The Fishing Academy

16 Adair Road, Brighton, MA 02135

Camp Dates for 2008
Week One: June 23th-27th
Week Two: July 7th-11th
Week Three: July 14th-18th
Week Four: July 28rd- August 1st
Week Five: August 11th-15th

Group Week for 2008
July 21th-25th
August 4th-8th
August 25th-29th

Please note: 2008 registration fee is $200.00 per camper
Reduced fees are on a sliding scale, based on income.

Due to the popularity of The Fishing Academy Program, all campers will be limited to one week of camp this year! Campers may be put on a waiting list for additional weeks if space is available.

Child's Name:__________________________________________________________________________________

 Address:______________________________________________________________________________________

 Age:__________________________________________________________________________________________

 Phone #:______________________________________________________________________________________

 I, (parent or Legal Guardian)______________________________________________________________________

 Give permission for (Child's Name)__ __________________________to attend.

The Fishing Academy Summer program from 9:00AM to 3:30 PM ____________ through __________. I also give permission for my child to participate in the following activities with The Fishing Academy. Daily Trips to local Fishing spots: Charles River, Jamaica Pond, Muddy River, Brookline Reservoir, Farm Pond, Chandler Pond, Walden Pond, Crystal Lake, Castle Island, Buckmaster Pond Parental Approval Yes ______(Check Box)
Fishing Academy Trip to Sandwich Fish Hatchery Sandwich, MA. ___________
Parental Approval Yes ______.(Check Box)

 I understand that my son/daughter will be obliged to abide by The Fishing Academy rules while participating in the program. In the event of serious illness or injury to my child/ward, I expressly consent to the administration of emergency medical care, if in the opinion of attending medical personnel, such action is advisable. If needed, I hereby authorize dispensation of medication by trained, non-nursing personnel in an emergency and or/life threatening situation or as prescribed by my child's primary provider.

 My Child Does require medication during this authorized trip ______.(Check Box)

 My Child Does Not require medication during this authorized trip ______.(Check Box)

 I have read this permission slip and understand its terms. I sign it voluntarily and with full knowledge of its significance. .
 Parent/Guardian Signature ______________________________________________________________________.
 Child's Health Plan/Primary Care #________________________________________________________________.
 Emergency Contact Name and Number ____________________________________________________________.