Section 1 of 18
Mini Majorette & Flagline Camp
Thank you for your interest in Mini Majorette & Mini Flagline Camp! We are excited for a fun camp!
All Registered campers are welcome to join us for lunch for the duration of camp. You may send/bring a lunch for your child(ren) or you can leave the work up to us by "purchasing" lunch in the payment section of our Square store. Lunch costs $12 for the camp (3 days of lunches). You may purchase lunch for the week on the first day of camp.
Lunch menu:
Monday: Chick-fil-a nuggets, chips, water
Tuesday: Ham/Turkey Sub sandwich, chips, water
Wednesday: Pizza, fruit, water
Registration after 5/25: Camp price is $90/camp/camper. No discounts after 5/25.
MAJORETTE CAMP: 9AM-NOON
FLAG CAMP: 1-4PM
Camp dates: June 4-6
>>> To pay online, visit: https://squareup.com/store/ABPA
*Please make sure to add the camper's name to the "notes to merchant" section at checkout.
Questions? Contact Haley Wine at hwine@auburnschools.org
All Registered campers are welcome to join us for lunch for the duration of camp. You may send/bring a lunch for your child(ren) or you can leave the work up to us by "purchasing" lunch in the payment section of our Square store. Lunch costs $12 for the camp (3 days of lunches). You may purchase lunch for the week on the first day of camp.
Lunch menu:
Monday: Chick-fil-a nuggets, chips, water
Tuesday: Ham/Turkey Sub sandwich, chips, water
Wednesday: Pizza, fruit, water
Registration after 5/25: Camp price is $90/camp/camper. No discounts after 5/25.
MAJORETTE CAMP: 9AM-NOON
FLAG CAMP: 1-4PM
Camp dates: June 4-6
>>> To pay online, visit: https://squareup.com/store/ABPA
*Please make sure to add the camper's name to the "notes to merchant" section at checkout.
Questions? Contact Haley Wine at hwine@auburnschools.org
Section 2 of 18
Camper Information
Please list all information for ONE child. There will be a place later in this registration to add information for additional children.
Madison Whidden
Madison Whidden
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Lisa Whidden
Lisa Whidden
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2059108203
2059108203
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4th
4th
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1.
1st grade
2.
2nd grade Flávio serraa
3.
3rd grade
4.
4th grade Camila
5.
5th grade
6.
6th grade
7.
7th grade Camila Serra
8.
Kindergarden
9.
Option 9
10.
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YXL
YXL
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Youth Medium
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Section 3 of 18
Mini Majorette Camp Information
MIni Majorette Camp will be held from 9am-noon
Does camper plan to attend Mini Majorette Camp? Yes
Does camper plan to attend Mini Majorette Camp? Yes
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Yes yes
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No
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Option 3
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Section 4 of 18
Mini Majorette--More information
Mini Majorette Camp will be held from 9am-noon
Does Camper have any baton experience? Yes
Does Camper have any baton experience? Yes
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Yes, attended camp last summer
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No no
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Baton camp last summer
Baton camp last summer
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Does Camper need a baton? No
Does Camper need a baton? No
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If camper needs a baton, please give length needed (length is determined by measuring from the top of your child's shoulder to the tip of his/her middle finger)
If camper needs a baton, please give length needed (length is determined by measuring from the top of your child's shoulder to the tip of his/her middle finger)
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Section 5 of 18
Mini Flagline Camp Information
Mini Flagline Camp will be held from 1-4pm
Does Camper plan to attend mini flagline camp?
Does Camper plan to attend mini flagline camp?
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Yes
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Section 6 of 18
Mini Flagline--More Information
If yes, Does Camper have any flag experience?
If yes, Does Camper have any flag experience?
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Flag camp last summer
Flag camp last summer
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Section 7 of 18
Parent information
Lisa Whidden
Lisa Whidden
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Is Parent address the same as camper's?
Is Parent address the same as camper's?
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If no, please list address below (street, city, state, zip)
If no, please list address below (street, city, state, zip)
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Is the parent/guardian to be listed as the primary emergency contact for the camper?
Is the parent/guardian to be listed as the primary emergency contact for the camper?
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Section 8 of 18
Primary Emergency Contact
Lisa Whidden
Lisa Whidden
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2059108203
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How is this person related to the camper?
How is this person related to the camper?
