Mendham Borough Day Camp Sign-Up * Fields in red are required General Information (Last day to register for each week is the Thursday prior. *Last day to register for week 1 is the Wednesday prior.) New in 2026: Medical Info and Treatment Release Form must be completed and uploaded through this registration page. With any registration questions, please email Recreation Coordinator Aubrey Egerter at aegerter@mendhamnj.org. NEW IN 2026: Please review the attached Camper Code of Conduct. The three pillars of the Mendham Day Camp remind campers to be respectful, stay together, and be safe. All campers are expected to follow these general rules. I have read and agree to the Camper Code of Conduct. Submission of this form and payment indicates the general camp rules are understood and accepted: Yes No 1. I understand and accept that the Day Camp must meet CDC, NJ, local, and legal health guidelines. 2. I understand and accept that all campers and staff may be asked to pass any daily health screenings to enter campgrounds. 3. I understand and accept that if a camper cannot access to campgrounds due to a failure to pass health screenings, I may be offered credits for future weeks. All attempts will be made to reschedule a camper at the next mutually available time. I understand that the Mendham Day Camp cannot issue refunds. Any refund requests must be passed by Mendham Borough Council. 4. I understand and accept that after this registration is completed, the Day Camp has staffed accordingly, and that any family decision made to keep a camper home (health, vacation, weather, etc.) is the family’s prerogative and is respected, but that family decision does not entitle a refund, as it is understood that the Mendham Day Camp cannot issue refunds. 5. I understand and accept that I may be called to pick up my camper when the camper is showing illness symptoms as determined by the Day Camp Medical Director, and will pick up my camper as soon as possible. 6. I understand and accept that if a camper is determined to be a health risk, that camper will be quarantined until a recognized person on the Registration Form has arrived. 7. I understand and accept that certain events that require shared resources (water, arts, play equipment, etc.) may be limited during the Day Camp. 8. I understand and accept that in the event that lightning is forecast or detected within a 40-mile radius during camp hours, the Day Camp may be moved to an indoor location at the discretion of the Day Camp Director. I understand and accept that it is the parent/guardian responsibility to register for and monitor BAND for updates. Updates for changes that may effect an entire day's schedule will be made by 6am of that day. 9. I understand and accept that Day Camp may remain open if only rain is forecast. Staff and Campers will get wet and it will be the campers' family choice to attend. I understand and accept that refunds are not available for weather related situations. 10. I understand and accept that the Mendham Day Camp does not provide food or drink, other than water. Bottled water will be provided. I understand and accept all of the Mendham Day Camp conditions. Completion of this form and payment indicates that all ten conditions above, and Code of Conduct, are understood and accepted. Please do not complete this form unless all ten conditions are understood and accepted. You will receive an email receipt for your registration. Please print this confirmation for your records as proof of registration: Yes No CAMPER REGISTRATION INFORMATION First Name: Last Name: Gender Group: Male Female Grade (as of Sept '26): K 1 2 3 4 5 6 Email Address: 1st Guardian (Full Name): 2nd Guardian (Full Name): 3rd Person Approved for Pick up: 4th Person Approved for Pick up: Primary Contact Phone Number: Walking / Biking home?: Pick up only Walk Bike Walk or Bike Approve to be photographed?: Yes No Weekly Registration Week 1: June 22-26 (COST $161): No Yes Week 2: June 29-July 2 (CLOSED JULY 3) (COST $128): No Yes Week 3: July 6-10 (COST $161): No Yes Week 4: July 13-17 (COST $161): No Yes Week 5: July 20-24 (COST $161): No Yes Week 6: July 27-31 (COST $161): No Yes NEW IN 2026: Please upload a clear photo of the camper you are registering. Upload Camper Photo Here: NEW IN 2026: To ensure all medical information is collected, please download and complete the following Medical Info and Treatment Release Form. Once you have completed the form, upload the file below. If your child has a food allergy, we recommend that you send, in addition to their Medical Information sheet, an Allergy Action Plan so that we know specific information about your child's condition. Any questions regarding medical information can be directed to the Camp Medical Director, Kyle Wiggins, at kwiggins@mendhamnj.org. Upload Medical Info and Treatment Release Form Here: Upload second page of Medical Release Waiver (only applicable if uploading images instead of a PDF): Upload Allergy Action Plan Here (If applicable): Insurance Information (In case of emergency, this information will be required at any medical facility.) Name of insurance company: ID#: Group #: Name of Policy Holder: Relationship to Camper: MEDICINE DISPERSMENT: We are only able to administer emergency medications, specifically: Epi-Pens, Benadryl (for anaphylactic allergies), and