Summer Camp Registration

2022 Show Choir Camp Jr. Registration Form

These forms are required for your children to attend camp.
Camper's Information
Camper Name*
Nickname
Camper Birthdate

MonthDayYear
Date
Age
NOTE - Children need to have completed 2nd Grade before they are eligible to participate.
School Camper Attends*
Entering Grade in 2022/23*
T-Shirt Size

Parents' Information

Parent/Guardian 1
Parent/Guardian 1*

First NameLast Name
Relationship to Child*
E-mail*
Cell Phone*
Home Phone*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent's Work Name*
Or enter N/A if not applicable
Parent's Work Phone
Parent's Work Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Where would you like to be reached while your child is at camp?*

Cell PhoneWork PhoneHome Phone
Parent/Guardian 2
Parent/Guardian 2

First NameLast Name
Relationship to Child
E-mail
Cell Phone
Home Phone
Home Address Same as Parent/Guardian 1?

Yes
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent's Work Name
Or enter N/A if not applicable
Parent's Work Phone
Parent's Work Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Where would parent/guardian 2 like to be reached while your child is at camp?

Cell PhoneWork PhoneHome Phone

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 in the event you, the parent, cannot be reached. Emergency contacts should be able to assist in contacting you. The FIRST emergency contact must live within twenty minutes of the school, be able to take responsibility for the child in case the parent/guardian cannot be contacted and be at least 18 years of age.
Emergency Contact #1
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*
Secondary Phone Number*
Relationship to Child*
Emergency Contact #2
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*
Secondary Phone Number*
Relationship to Child*

Payment and Statement of Understanding
The Scranton HS Show Choirs Inc. staff has permission to secure emergency transportation for my child in the event of an illness or injury which requires emergency treatment. The emergency transportation service will determine the facility to which my child will be transported.*
Type first and last name above to consent
Camper Fees
prevnext( X )
Regular Registration$100.00

Multiple Sibling Registration Discount$90.00

Total $0.00
Sign Document*
Date Signed*

MonthDayYear
For questions or more information you can email:

ShowChoirCampJr@shsshowchoirs.org
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