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Section 9 of 18
Second Emergency Contact
Please list an emergency contact OTHER THAN the primary emergency contact listed on the previous page, in case we cannot reach the aforementioned person.
Chris Whidden
Chris Whidden
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2059109986
2059109986
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How is the emergency contact related to the camper?
How is the emergency contact related to the camper?
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Section 10 of 18
Physician Information
Dr. Carter Who is the camper's primary care physician?
Dr. Carter Who is the camper's primary care physician?
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Pediatric Clinic What is the name of the doctor's practice? (ex. Pediatric Clinic)
Pediatric Clinic What is the name of the doctor's practice? (ex. Pediatric Clinic)
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3347498121 Doctor's phone number
3347498121 Doctor's phone number
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Section 11 of 18
Insurance Information
BCBS Insurance carrier (Ex. Peehip, BCBS, All Kids)
BCBS Insurance carrier (Ex. Peehip, BCBS, All Kids)
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suv800525442 Insurance policy/contract number
suv800525442 Insurance policy/contract number
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54088 Group Number
54088 Group Number
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Number
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Length
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Christopher Whidden
Christopher Whidden
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Section 12 of 18
Do you have additional campers you'd like to register?
ONLY USE THIS OPTION IF ADDITIONAL CAMPER HAS SAME PARENT/GUARDIAN AS CAMPER #1.
If this camper doesn't live at the same address, have the same insurance information, or same emergency contact, please submit this form with only one camper registered and return to the main screen to register another camper.
If this camper doesn't live at the same address, have the same insurance information, or same emergency contact, please submit this form with only one camper registered and return to the main screen to register another camper.
I have read the information above and I would like to register additional camper(s)
I have read the information above and I would like to register additional camper(s)
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Yes
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No
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Section 13 of 18
Waiver to participate
I give my child to participate in Auburn High School's Mini Majorette and/or Mini Flagline camp. I agree not to hold Auburn City Schools, Auburn High School, Auburn High School Band, Majorettes, Color Guard, any camp directors, sponsors, employees, or staff responsible for injuries or accidents that could potentially occur. I also agree that the above information is correct. This is to certify that the hearer of this form has permission of the undersigned to authorize necessary emergency medical care of a physician chosen in the event of an accidental injury or illness. By checking "yes" below, I am agreeing to the statement above and give my consent for my child to participate.
I give my child to participate in Auburn High School's Mini Majorette and/or Mini Flagline camp. I agree not to hold Auburn City Schools, Auburn High School, Auburn High School Band, Majorettes, Color Guard, any camp directors, sponsors, employees, or staff responsible for injuries or accidents that could potentially occur. I also agree that the above information is correct. This is to certify that the hearer of this form has permission of the undersigned to authorize necessary emergency medical care of a physician chosen in the event of an accidental injury or illness. By checking "yes" below, I am agreeing to the statement above and give my consent for my child to participate.
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Yes, I agree with the statement above and give consent for my child(ren) to participate
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Section 14 of 18
Additional Camper Registration
ONLY USE THIS OPTION IF ADDITIONAL CAMPER HAS SAME PARENT/GUARDIAN AS CAMPER #1.
If this camper doesn't live at the same address, have the same insurance information, or same emergency contact, please submit this form with only one camper registered and return to the main screen to register another camper.
If this camper doesn't live at the same address, have the same insurance information, or same emergency contact, please submit this form with only one camper registered and return to the main screen to register another camper.
Allison
Allison
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Whidden
Whidden
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2nd
2nd
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1.
k4 or 4 years old
2.
k5 or Kindergarten
3.
1st Grade
4.
2nd Grade
5.
3rd Grade
6.
4th Grade
7.
5th Grade
8.
6th Grade
9.
7th grade
10.
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None Please list any allergies
None Please list any allergies
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youth Large
youth Large
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Both
Both
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Mini Majorette (9-noon)
Mini Flag Line (1-4pm)
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No
No
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No
Not attending majorette camp
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If yes, please list length
If yes, please list length
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Does Camper have any baton experience?
Does Camper have any baton experience?
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Not attending majorette camp
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Baton experience from last summer If yes, briefly describe experience
Baton experience from last summer If yes, briefly describe experience
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Flag experience from last summer
Flag experience from last summer
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Not attending flag camp
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If yes, briefly describe experience
If yes, briefly describe experience
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Section 15 of 18
Do you have additional campers you'd like to register?
