Four Mile Historic Park Day Camp Registration Kit


Thank you very much for choosing Four Mile Historic Park as an educational resource for your child. Your support enables us to fulfill our mission to educate, preserve, and interpret the western rural heritage of Colorado to a diverse public. This form will help us to properly record and process your Day Camp Registration.


DIRECTIONS: Please complete the following Registration Formand Emergency Medical Form for each child you are registering for a Four Mile Historic Park Day Camp and return with payment and a copy of the child’s Certificate of Immunization to: Four Mile Historic Park, Attn: Education, 715 S. Forest Street, Denver, CO 80246 – OR – Fax to 720-865-0801, Attn: Education.


Four Mile Historic Park must receive all registration documents and payment at minimum 3 weeks prior to session.


Please contact the Education Department at 720-865-0814 or education@fourmilepark.org if you have any questions or are in need of additional information.


Registrant Information (to be filled out Parent/Guardian) **ONE CHILD PER FORM PLEASE**: Camper’s Name:


Camper’s Age (6-11 years):


Parent/Guardian Name(s): Mailing Address: City:


Email Address(es): How did you hear about us:


State:


Zip:


Phone:


Date of Registration:___/___/____


Special Accommodations, if any. Attach additional pages if necessary: Camp Title(s):


Camp Session Date(s):


Please mark if you would like to be added to Four Mile Historic Park’s mailing list: Yes No


**As a non-profit agency, Four Mile Historic Park, Inc. has been granted tax-exempt status under Internal Revenue Service Code 501(c)(3). Copies of the IRS certification letter are available upon request. Federal Tax ID: 84-0754945


Four Mile Historic Park, Inc. Attn: Education, 715 S. Forest Street, Denver, Colorado 80246 www.FourMileHistoricPark.org | Phone: 720-865-0800 | Fax: 720-865-0801 | info@fourmilepark.org


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5