Saint Peter Catholic Kids Camp

Saint Peter the Apostle Catholic Kids Summer Camp "Virtus of Hope, Faith & Love"

Fill out the form carefully for registration
Student Name | Nombre del Estudiante

First NameMiddle NameLast Name
Birth Date | Fecha de Nacimiento

MonthDayYear
Gender | Genero
Address | Direccion

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent E-mail | Email de los Padres
example@example.com
Mobile Number | Telefono
Grade (August 2023) | Grado en (Agosto 2023)
Sibling at Camp | Hermanos en el campamento?
Does your child have any physical limitations | Su hijo(a) tiene alguna limitacion fisica?
Does your child take any medications that we need to be aware of? | Su hijo(a) toma algun medicamento, que tenemos que ser considerar?
Please list your child's allergies, if any. | Por favor, mencione si su hijo(a) tiene alergias?
Does your child have medical insurance? | Su hijo tiene seguro medico?
Please provide a copy of child medical insurance | Por favor provee una copia de tarjeta de seguro medico

Cancelof
Parent Signature | Firma del Padre o Tutor

Powered by Jotform Sign Clear
Additional Comments
Should be Empty:

Saint Peter the Apostle Catholic Kids Summer Camp "Virtus of Hope, Faith & Love"