Summer Camp Form – The Flour Shop Bakery

About the Baker

Baker's Name*

First Last

Baker's Birthday*

Baker's Upcoming Grade Level*

Baker's Gender*

Responsible Adult Information

Responsible Adult Name*

First Last

Responsible Adult Relationship to Baker*

Email*

Phone*

Emergency Contact Information

Emergency Contact Name*

First Last

Emergency Contact Relationship to Baker*

Emergency Contact Phone*

Physician Information

Physician Name*

Physician Phone*

Other Information

What kind of Firehouse sub would the baker like?

Ham
Ham & Cheese
Turkey
Turkey & Cheese

Does your child have any food allergies and provide severity (do you need to provide an EPI pen, diabetic monitoring, etc.)?*

Yes
No

Please tell us how The Flour Shop Bakery staff needs to follow through.

Does your child need to be given any medication during their time at The Flour Shop Bakery?*

Yes
No

Please explain

Does your child need any special attention (from our staff) to provide additional one-to one interaction? Is there any behavioral information about your child we should know about?*

Yes
No

Please provide that information and our staff will follow-up with a phone call to discuss details so that we may provide the most positive experience for your child.

How did you hear about The Flour Shop summer camps?*

I agree to the terms and conditions for The Flour Shop Bakery camps.*

Click here to view the Terms & Conditions

I agree

Summer Camp

Total

$0.00

Cart

Summer Camp

About the Baker

Responsible Adult Information

Emergency Contact Information

Physician Information

Other Information

The Flour Shop Bakery