camp staff immediately.

3. I understand that A Step Ahead Day Camp LLC cannot serve campers who display chronically disruptive behavior. Chronically disruptive behavior is defined as verbal or physical activity which may include, but is not limited to such behavior that: requires constant attention from Camp staff, inflicts physical or emotional harm on other campers, abuses Camp staff, or ignores/disobeys the rules which guide behavior during the program time. For the safety and general welfare of all campers, the Camp reserves the unrestricted right to dismiss a camper whose conduct or influence, in the opinion of the director, is detrimental to the best interests of the Camp.

4. Due to the seasonal nature of Camp and the set limitation on spaces offered, no refund shall be provided for absences, changes, withdrawal, or dismissal for cause. There will be no refund of tuition for any days that a camper misses due to illness or vacation. I understand that in the event of any absences during program hours or activities, I will be responsible for fees during time reserved, not actual time spent in the program. I will give 30 days notice in writing, prior to withdrawal from the program, during which time I will be responsible for payment of fees.

5. ASSUMPTION OF RISK AND HOLD HARMLESS AGREEMENT. Our Camp takes place both indoors and outdoors and includes activities that are adventurous and challenging. All Camp activities contain certain inherent risks. Our purpose for this disclosure is not to cause you undo concern but to inform you of the risks connected with the fun, adventure, and challenge of all Camp programs. You, as a parent/guardian of your child(ren), are aware of the inherent risks of injury, death, and property damage involved in Camp activities. This includes but is not limited to swimming, hiking, trampoline, nature activities, playgrounds, sports, etc. You, as parent/guardian, shall indemnify, defend, and hold harmless A Step Ahead Day Camp LLC and its officers, directors, shareholders, employees, contractors, agents, owners of property used/leased by A Step Ahead Day Camp LLC and representatives (collectively) against all liability demands, claims, costs, losses, damages, recoveries, settlements incurred by indemnities(“losses”) regardless of cause other than gross negligence, known or unknown, arising from your child(ren)’s participation in A Step Ahead Day Camp LLC activities.

I have read the Terms of Agreement above and understand its terms and accept its conditions. I understand the stated policies and procedures of the A Step Ahead Day Camp LLC as stated above, and give my camper permission to participate fully in this program.

Please Provide Your Consent to the Following:

FERPA Request to Withhold Directory Data*

The Family Educational Rights and Privacy Act (FERPA), a federal law, requires A Step Ahead Day Camp LLC, with certain exceptions, to obtain your written consent prior to the disclosure of personally identifiable information from your child’s records. The primary purpose of directory information is to allow the camp to include this type of information from your child’s records in certain camp publications. Examples include: a playbill with your child’s role in a production, recognition lists and a Camp newsletter.

I CONSENT

I DO NOT CONSENT

Camp Web Publishing & Photo/Video Release*

A Step Ahead Day Camp LLC frequently uses photos and video in their publications as well as media in the community. Examples include: local newspaper articles and ads promoting the Camp, Camp newsletters, videos taken by the Camp, and the Camp's website. All photos and video are approved by A Step Ahead Day Camp LLC. This footage may be used in future publicity of A Step Ahead Day Camp LLC.

I CONSENT

I DO NOT CONSENT

Field Trip Permission*

One of the highlights of your child’s experience at A Step Ahead Day Camp will be the daily local excursions and field trips. In order to do so, we need your authorization for your child to leave the A Step Ahead Day Camp LLC premises (base camp) for field trips and excursions on contracted transportation vehicles (school/coach busses) as well as walking to local excursions. Examples include: parks, libraries, swimming pools, bowling allies and local businesses.

I give permission for my child to participate in TRANSPORTED field trips and other activities during operating hours.*

YES

NO

I give permission for my child to participate in WALKING field trips and other activities during operating hours.*

YES

NO

Anything else you'd like to add?

Signature

Parent, Guardian or Legal Custodian Signature

	Not Important	Neutral	Very Important
Academics
Make New Friends
Improve Self Esteem
Improve Social Skils
Enhance Athletic Skills
Experience New Activities
Gain Greater Independence

COMPLETE 2026 CAMP REGISTRATION FORMS

Please fill out a separate set of forms for each child participating in camp this year.

Before you start...

Camper Information

Camper's Parent/Guardian

Alternate Arrival

Alternate Departure

Additional Information

Medical Information

Medical Conditions

Allergies

Medications

Immunizations

Sunscreen / Insect Repellent Authorization

Tell us more about your Camper

Please READ AND ACCEPT the following terms and conditions:

Please Provide Your Consent to the Following:

Signature

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