Transcription of PAGE 1 The Fresh Air Fund: Child & Family …
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PAGE 1 The Fresh Air Fund: Child & Family …
PAGE 1 The Fresh Air Fund: Child & Family Information 2018 Child APPLICATION. Program: Friendly Towns Camp Career Awareness *PAGEA1*. Please do not cover New applicant Returning applicant barcode . Child Information Please PRINT clearly and use INK pen. Is this Child in foster care? Yes No First Name: Last Name: Date of birth: Age: Gender: Male Female Other: M M D D Y Y Y Y. Home address: Apt #: City: Borough: Zip: School: _____ School borough: _____ Current grade: Type: Public Charter Parochial/Religious Independent/Private Other: 1. Has your Child ever spent the night away from home? Yes No If yes, how many nights? 2. Child 's T-shirt Size: (Pick one) Youth: S M L Adult: S M L XL. 3. How did you hear about us? Friend/ Family Website School Ad Flyer Community Agency Other: Household Information Please PRINT FIRST then LAST NAME.
PAGE 3 The Fresh Air Fund: Health Information 2018 CHILD APPLICATION Must be Completed by Parent/Legal Guardian Please do *PAGEA15* not cover
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