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Early Bird Registration - Camper Information 2021
Please complete and submit by March 1, 2021
Camper Information
Has your child attended Action Kids summer camp before
Parent Information
Custodial Parent
Custodial Parent
Need Extended Care? Add it here.
Week One ~ June 21 to June 25 ~ Wacky Wizards
Early Care 7:30 to 8:30Whole Week Single Day
Late Care 4:30 to 6 pmWhole week or Single Days
Week Two ~ June 28 to July 2 ~ Star Wars
Early Care 7:30 to 8:30Whole Week Single Day
Late Care 4:30 to 6 pmWhole week or Single Day
Week Three ~ July 6 to July 9 ~ Super Sports (No camp July 5)
Early Care 7:30 to 8:30Whole Week Single Day
Late Care 4:30 to 6 pmWhole week or Single Day
Week Four ~ July 12 to July 16 ~ Disney Mania
Early Care 7:30 to 8:30Whole Week Single Day
Late Care 4:30 to 6 pmWhole week or Single Day
Week Five ~ July 19 to July 23 ~ Ninja Warriorfest
Early Care 7:30 to 8:30Whole Week Single Day
Late Care 4:30 to 6 pmWhole week or Single Day
Week Six ~ July 26 to July 30 ~ Color Wars
Early Care 7:30 to 8:30Whole Week Single Day
Late Care 4:30 to 6 pmWhole week or Single Day
Week Seven ~ August 2 to August 6 ~ Wet N Wild!
Early Care 7:30 to 8:30Whole Week Single Day
Late Care 4:30 to 6 pmWhole week or Single Day
Week Eight ~ August 9 to August 13 ~ Code Name: Spy Kids
Early Care 7:30 to 8:30Whole Week Single Day
Late Care 4:30 to 6 pmWhole week or Single Day
Week Nine ~ August 16 to August 20 ~ Lights, Camera, ACTION!
Early Care 7:30 to 8:30Whole Week Single Day
Late Care 4:30 to 6 pmWhole week or Single Day
Week Ten ~ August 23 to August 27 ~ Summer Rewind
Early Care 7:30 to 8:30Whole Week Single Day
Late Care 4:30 to 6 pmWhole week or Single Day
Tell Us About Your Child

(a) Mental- Emotional-Social-Health. (MESH)

Camp is a fast-paced, group oriented, social, hands-on learning experience that can have a tremendous positive impact on children. That said, every child needs to be ready for camp!  In order for your child to make the transition to camp as smoothly as possible and to have the most positive experience, it helps us to know about anything that might affect your child’s ability to participate fully and successfully.

 Please be candid! The reason we need this information is to prepare for your child in a way that supports their transition to and successful participation in camp.

Does your child experience challenges that affect their experiential success and/or academic success (i.e. ADHD, sensory processing/sensory integration, dyslexia, hearing or vision loss)?
Does your child experience (or been diagnosed with) challenges that affect their social, emotional, mental wellbeing (i.e. anxiety, mood or behavioral)?
Is your child challenged by/diagnosed with a specific condition (i.e. Asperger’s, Autism, Anxiety)?
Does your child take medication related to social, emotional and/or behavioral wellbeing?
Does your child have an IEP (Individualized Educational Plan) or 504 Behavioral Plan in school?
During the past year has your child received the services of a professional for motor, emotional, behavioral or mental health issues either in school or at home?

b) Medical Issues/Allergies

c) Sunscreen/First Aid

Can we apply Sunscreen to your child?
Can we apply First Aid ointments if needed to your child? *ointments refers to anti-itch cream or anti-bacterial ointment.
Mesh/Health Policies PLEASE READ

Per State of New Hampshire Licensing regulations, we must have a Completed Summer Camp Medical Form on file before your child attends any summer camp. There are NO EXCEPTIONS to this policy.  Completed forms must be submitted by May 15, 2021. Please plan accordingly as this form must be completed by your child’s physician.  These forms are also available on our website.   Physical exams completed within two years of camp attendance are valid. 

For campers requiring an epi-pen, inhalers or prescription, or OTC medication we require a Medication Consent Form. This form is available on our website www.summeratbrentwoodcommons.com. We also require a FARE form if applicable.  (Food Allergy and Anaphylaxis Emergency Care Plan)

If you answer “yes” to any questions in section (a), we may call you to learn more about how best to support your child.  We may also ask you to provide additional information from the professional working with your child. 

If, in our estimation additional counselor support is necessary, additional fees may be applicable. Please review the MESH policy and information on our website and in the parent handbook

If any of your answers or information about your child changes between registration and the first day of camp, please contact a camp director as soon as possible.

Campers who leave the program due to behavioral reasons will not receive refunds for unused camp days.

I have read and agree to the above MESH/Health policies
Extended Care Rates

Ages 4 to 5th Grade
Early Care: $10 per day
Late Care: $12 per day
Early Care and Late Care: $20 per day

LIT
Early Care: $5 per day
Late Care:  $8 per day
Early Care and Late Care: $10 per day

Extended Care Payment Options

Please remember

Any date changes to your original camp registration can be made until May 15, 2021 Space permitting  All requests must be made in writing.

Make ups for missed camp days are not available.

Waiver/Release
Confirmation
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