ONLY USE THIS OPTION IF ADDITIONAL CAMPER HAS SAME PARENT/GUARDIAN AS CAMPER #1.
If this camper doesn't live at the same address, have the same insurance information, or same emergency contact, please submit this form with only one camper registered and return to the main screen to register another camper.
If this camper doesn't live at the same address, have the same insurance information, or same emergency contact, please submit this form with only one camper registered and return to the main screen to register another camper.
I have read the information above and I would like to register additional camper(s)
I have read the information above and I would like to register additional camper(s)
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Yes
Continue to next section
No
Continue to next section
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Section 16 of 18
Additional Camper Registration
ONLY USE THIS OPTION IF ADDITIONAL CAMPER HAS SAME PARENT/GUARDIAN AS CAMPER #1.
If this camper doesn't live at the same address, have the same insurance information, or same emergency contact, please submit this form with only one camper registered and return to the main screen to register another camper.
If this camper doesn't live at the same address, have the same insurance information, or same emergency contact, please submit this form with only one camper registered and return to the main screen to register another camper.
Lauren
Lauren
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Whidden
Whidden
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Kindergarten
Kindergarten
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1.
k4 or 4 years old
2.
k5 or Kindergarten
3.
1st Grade
4.
2nd Grade
5.
3rd Grade
6.
4th Grade
7.
5th Grade
8.
6th Grade
9.
7th grade
10.
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none
none
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Youth medium
Youth medium
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Both camps
Both camps
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Mini Majorette (9am-noon)
Mini Flag Line (1-4pm)
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No
No
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Yes (+$15)
No
Not attending majorette camp
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If yes, please list length
If yes, please list length
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Does Camper have any baton experience?
Does Camper have any baton experience?
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Yes
No
Not attending majorette camp
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Baton camp last summer If yes, briefly describe experience
Baton camp last summer If yes, briefly describe experience
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no
no
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Yes
No
Not attending flag camp
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If yes, briefly describe experience
If yes, briefly describe experience
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Section 17 of 18
Do you have additional campers you'd like to register?
ONLY USE THIS OPTION IF ADDITIONAL CAMPER HAS SAME PARENT/GUARDIAN AS CAMPER #1.
If this camper doesn't live at the same address, have the same insurance information, or same emergency contact, please submit this form with only one camper registered and return to the main screen to register another camper.
If this camper doesn't live at the same address, have the same insurance information, or same emergency contact, please submit this form with only one camper registered and return to the main screen to register another camper.
I have read the information above and I would like to register additional camper(s)
I have read the information above and I would like to register additional camper(s)
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Yes
Continue to next section
No
Continue to next section
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add "Other"
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Section 18 of 18
Yes, believe it or not, I do still have another camper to register
ONLY USE THIS OPTION IF ADDITIONAL CAMPER HAS SAME PARENT/GUARDIAN AS CAMPER #1.
If this camper doesn't live at the same address, have the same insurance information, or same emergency contact, please submit this form with only one camper registered and return to the main screen to register another camper.
If this camper doesn't live at the same address, have the same insurance information, or same emergency contact, please submit this form with only one camper registered and return to the main screen to register another camper.
Camper first name
Camper first name
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Camper Last Name
Camper Last Name
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Grade most recently completed (2017-2018 school year)
Grade most recently completed (2017-2018 school year)
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1.
k4 or 4 years old
2.
k5 or Kindergarten
3.
1st Grade
4.
2nd Grade
5.
3rd Grade
6.
4th Grade
7.
5th Grade
8.
6th Grade
9.
7th grade
10.
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Please list any allergies
Please list any allergies
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T-shirt size
T-shirt size
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Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Other…
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Please check all camps attending
Please check all camps attending
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Mini Majorette (9-noon)
Mini Flag Line (1-4PM)
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Does Camper need a baton?
Does Camper need a baton?
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Yes (+$15)
No
Not attending majorette camp
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If yes, please list length
If yes, please list length
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Does Camper have any baton experience?
Does Camper have any baton experience?
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No
Not attending majorette camp
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If yes, briefly describe experience
If yes, briefly describe experience
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Does Camper have any flag experience?
Does Camper have any flag experience?
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No
Not attending flag camp
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If yes, briefly describe experience
If yes, briefly describe experience
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