SUMMER CAMP 2022
St. Joseph Catholic School
1210 Anniston Avenue
Shreveport, LA 71105
318-865-3585
Student Information
Student's Full Name
First Name
Last Name
Grade Level for 2022-2023
Date of Birth
-
Month
-
Day
Year
Date
Address
Phone Number
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Mother's Name
Mother's Cell Phone Number
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Mother's Email Address
example@example.com
Mother's Work Phone Number
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Mother's Employer
Father's Name
Father's Cell Phone Number
Father's Email Address
example@example.com
Father's Work Phone Number
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Father's Employer
Emergency Information
Emergency Contact #1
First Name
Last Name
Home Phone Number
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Cell Phone Number
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Emergency Contact #2
First Name
Last Name
Home Phone Number
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Cell Phone Number
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Carpool Information
Please list anyone who has permission to pick up your child from camp.
Pick-up Person # 1
Phone Number
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Pick-up Person # 2
Phone Number
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Please list any allergies, medical problems, recent surgeries or concerns:
Please list any medications your child is taking:
Is there anything else you would like for us to know about your child?
Camp Choices
Camp balances are due at time of registration. *See flyer of camp descriptions and times.
June 6-10
Camping Adventures (rising K3-1st grade, $200.00)
Around the World (rising 2nd-6th grade, $200.00)
June 13-17
Chill Out at Decades Camp (rising 6th-8th, $200.00)
June 20-24
Factory Fun Maker: Made by God (rising K3 - K5, $200.00)
What a Zoo (rising 2nd-3rd graders, $100.00)
June 27-July 1
Creepy Crawly Ocean Creatures (rising 1st-4th graders, $200.00)
July 11-15
God's Creation (rising K3-1st graders, $200.00)
Little Cheer Camp (rising 1st-5th graders, $100.00)
July 18-22
God Bless the USA (rising K3-K5 graders, $200.00)
ALL CAMP BALANCES ARE DUE IN FULL AT TIME OF REGISTRATION. SPORTS CAMP IS FULL AND NO LONGER AVAILABLE.
My Products
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Summer Camp
Camping Adventures, Around the World, Decades Camp, Factory Fun Maker, Creepy Crawly Ocean Creatures, God's Creation, God Bless the USA
$
200.00
Number of Camps
1
2
3
4
5
6
7
8
9
10
Summer Camp
What a Zoo!, Little Cheer Camp
$
100.00
Number of Camps
1
2
3
4
5
6
7
8
9
10
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
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the form.
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