Dojo 2024 Camper Information
NOTE: IF YOU HAVE A FORM ON FILE FROM PRIOR YEARS WE DO NOT NEED A NEW ONE UNLESS YOUR INFORMATION HAS CHANGED!

THIS FORM DOES NOT REGISTER YOUR CHILD FOR ANY CAMP!!  IT IS A GENERAL INFORMATION SHEET WE NEED ON FILE FOR EACH CAMPER.  EVERY CAMP HAS EITHER AN ELECTRONIC REGISTRATION FORM TO BE SUBMITTED ONLINE, OR A PAPER REGISTRATION FORM WHICH MUST BE SUBMITTED TO THE FRONT DESK!

Please fill out this entire form as completely and accurately as you can. We will use this information for contact and check-out for every camp your child may attend (Spring Break, Summer Camps, or the various day camps) during 2024, so be sure to let us know if there are any updates or changes.  You will need to complete this form only once during the calendar year.
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Camper Information
Please fill out a separate form for each child who will be attending camp.
1. First Name *
Please give us your child's nickname or preferred name. We'll get the "legal" name on the registration form!
2. Last Name *
Child's last name.
3. Age *
Your child's age at the first camp he or she will attend this year.
4. Birthday *
Your child's date of birth
MM
/
DD
/
YYYY
Parent or Legal Guardian Information
We are required to maintain contact information for anyone having parental rights or legal guardianship for this child.
5. Parent 1 Last *
Enter only the LAST name for the first parent or guardian.
6. Parent 1 First *
Enter only the FIRST name for the first parent or guardian.
7. Email *
Please enter the email address carefully and accurately. We will use this email to send you notices and updates about camps your child is attending.
8. Phone *
Enter your preferred phone number. You may enter more than one if necessary; if so, please identify the type -- home, cell, work, etc.
9. Parent 2 Last *
Enter only the LAST name for the second parent or guardian. Enter "none" if there is only one parent or legal guardian, and skip to question 13.
10. Parent 2 First
Enter only the FIRST name of the second parent or guardian.
11. Email
Type carefully!
12. Phone
Same guidelines as question 8.
Persons Authorized to Pick Up Your Child
In this section please list every additional person  you are authorizing to pick up your child from the Dojo. We will not release to any person you have not specifically authorized, and we will require identification from any person we do not already know. PARENTS AND GUARDIANS ARE AUTOMATICALLY INCLUDED ON OUR AUTHORIZED PERSONS LIST AND DO NOT NEED TO BE ENTERED AGAIN IN THIS SECTION!
13. AP 1
Please enter First and Last name of each authorized person. If you have more than six, you may combine couples on the same line, or you can tell us additional authorizations at the end of this form.
14. AP 2
15. AP 3
16. AP 4
17. AP 5
18. AP 6
Emergency Contact Information
If there is anyone not already listed who we could contact in the event of an emergency, please provide that information here.
19. Emergency contacts
Please list name(s), relationship, and phone number(s) of any person(s) you'd like for us to contact in the event we were not able to reach you in an emergency.
Medical or Other Concerns; Additional Information
In the questions below please tell us if your child has any special health, medical, or other concerns.
20. Allergies
If your child has any allergies or food sensitivities we need to be aware of, please give us details here.
21. Medication
Will you be leaving any routine or emergency medication with us? If so, describe here, and please be sure to fill out a medication authorization form at the front desk.
22. Other Needs
If your child has any other health issues, physical or social limitations, or any other similar needs, please give us full information here.
23. Miscellaneous
If you have any other concerns or feedback, or need to give additional information about authorized persons, please enter that information here.
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