434.817.0506
1750 Piper Way | Keswick, VA 22947
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2024 Summer Camp Registration (half day camps)
>> ALL HALF DAY CAMPS FILLED TO CAPACITY! <<
This registration form is for half-day camp weeks (8am drop off, 2pm pick up).
Half-day camps are $350 per week per child/grandchild, $325 for each additional child/grandchild from the same family.
For full day camp weeks please see
here
.
More details on each week's programming are
here
.
Please note that these camps often fill to capacity and to ensure access for all who wish to participate there is a strict cancellation policy. A full refund is available when cancelling with 14+ days notice, there is a 50% refund with 13 days to 24 hours notice, and there no refund with less than 24 hours notice. Thank you for your understanding.
Member Name
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Member Number
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Week(s) Your Child(ren) Will Attend
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1st Child's Name
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1st Child's DOB
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2nd Child's Name
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2nd Child's DOB
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3rd Child's Name
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3rd Child's DOB
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Parent/Guardian Contact Name
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Parent/Guardian Contact Phone
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Parent/Guardian Contact Email
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Alternate Emergency Contact(s)
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Alternate Emergency Contact Phone #1
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Alternate Emergency Contact Phone #2
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Would you like your child(ren) to have club provided lunches? (Can be changed as dates get closer)
Yes
No
Unsure
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Does your child(ren) have any known medical issues?
No
Yes
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If yes, please explain:
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Does your child(ren) take any medication(s)?
No
Yes
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If yes, please explain:
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Does your child(ren) have any food allergies?
No
Yes
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If yes, please explain:
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Is your child(ren) allergic to insect bites/stings of any kind?
No
Yes
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If yes, please explain:
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Is your child(ren) unable to participate in any camp activities?
No
Yes
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If yes, please explain:
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When did your child(ren) receive his/her last Tetanus shot?
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Notes:
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I give permission for my child to participate in camp activities, both on and off The Club at Glenmore (the “Club”) property, with the understanding that camp activities may involve a certain degree of risk. I understand certain dangers, accidents, and/or injuries may occur. I, on behalf of myself, my personal representatives, heirs, administrators, agents and assigns, and any and all entities or persons claiming rights by or through me, agree to and hereby release and discharge the Club, its officers, employees, agents, affiliates, partners, and insurers, from any and all claims or causes of action, both known and unknown and whether arising out of negligence, tort, contract, warranty, or otherwise which may arise from camp activities, including but not limited to my child’s use of the Club’s facilities and participation in camp activities. I will notify the Club staff in writing of activities in which I do not wish my child to participate. In case of emergency if I, parent, guardian or emergency contact cannot be reached, I consent to emergency medical care and transportation in order to obtain treatment in the event of injury to the participant as the Club may deem appropriate.
I have read and agree to the above
No
Yes
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Submit
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Membership
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Contact
Home
About
Club
Team
Amenities
Golf
Racquet Sports
Aquatics
Fitness
Dining & Social
Youth Programs
Membership
Membership Info
Full Membership/Golf
Sports Membership
Social Membership
Weddings
Wedding Info
Our Spaces
Our Services
Rehearsal Dinners
Wedding Inquiries
Events
Contact
Contact Us
Directions
Employment
Join Us
434.817.0506
1750 Piper Way | Keswick, VA 22947
Member Login