After Camp Application Lakewood - Boys Division Apply Online Please fill out all the required fields, and click Submit when you are done. 1. Child Information Are you already a Glick Girl/Guy? Yes! First Name Last Name Grade Entering Primary1st Grade2nd Grade3rd Grade4th Grade Child #2 First Name Child #2 Grade Entering Primary1st Grade2nd Grade3rd Grade4th Grade Child #3 First Name Child #3 Grade Entering Primary1st Grade2nd Grade3rd Grade4th Grade Child #4 First Name Child #4 Grade Entering Primary1st Grade2nd Grade3rd Grade4th Grade Allergy: Please list anything your child is allergic to. If your child owns an EpiPen, please state: Does your child receive extra assitance in a school/camp setting? (This way we can ensure to provide properly for your child). Note: Please don't register any child in a diaper for this program. Thank you! 2. Personal Information Mother's Name Mother's Cell Father's Name Father's Cell Email Address 3. Pick your DaysSave money by signing up for full program! Monday August 14 Monday August 14 Tuesday August 15 Tuesday August 15 Wednesday August 16 Wednesday August 16 Thursday August 17 Thursday August 17 Friday August 18 Friday August 18 Monday August 21 Monday August 21 Tuesday August 22 Tuesday August 22 4. SubmitBy registering your child in GlickGirl, you and any legal guardian of your child give permission for the staff at GlickGirl to deal with any medical emergencies and make any necessary medical decisions, and agree not to hold Glick Girl LLC liable for illness or injury. I agree to the terms and conditions as seen here. I agree Date Electronic Signature Submit & Pay The form was sent successfully. An error occured.