Boys' Summer Day Camp registration form August 19-21 Run by St. Timothy Conquest Boys' Club
To complete your registration and payment, you need to complete the following three steps:

1-Fill out the registration form below and then click "submit" at the bottom. Only click "submit" once!

2- After you click "submit", a confirmation message will pop up with instructions for you to copy and paste the payment link. Payment is remitted through Faith Direct. You do not need an account. You can pay as a guest. You can also access the payment link here: https://membership.faithdirect.net/givenow/VA13/32817

3-Once step 1 and 2 are complete, you will receive an email acknowledging your registration along with a permission slip which you must fill out, sign, and return.

Please email Sam at sttimothyconquestclub@gmail.com with any questions.

First and last name of 1st boy attending *
Your answer
1st boy grade in September 2019 *
list any allergies (leave blank if none)
Your answer
name of school attending *
Your answer
first and last name of 2nd boy attending (leave blank if none)
Your answer
2nd boy grade in September 2019 (leave blank if none)
list any allergies (leave empty if none)
Your answer
Name of school attending (leave empty if n/a)
Your answer
Parent/guardian first and last name *
Your answer
Parent/guardian Email address *
Your answer
Emergency contact name 1 *
Your answer
Emergency contact phone number 1 *
Your answer
Emergency contact name 2 *
Your answer
Emergency contact phone number 2 *
Your answer
Medical insurance company name and ID number *
Your answer
Name of home parish
Your answer
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