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 Name
Middle Name
Last Name
Birth Date | Fecha de Nacimiento
January
February
March
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Month
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Day
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Year
Gender | Genero
Please Select
Male
Female
N/A
Address | Direccion
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent E-mail | Email de los Padres
example@example.com
Mobile Number | Telefono
Grade (August 2023) | Grado en (Agosto 2023)
Please Select
1st
2nd
3rd
4th
5th
6-8th
Sibling at Camp | Hermanos en el campamento?
Does your child have any physical limitations | Su hijo(a) tiene alguna limitacion fisica?
Please Select
Yes
No
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 Select
Yes
No
Please provide a copy of child medical insurance | Por favor provee una copia de tarjeta de seguro medico
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Parent Signature | Firma del Padre o Tutor
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