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PBC Parks

West Boynton TEEN Summer Camp 2021

Lottery/Registration Form
TEEN CAMP ONLY AGES 12-14

 
Programs will adhere to all state, county orders and CDC guidelines.
For future information regarding COVID protocols please call 355-1125.

Camp Location: Park Vista High School (portables) 7900 Jog Rd. Lake Worth, FL 33467
Please note the minimum eligibility requirements to participate in the program include:
  • Ages 12-14 (as of 9/1/2021)
  • Independent bathroom skills
  • Ability to follow basic instructions and safely participate in group activities
This question requires a valid email address.
CHILD #1 *This question is required.
This question requires a valid date format of MM/DD/YYYY.
calendar
Sex *This question is required.
Select Session(s) *This question is required.
T-shirt Size:  *This question is required.
CHILD #2 (If Applicable)
This question requires a valid date format of MM/DD/YYYY.
calendar
Sex
Select Session(s)
T-shirt Size: 
CHILD #3 (If Applicable)
This question requires a valid date format of MM/DD/YYYY.
calendar
Sex
Select Session(s)
T-shirt Size: 
CHILD #4 (If Applicable)
This question requires a valid date format of MM/DD/YYYY.
calendar
Sex
Select Session(s)
T-shirt Size: 
Special Needs

You can help us ensure that your child enjoys the activities in the program(s) you have selected. Does the participant have any special health, accessibility, or behavioral need? (If yes, you will be privately contacted for further information.) *This question is required.
Photo Release Authorization

Permission is hereby granted for participant to appear in still or motion pictures using participants' name for educational, promotional, or other purposes only.  *This question is required.
Scholarship

Have you applied or will you be applying for a scholarship through Youth Services?
E-mail Disclaimer:

Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.