CAMP ADVENTURE 2026

Tuesday, August 4 | Wednesday, August 5 | Thursday, August 6

11:00 AM – 3:30 PM

Buffalo Dream Center: 286 Lafayette Avenue Buffalo, NY 14213

Please fill in the form below to register your child for Camp Adventure.

Please note: A parent or legal guardian must fill in the form and sign it.

Please enable JavaScript in your browser to complete this form.

Camper's Name *

First

Last

Parent/Legal Guardian Name *

First

Last

Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Parent/Legal Guardian Cell

Camper's Birthdate *

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Home Phone

Camper's Age *

Parent/Legal Guardian Email

Camper's Gender *

• Male
• Female

Will your camper be riding the bus? *

• Yes
• No

Which bus stop will your camper be picked up at: *

• 10:00 AM | 234 Jefferson Ave (in the parking lot)
• 10:07 AM | Corner of Swan Street and Hamburg St
• 10:25 AM | 110 Blum Avenue
• 10:35 AM | Near 87A Jasper Parrish Drive
• 10:45 AM | Corner of Arkansas St & Herkimer St

Are other children in your family attending Camp Adventure? *

• Yes
• No

If yes, please list their first & last names *

Emergency Contact Information

Emergency Contact Name *

First

Last

Emergency Contact Phone *

Emergency Contact Relation To Camper *

Health/Medical

Does your camper have any allergies or medical conditions? *

• Yes
• No

If yes, please list them, each on a separate line.

Please explain the treatment of the above allergies/health conditions.

CAMP ADVENTURE 2026 WAIVER/RELEASE STATEMENT

Aknowledgement

• I am the parent/legal guardian of the child listed on this form.

Parent/Legal Guardian Name *

First

Last

Camper Attending Camp Adventure Name *

First

Last

I understand and agree to the following:

Acknowledgement 1 *

• 1. I understand the nature of the activities at Camp Adventure and I give my child permission to attend and participate in those activities.

Acknowledgement 2 *

• 2. I will not hold the Buffalo Dream Center, their Board of Directors, representatives, employees, or volunteers liable in the case of injury, loss of property, or accidental death during Camp Adventure and/or while being transported to and from the program.

Acknowledgement 3 *

• 3. In the event that my child becomes injured or becomes ill during camp, and I cannot be reached, the Buffalo Dream Center is authorized to provide the necessary first aid and medical care. I understand that I am financially responsible for all medical treatments, emergency care, transportation, and other related expenses. I have listed all my child’s medical conditions and the appropriate treatment on the registration form.

Acknowledgement 4 *

• 4. I understand the during Camp Adventure my child may be videotaped, audio-taped, interviewed, and photographed. I agree to allow the Buffalo Dream Center to use these for newsletters, websites, and other publications. I understand that I will not be compensated for such use.

Acknowledgement 5 *

• 5. I give permission for my child to ride the bus to Camp Adventure and return home on the same bus. I will not hold the Buffalo Dream Center, their Board of Directors, representatives, employees, or volunteers liable in the case of injury, loss of property, or accidental death while being transported to and from Camp Adventure.

Parent/Legal Guardian Signature *

Clear Signature

Parent/ Legal Guardian Type Name *

First

Last

Today's Date *

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