CAMP STING REGISTRATION 2019
PLEASE FILL OUT THE INFORMATION BELOW. SEND YOUR REGISTRATION FEE TO CATHOLIC ELEMENTARY (ATTN: MEGAN GIRLINGHOUSE). YOUR CHILD(REN) WILL NOT BE FULLY REGISTERED UNTIL THE FORM AND REGISTRATION FEE ($60/CHILD) HAVE BEEN RECEIVED. PLEASE FILL ONE FORM OUT PER CHILD. *MAKE CHECKS PAYABLE TO CATHOLIC OF POINTE COUPEE*
CAMPER'S LAST NAME *
Your answer
CAMPER'S FIRST NAME *
Your answer
T-SHIRT SIZE (included in registration fee) *
GRADE LEVEL FOR 19-20 SCHOOL YEAR *
Your answer
SCHOOL ATTENDING FOR 19-20 SCHOOL YEAR *
Your answer
E-MAIL ADDRESS *
Your answer
MAILING ADDRESS *
Your answer
MAILING ADDRESS - CITY *
Your answer
MAILING ADDRESS - STATE *
Your answer
MAILING ADDRESS - ZIP CODE *
Your answer
MOTHER'S NAME (FIRST & LAST) *
Your answer
MOTHER'S PHONE NUMBER *
Your answer
FATHER'S NAME (FIRST & LAST) *
Your answer
FATHER'S PHONE NUMBER *
Your answer
EMERGENCY CONTACT (NAME, RELATIONSHIP, NUMBER) *
Your answer
PHYSICIAN'S NAME & NUMBER *
Your answer
DOES YOUR CHILD HAVE ANY PHYSICAL LIMITATIONS OR OTHER IMPORTANT MEDICAL INFORMATION OR HEALTH CONCERNS?
Your answer
MY CHILD WILL BE ATTENDING CAMP ON THE FOLLOWING WEEKS: *
Required
I UNDERSTAND THAT IF MY REGISTRATION FEE OF $60/CAMPER IS NOT PAID BY THE DUE DATE (APRIL 12TH) THAT THE AFOREMENTIONED CAMPER WILL LOSE HIS/HER RESERVED SPOT FOR CAMP STING. (PLEASE INITIAL) *
Your answer
PLEASE INITIAL BELOW VERIFYING THAT ALL INFORMATION ABOVE IS CORRECT. *
Your answer
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