YMCA of Greater Oklahoma City Immunization & Photo

YMCA of Greater Oklahoma City Immunization & Photo

School Age Program Registration (Day Camp + School Year)
Please complete this form to submit the child's current immunization records and a recent photo.

ONE form must be completed for EACH child registered.

All immunization records and photos must be submitted prior to the start of your enrollment to maintain your child's registration in the program.
Program Branch/Location *
Day Camp Name or Site
(Camp Name example: Camp Hero or Teen Camp OR Site example: Hillcrest Baptist Church)
Child/Participant Name

First Name Last Name
Parent/Guardian 1 Name

First Name Last Name
Parent/Guardian 2 Name

First Name Last Name
Parent/Guardian Preferred Email Address
example@example.com
Child's Primary Home Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Immunization Records

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Cancel of
Recent Photo

Browse Files

Cancel of
Submission Date

Month Day Year
Date
Parent/Guardian Signature

Clear
Should be Empty: