Playground and Xtreme Teen Center Forms
Summer Playground/Summer Xtreme Teen Center Required Forms Process
To comply with the state of Maryland’s Youth Camp Standards, The Department of Parks and Recreation has instituted a new, streamlined process for completing and collecting required forms. It is the parent/guardian’s responsibility to deliver all necessary, completed forms to each program location. Children may not attend any session without completed forms on site. NO EXCEPTIONS.
If you have any questions or need any help before or during registration, please call the Customer Service Help Desk at 301-699-CALL(2255); TTY 301-699-2544. Información en Español: 301-445-4509.
Once you’ve selected the program you want for your child, a pop-up screen will appear listing 8 prompts which you are required to answer in order to complete a registration. The prompts are:
Emergency Contact Name (other than parent/guardian)
Please provide the full name of the person to contact in case of an emergency.
Emergency Contact Phone Number (other than parent/guardian)
Please provide the phone number of the emergency contact.
Please provide the name of your child’s physician.
Physician’s Phone Number
Please provide the physician’s phone number.
Is the participant a swimmer/non-swimmer?
Please indicate whether the child is a swimmer or a non-swimmer. (See page 4 of the summer brochure or online flip book.)
Has the participant been immunized?
Your options are: (a) Yes – student in a Maryland public or private school ; (b) Yes – student is home-schooled or was in a school other than in the state of Maryland school; (c) No.
If you answer Yes – and the student was in a Maryland public or private school, you will not need to complete a Maryland DHM Immunization Certificate.
If you answer No, or Yes, the student is home-schooled or was in a school other than the state of Maryland, then the Maryland DHM Immunization Certificate will print out with your Day Camp Confirmation Receipt. This Certificate must be completed and returned to staff prior to your child’s participation in the day camp program.
Are there any health issues?
Please answer Yes or No. Participants who have health issues such as allergies or other illness, take medication (prescription or over-the-counter), or use emergency medical devices such as inhalers or Epi-pens should answer Yes. The Health-Medication Form will be printed with your Day Camp Confirmation Receipt at the end of the registration. This form must be completed and returned to staff prior to your child’s participation in the day camp program. If you answer No, you will not need to complete any additional health forms.
Date of last Tetanus or DPT vaccination
Please fill-in the month/year (example: 01/2014) when the child last received a Tetanus or DPT vaccination. This is a requirement of the State of Maryland.
Once your registration and transaction are complete, the following items will print out for your convenience:
A Summer Playground/Teen Center Confirmation Receipt,
A Deputy Director’s Letter which must be signed and returned to program staff prior to participation in the program,
Depending upon your answers to the prompts, the Participant Health-Medication Form or Maryland DHM Immunization Certificate.
Health/Medication Form: This form includes detailed information about a participant's health issues, including illnesses, allergies and any medication, emergency medical devices, or asthma inhalers that are taken during program hours. If necessary, return a completed copy to the program location on to June 29.
- Download the Health/Medication Form
MD Department of Health Immunization Certificate: This form details the participant's immunization history. It should be completed for any child who did NOT attend a public/private school in Prince George’s County. If necessary, please return a completed copy to the program location on June 23.
- Download the English version
- Download the Spanish version