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Camp Registration form
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  Camper Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Home Address REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Sex REQUIRED Please fill out this field.
  
  Child's Grade as of September 2023 REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Select Camp Session
  
  Please note one registration form is required per week of camp. If you would like to register your child for a second week, please complete a second registration form.
  
  Select Camp Session REQUIRED Please fill out this field.
  
  Parent/Guardian Information
  
  Mother's First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email Address REQUIRED Please fill out this field. Please enter valid data.
  
  Primary Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Secondary Phone Number Please enter valid data.
  
  Father's First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email Address REQUIRED Please fill out this field. Please enter valid data.
  
  Primary Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Secondary Phone Number Please enter valid data.
  
  Emergency Contact Information
  
  In case we are unable to contact a parent or guardian, please provide an emergency contact and their relationship to the camper.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship to Camper REQUIRED Please fill out this field. Please enter valid data.
  
  Permission to Pick Up
  
  Please include parents/guardians and anyone else who may be picking up your child. For safety reasons, if anyone not listed comes to pick up your child, the child will remain with us until a parent/guardian has been contacted and given permission.
  
  Names
  
  Medical Information
  
  Does your child have any food, medication, or environmental allergies? REQUIRED Yes No Please fill out this field.
  
  If yes, please list all known allergies
  
  Does your child have any special needs due to a learning disability, physical disability, reading difficulty, hearing impairment, or emotional concerns? If so, please describe
  
  OHIP Number
  This will only be used in case of a medical emergency.
  Please enter valid data.
  
  By checking "I understand" below under Safety Consent, I/we understand that reasonable precaution will be taken to safeguard the health and safety of the participant and that the designated parent/guardian or emergency contact person will be notified as soon as possible in case of emergency. In the event of any sickness or accident, person(s) will not hold St. Patrick's Parish, the Archdiocese of Toronto, any staff or volunteer responsible.
  
  Safety Consent REQUIRED I understand Please fill out this field.
  
  By checking "Yes" under Medical Consent, you hereby consent to the administration of any medical treatment deemed by a qualified medical practitioner to be necessary for the health and welfare of your child.
  
  Medical Consent REQUIRED Yes No Please fill out this field.
  
  Permission to Photograph
  
  Photographs will be taken at camp, and some may be used for promotional materials such as the parish website, posters and flyers, and our youth ministry Instagram account. By checking below, you agree to allow your child to be photographed and for those photographs to be used in promotional materials. If you do not wish to have your child photographed, then we will make sure any photographs used do not include your child or have their face blocked out.
  
  I give permission for my child to be photographed and for the photographs to be used in promotional materials REQUIRED Yes No Please fill out this field.
  
  Camp Release
  
  By checking below, I/we grant permission for my child to participate in Agnus Dei Camp at St. Patrick's Parish.
  
  I give permission REQUIRED Yes No Please fill out this field.
  
  Submit
  
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