TOWN OF NORTH READING
APPLICATION FOR A LICENSE TO CONDUCT A
RECREATIONAL CAMP FOR CHILDREN
Fee: $100.00
Name of Camp________________________________________________________
Site Address__________________________________________________________
Site Telephone________________________________________________________
Name of Camp Owner__________________________________________________
Office Address________________________________________________________
Telephone Number_____________________________________________________
Name of Camp Operator (on site)_________________________________________
Address_____________________________________________________________
Telephone Number____________________________________________________
Name of Health Care Consultant_________________________________________
Telephone Number____________________________________________________
Type of Camp Day_______ Residential_______
Hours of Operation____________________________________________________
Dates of Operation Opening________________ Closing_________________
Meals Provided Yes_____ Food Permit Number_______________
#Staff per season:____ #Volunteers per season:____ #Campers per season:____
Signature of Applicant__________________________________________________
Official Title________________________________ Date____________________
Enclose Camp Manual as well as Policy & Procedures with application.
If Cori’s, Sori’s and Medical forms not provided to Board of Health prior to start
of camp it will not be allowed to open.
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