Summer Camp Registration

STUDENT INFORMATION

Student Name:

Grade (2025-2026 School Year):

Date of Birth:

PARENT/GUARDIAN INFORMATION

Parent/Guardian Name(s):

Email Address:

Phone Number:

EMERGENCY CONTACT INFORMATION

Name:

Relationship:

Phone Number:

MEDICAL INFORMATION

Allergies/Medical Conditions:

Medications (if applicable):

ATTENDANCE COMMITMENT

Please check all weeks your child will attend:

Week 1 (May 26-29)Week 2 (June 2-5)Week 3 (June 9-12)Week 4 (June 16-18)

FIELD TRIP WAIVER & PERMISSION

I understand that my child may participate in supervised field trips during the Sister Thea Bowman Summer Camp. I give permission for my child to attend off-campus activities.

I acknowledge that reasonable precautions will be taken to ensure the safety of all participants; however, I understand that participation in field trips involves some risk. I agree not to hold Sister Thea Bowman Catholic School, its staff, or volunteers liable for injuries that may occur during these activities.

In case of emergency, I authorize school staff to seek medical treatment for my child if I cannot be reached.

Parent/Guardian Initials:

PERMISSIONS

I give permission for my child to participate in the Sister Thea Bowman Summer Camp program.