inhalers. All other medications must be dispersed either at home, prior to arrival at camp, or on camp premises by a parent/guardian. Please note that campers who require an Epi-Pen for allergies must bring 2 to camp and that ALL medications MUST be in the original prescription box with the camper's name on it, his/her physician's name, a future expiration date, and the name of the pharmacy from which you obtained the medication. ALLERGIES/HEALTH ISSUES: Does your child have any of the following issues? If you answer "yes", please describe below the allergy/issue and the reaction seen. Provide any updated action plans to our Medical Director after registration. Does your child have any food allergies?: Yes No Epi-Pen for food allergies?: Yes No If yes, to which food(s)? Describe the reaction and indicate if an Epi-Pen was ever administered in the past: Does your child have insect sting allergies?: Yes No Epi-Pen for insect sting allergies?: Yes No If yes, please describe the reaction and indicate if an Epi-Pen was ever administered in the past: Does your child have asthma?: Yes No Inhaler?: Yes No Does your child have latex allergies?: Yes No If yes, please describe the reaction: Does your child have a history of seizures?: Yes No If yes, please describe the reaction: Does your child have diabetes?: Yes No If yes, please describe the reaction: MEDICAL/PHYSICAL/EMOTIONAL CONDITIONS: Are there any physical, mental, psychological, or behavioral conditions requiring medication, treatment, or special restrictions or considerations while at camp of which we should be aware to ensure your child's fullest enjoyment of their camp experience? Please describe, including any special accommodations necessary. Please note that it is your responsibility to supply any necessary medical equipment that relates to a specific medical condition. Are there any camp activities from which the camper should be exempted for health reasons?: Do you want to be notified immediately during the camp session for minor injuries (e.g. scrape, non-allergic bee sting, bloody nose, sliver) that do not limit participation in the program?: Yes No RELEASE OF LIABILITY & AUTHORIZATION FOR TREATMENT: I recognize and acknowledge that there are certain risks of physical injury to campers and I agree to assume the full risk of any injuries, damages or loss, regardless of severity, which my minor child/ward or I may sustain as a result of participating in any and all activities connected with or associated with Mendham Borough Day Camp. I agree to waive and relinquish all claims my minor child/ward or I may have against Mendham Borough and its officers, agents, volunteers, and employees as a result of participation in the program. I do hereby fully release and discharge the Mendham Borough and its officers, agents, volunteers, and employees from any and all claims from injury, damage or loss with the activities of the program(s). I further agree to indemnify and hold harmless and defend the Mendham Borough and its officers, agents, servants, and employees from any and all claims resulting from injuries, damages, and losses sustained by me or my minor child arising out of, connected with, or in any way associated with the activities of the program(s). I hereby give permission to Mendham Borough Day Camp to provide first aid treatment for minor injury or illness and to provide and arrange for emergency treatment of other illnesses. In the event of any emergency, I authorize the Mendham Borough Day Camp to secure from any licensed hospital, physician, and/or medical personnel any treatment deemed necessary for me or my minor child/ward's immediate care and agree that I will be responsible for payment of any and all medical services rendered. I understand that this authorization includes that transporting of my child by ambulance, if necessary, to the nearest medical treatment facility or to the hospital, if I am unable to be reached first. I give permission to Mendham Borough Day Camp to photocopy this form to accompany camper for medical treatment and for trips off campgrounds. I have read and agree to the RELEASE OF LIABILITY & AUTHORIZATION FOR TREATMENT. Submission of this form and payment indicates the conditions of the abovementioned release are understood and accepted.: Yes IMPORTANT PAYMENT INFORMATION: When adding payment information, please be sure to double check the payment amount, routing number, and account number. Any incorrect information is unable to be changed and your registration will not be confirmed. You will need to go through the online registration process again. Weeks 1,3,4,5,6: $161/week Week 2: $128 Payer Information Billing Name: Address: Address 2: City: State: - - AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY ZIP Code: Daytime Phone: Payer E-mail Address: Payment Information Payment Amount: $ Enter amount. Payment Method: ACH Payment (e-Check) Convenience Fee: Enter information as it appears on your check (USA Banks Only) Account Type: Select Type Personal Checking Business Checking Routing Number: Account Number: Re-Enter Account #: Using the following lower portion of a personal check as an example, enter the information that appears at the bottom of your check. Do NOT include any dashes or spaces. Comments:
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