Registration

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- Formation

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- Family Information
  
  Family Information
  
  Family Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's First Name Please enter valid data.
  
  Mother's First Name Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Please fill out as many phone numbers as possible, in case of emergency.
  
  Home Phone Maximum 20 characters Please enter a phone number.
  
  Father's Cell Phone Maximum 20 characters Please enter a phone number.
  
  Mother's Cell Phone Maximum 20 characters Please enter a phone number.
  
  Father's Work Phone Maximum 20 characters Please enter a phone number.
  
  Mother's Work Phone Maximum 20 characters Please enter a phone number.
- Children Information
- Number of Children REQUIRED Please fill out this field.
  
  Child 1
  
  Child's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field.
  
  This Child's T-Shirt Size REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Age (as of July 22, 2024) REQUIRED Please fill out this field. Please enter an integer (number).
  
  This Child's Health Problems
  
  This Child's Allergies and/or Diet Restrictions
  
  This Child's Physical Limitations
  
  This Child's Emotional or Behavioral Conditions (anxiety, depression homesickness, etc.)
  
  This Child's Medications
  
  Child's Bunkmate Please enter valid data.
  
  Our camp groups are divided into 7-9yrs, 10-12yrs, and 13-16yrs. Please take this into consideration when requesting a bunk mate.
  
  Child 2
  
  Child's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field.
  
  This Child's T-Shirt Size REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Age (as of July 22, 2024) REQUIRED Please fill out this field. Please enter an integer (number).
  
  This Child's Health Problems
  
  This Child's Allergies and/or Diet Restrictions
  
  This Child's Physical Limitations
  
  This Child's Emotional or Behavioral Conditions (anxiety, depression homesickness, etc.)
  
  This Child's Medications
  
  Child's Bunkmate Please enter valid data.
  
  Our camp groups are divided into 7-9yrs, 10-12yrs, and 13-16yrs. Please take this into consideration when requesting a bunk mate.
  
  Child 3
  
  Child's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field.
  
  This Child's T-Shirt Size REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Age (as of July 22, 2024) REQUIRED Please fill out this field. Please enter an integer (number).
  
  This Child's Health Problems
  
  This Child's Allergies and/or Diet Restrictions
  
  This Child's Physical Limitations
  
  This Child's Emotional or Behavioral Conditions (anxiety, depression homesickness, etc.)
  
  This Child's Medications
  
  Child's Bunkmate Please enter valid data.
  
  Our camp groups are divided into 7-9yrs, 10-12yrs, and 13-16yrs. Please take this into consideration when requesting a bunk mate.
  
  Child 4
  
  Child's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field.
  
  This Child's T-Shirt Size REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Age (as of July 22, 2024) REQUIRED Please fill out this field. Please enter an integer (number).
  
  This Child's Health Problems
  
  This Child's Allergies and/or Diet Restrictions
  
  This Child's Physical Limitations
  
  This Child's Emotional or Behavioral Conditions (anxiety, depression homesickness, etc.)
  
  This Child's Medications
  
  Child's Bunkmate Please enter valid data.
  
  Our camp groups are divided into 7-9yrs, 10-12yrs, and 13-16yrs. Please take this into consideration when requesting a bunk mate.
  
  Child 5
  
  Child's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field.
  
  This Child's T-Shirt Size REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Age (as of July 22, 2024) REQUIRED Please fill out this field. Please enter an integer (number).
  
  This Child's Health Problems
  
  This Child's Allergies and/or Diet Restrictions
  
  This Child's Physical Limitations
  
  This Child's Emotional or Behavioral Conditions (anxiety, depression homesickness, etc.)
  
  This Child's Medications
  
  Child's Bunkmate Please enter valid data.
  
  Our camp groups are divided into 7-9yrs, 10-12yrs, and 13-16yrs. Please take this into consideration when requesting a bunk mate.
  
  Child 6
  
  Child's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field.
  
  This Child's T-Shirt Size REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Age (as of July 22, 2024) REQUIRED Please fill out this field. Please enter an integer (number).
  
  This Child's Health Problems
  
  This Child's Allergies and/or Diet Restrictions
  
  This Child's Physical Limitations
  
  This Child's Emotional or Behavioral Conditions (anxiety, depression homesickness, etc.)
  
