Sunday Adventures Registration Form
Winter 2022-23 Registration and Waiver Form
Participant's Information
Member ID
Participant's Name
*
Participant's Grade
*
Please Select
2nd
3rd
4th
Date of Birth
*
-
Month
-
Day
Year
Date
Age
Please provide any additional information that you think is important or may affect the camper's ability to fully participate in the camp program.
BACK
NEXT
Save
Parents' Information
Parent/Guardian #1
*
First Name
Last Name
Relationship to Child
*
E-mail
*
example@example.com
Cell Phone
*
Format: (000) 000-0000.
Home Phone
*
Format: (000) 000-0000.
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian #2
*
First Name
Last Name
Relationship to Child
*
E-mail
*
example@example.com
Cell Phone
*
Format: (000) 000-0000.
Home Phone
*
Format: (000) 000-0000.
Home Address (If different than above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
BACK
NEXT
Save
Emergency Contacts/Authorized Pickup
Parents cannot be listed as emergency contacts. List the name of at least one person who can be contacted in the event of an emergency or illness if you cannot be reached. Any person listed should be able to assist in contacting you.
Emergency Contact
Full Name
*
First Name
Last Name
Primary Phone Number
*
Format: (000) 000-0000.
Secondary Phone Number
*
Format: (000) 000-0000.
Relationship to participant
*
BACK
NEXT
Save
Medical / Health Information
Name of Physician
Phone Number
Format: (000) 000-0000.
BACK
NEXT
Save
WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT
READ BEFORE SIGNING
Sign Document
*
Date Signed
*
-
Month
-
Day
Year
Date Picker Icon
Save
SUBMIT
Should be Empty: