SUMMER CAMP REGISTRATION FORM- 2023
Please fill out the entire form!
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Email *
CHILD NAME *
PARENT'S NAMES *
PARENT'S PHONE NUMBERS *
GRADE IN SEPTEMBER *
SCHOOL YOUR CHILD WILL ATTEND IN SEPTEMBER *
AGE *
ADDRESS *
PHONE NUMBER *
ALLERGIES? *
EMERGENCY CONTACT 1 (Include Name, Relationship and Phone Number) *
EMERGENCY CONTACT 2 (Include Name, Relationship and Phone Number) *
PLEASE CHECK OFF WHICH WEEK(S) YOUR CHILD WILL ATTEND: *
Required
I give my child persmission to be photographed and posted on LBCRS social media platforms. *
Required
I understand that payment is due the first day my child attends camp.  I also understand that NO REFUNDS can be given if my child misses camp. *
Required
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Diocese of Rockville Centre. Report Abuse