Registration Form June 20 24, 2016 9: 00 am noon One form per family
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- Due no later than
- birthday will occur by September 1, 2016)
- Parent/Guardian Name
- *T-Shirt Order Information
- In regard to my child(ren) attending CKC: (list names of children)
- _________________ _________________________________________________
St Michael’s Catholic Parish 
Catholic Kids Camp Registration Form June 20 - 24, 2016 9:00 AM – Noon One form per family – Due no later than June 1, 2016 Enliven your children’s summer! Catholic Kids Camp includes both fun-filled activities for children and a service commitment for youth. Learn about the Church and the Vatican! Registration is open for Pre-K through rising 6th graders. (Note: Children under 4 yrs can participate if their 4th birthday will occur by September 1, 2016) Fees cover the cost of CDs and t-shirts, and craft supplies. Please do not let the fee keep you from registering. Contact Geri Murray if you can’t afford the fee. Registration Fee: $15/Child $25/Family
Child’s Name T-shirt size (see below*) Grade 2016-2017 Date of Birth
Child’s Name T-shirt size (see below*) Grade 2016-2017 Date of Birth
Child’s Name T-shirt size (see below*) Grade 2016-2017 Date of Birth Volunteers must fill out the Volunteer Form. (Adults and Students 7th grade or higher may volunteer.) Parent/Guardian Name ______________________________________________________________________________________ Address _______________________________________________________________________________________ Telephones: #1 (_____)________________________ #2 (_____)_______________________________ Parent email 1 ______________________________ email 2 _____________________________________ Please list any allergies (including food), medical issues, or disabilities the CKC staff should be aware of: ________________________________________________________________________________________ ________________________________________________________________________________________ Emergency Contact (other than Parent): ______________________________________________________________________________________
_______________________________________________________________________________________ *T-Shirt Order Information Youth sizes XS S M L XL Adult sizes S M L XL XXL Non-volunteer additional shirts may be ordered for $10/each. Please state size________ (T Shirt cost for registered participants included in registration fee)
I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Michael Catholic Parish in Auburn, its officers, directors, employees and agents, and the Archdiocese of Mobile, its employees and agents, chaperones, or representatives associated with the Religious Education program or Catholic Kids Camp, from any claim arising from or in connection with my child attending CKC or in connection with any illness or injury (including death) or cost of medical treatment in connection therewith, and I agree to compensate the parish, its officers, directors, and agents, and the Archdiocese of Mobile, its employees and agents, and chaperones, or representative associated with the Archdiocese for reasonable attorney’s fees and expenses which may incur in any action brought against them as a result of such injury or damage, unless such claim arises from the negligence of the Parish or Archdiocese. _________________ _________________________________________________ Date Parent/Guardian Signature Photo Release I authorize CKC staff to obtain, store, and use photographs or videos taken at CKC for events associated with St. Michael’s Parish or on the Parish website. _________________ _________________________________________________ Date Parent/Guardian Signature Office Use Only: Cash _____ Check # _________ Amount Paid: Directory: documents -> 2016 2016 -> Symbols: = Graduate Student 2016 -> A time for Reflection, Renewal, and Rejuvenation 2016 -> Mavis mccready 2016 -> Questionnaire responses on interpretation and translation 2016 -> Colby-sawyer college intercollegiate athlete handbook 2016 -> What’s New in the National Police Library 2016 -> Middle school planning guide 2016 -> Section III commission 2016 -> News release 2016 -> The state education department Download 14.75 Kb. Share with your friends:
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