Summer Camp Detailed Registration Form

GSIS Summer Camp Registration 2023
Student Information
Student Name

First NameLast Name
Date of Birth (DOB)

MonthDayYear
Age Group
MaleFemale
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Name

First NameLast Name
Cell Number
Format: (000) 000-0000.
E-mail
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Does the student have any allergies, chronic illness, or medical conditions? If yes, please describe.
Informed Consent and Acknowledgement

I, undertake to enroll my child, in the GSIS summer camp. I acknowledge and agree to the camp's terms and conditions, including the activities, safety measures, and behavior expectations. I will provide accurate information and ensure my child's compliance.
Date

MonthDayYear
Date
Signature
Should be Empty:

GSIS Summer Camp Registration 2023