Camp Guadalupe Registration Form

Camp Guadalupe 2019 Camper Registration
Camp Location
St. Francis of Assisi, June 24-28Malvern Retreat House, July 15-19
How did you hear about Camp this year?

Church BulletinEmailWord of mouthPrevious camper/volunteerOther
Family Information
Parent #1*

First NameLast Name
Cell Number*

Area CodePhone Number
E-mail*
Parent #2

First NameLast Name
Cell Number

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*

Area CodePhone Number
Camper #1
Child #1 *

First NameLast Name
Birth Date*

MonthDayYear
Group (age as of 6/1/2019)*

Red 4 yr oldsGreen 5-6 yr oldsPurple 7-8 yr oldsYellow 9-10 yr oldsBlue 11-12 yr olds
Please choose T-shirt size for the camper

child smallchild mediumchild largeadult smalladult medium
Does the camper have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the camper prescribed an inhaler or epi-pen? If yes, please explain any instructions.
If you are finished entering all campers, scroll to the bottom of the page.
Camper #2
Child #2

First NameLast Name
Birth Date

MonthDayYear
Group (age as of 6/1/2019)

Red 4 yr oldsGreen 5-6 yr oldsPurple 7-8 yr oldsYellow 9-10 yr oldsBlue 11-12 yr olds
Please choose T-shirt size for the camper

child smallchild mediumchild largeadult smalladult medium
Does the camper have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the camper prescribed an inhaler or epi-pen? If yes, please explain any instructions.
If you are finished entering all campers, scroll to the bottom of the page.
Camper #3
Child #3

First NameLast Name
Birth Date

MonthDayYear
Group (age as of 6/1/2019)

Red 4 yr oldsGreen 5-6 yr oldsPurple 7-8 yr oldsYellow 9-10 yr oldsBlue 11-12 yr olds
Please choose T-shirt size for the camper

child smallchild mediumchild largeadult smalladult medium
Does the camper have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the camper prescribed an inhaler or epi-pen? If yes, please explain any instructions.
If you are finished entering all campers, scroll to the bottom of the page.
Camper #4
Child #4

First NameLast Name
Birth Date

MonthDayYear
Group (age as of 6/1/2019)

Red 4 yr oldsGreen 5-6 yr oldsPurple 7-8 yr oldsYellow 9-10 yr oldsBlue 11-12 yr olds
Please choose T-shirt size for the camper

child smallchild mediumchild largeadult smalladult medium
Does the camper have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the camper prescribed an inhaler or epi-pen? If yes, please explain any instructions.
If you are finished entering all campers, scroll to the bottom of the page.
Camper #5
Child #5

First NameLast Name
Birth Date

MonthDayYear
Group (age as of 6/1/2019)

Red 4 yr oldsGreen 5-6 yr oldsPurple 7-8 yr oldsYellow 9-10 yr oldsBlue 11-12 yr olds
Please choose T-shirt size for the camper

child smallchild mediumchild largeadult smalladult medium
Does the camper have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the camper prescribed an inhaler or epi-pen? If yes, please explain any instructions.

Camp Guadalupe 2019 Camper Registration

Camper #2

Camper #3

Camper #4

Camper #5