Knight Passing Academy School of Logic Registration Form
These forms are required for your children to attend camp.
Camper's Information
Camper Name
*
Date of Birth
*
-
Month
-
Day
Year
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Age
Entering Grade in 2025/2026
*
Please Select
7th
8th
School Camper Attends
*
Please Select
Regents School of Austin
Other
Please provide any additional information that you think is important or may affect the camper's ability to fully participate in the camp program.
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Parents' Information
Parent/Guardian 1
Parent/Guardian 1
*
First Name
Last Name
Relationship to Child
*
E-mail
*
example@example.com
Cell Phone
*
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
Home Address Same as Parent/Guardian 1?
Yes
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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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. At least one person listed must be within one hour of the center/home, able to take responsibility for the child in case the parent/guardian cannot be contacted and should be at least 18 years of age. The first emergency contact must live no more than 1 hour away and be over the age of 18.
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Phone Number
*
Secondary Phone Number
Relationship to Child
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Medical / Health Information
Name of Physician or Clinic/Hospital
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Does your child have any food, medication or environmental allergies?
*
Yes
No
Allergies? Check all that apply
*
Food
Medication
Environmental
Please list and explain any allergies
*
0/150
Does your child have a special health or medical condition?
*
Yes
No
Please explain
*
0/150
Does your child have any dietary restrictions, including those for medical, religious or cultural reasons?
*
Yes
No
Please explain
*
0/150
List any history of hospitalization, outpatient surgery, or previous health concerns that would be needed to assist the staff or medical personnel in an emergency situation.
0/200
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Payment
Date Signed
*
-
Month
-
Day
Year
Date Picker Icon
Camp Director Name and Contact Info
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Armor Passing Academy - School of Logic
April 26
$
90.00
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