  This Child's Medications
  
  Child's Bunkmate Please enter valid data.
  
  Our camp groups are divided into 7-9yrs, 10-12yrs, and 13-16yrs. Please take this into consideration when requesting a bunk mate.
  
  Child 7
  
  Child's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field.
  
  This Child's T-Shirt Size REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Age (as of July 22, 2024) REQUIRED Please fill out this field. Please enter an integer (number).
  
  This Child's Health Problems
  
  This Child's Allergies and/or Diet Restrictions
  
  This Child's Physical Limitations
  
  This Child's Emotional or Behavioral Conditions (anxiety, depression homesickness, etc.)
  
  This Child's Medications
  
  Child's Bunkmate Please enter valid data.
  
  Our camp groups are divided into 7-9yrs, 10-12yrs, and 13-16yrs. Please take this into consideration when requesting a bunk mate.
  
  Child 8
  
  Child's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field.
  
  This Child's T-Shirt Size REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Age (as of July 22, 2024) REQUIRED Please fill out this field. Please enter an integer (number).
  
  This Child's Health Problems
  
  This Child's Allergies and/or Diet Restrictions
  
  This Child's Physical Limitations
  
  This Child's Emotional or Behavioral Conditions (anxiety, depression homesickness, etc.)
  
  This Child's Medications
  
  Child's Bunkmate Please enter valid data.
  
  Our camp groups are divided into 7-9yrs, 10-12yrs, and 13-16yrs. Please take this into consideration when requesting a bunk mate.
  
  Child 9
  
  Child's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field.
  
  This Child's T-Shirt Size REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Age (as of July 22, 2024) REQUIRED Please fill out this field. Please enter an integer (number).
  
  This Child's Health Problems
  
  This Child's Allergies and/or Diet Restrictions
  
  This Child's Physical Limitations
  
  This Child's Emotional or Behavioral Conditions (anxiety, depression homesickness, etc.)
  
  This Child's Medications
  
  Child's Bunkmate Please enter valid data.
  
  Our camp groups are divided into 7-9yrs, 10-12yrs, and 13-16yrs. Please take this into consideration when requesting a bunk mate.
  
  Child 10
  
  Child's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field.
  
  This Child's T-Shirt Size REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Age (as of July 22, 2024) REQUIRED Please fill out this field. Please enter an integer (number).
  
  This Child's Health Problems
  
  This Child's Allergies and/or Diet Restrictions
  
  This Child's Physical Limitations
  
  This Child's Emotional or Behavioral Conditions (anxiety, depression homesickness, etc.)
  
  This Child's Medications
  
  Child's Bunkmate Please enter valid data.
  
  Our camp groups are divided into 7-9yrs, 10-12yrs, and 13-16yrs. Please take this into consideration when requesting a bunk mate.
  
  Child 11
  
  Child's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field.
  
  This Child's T-Shirt Size REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Age (as of July 22, 2024) REQUIRED Please fill out this field. Please enter an integer (number).
  
  This Child's Health Problems
  
  This Child's Allergies and/or Diet Restrictions
  
  This Child's Physical Limitations
  
  This Child's Emotional or Behavioral Conditions (anxiety, depression homesickness, etc.)
  
  This Child's Medications
  
  Child's Bunkmate Please enter valid data.
  
  Our camp groups are divided into 7-9yrs, 10-12yrs, and 13-16yrs. Please take this into consideration when requesting a bunk mate.
  
  Child 12
  
  Child's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field.
  
  This Child's T-Shirt Size REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Age (as of July 22, 2024) REQUIRED Please fill out this field. Please enter an integer (number).
  
  This Child's Health Problems
  
  This Child's Allergies and/or Diet Restrictions
  
  This Child's Physical Limitations
  
  This Child's Emotional or Behavioral Conditions (anxiety, depression homesickness, etc.)
  
  This Child's Medications
  
  Child's Bunkmate Please enter valid data.
  
  Our camp groups are divided into 7-9yrs, 10-12yrs, and 13-16yrs. Please take this into consideration when requesting a bunk mate.
  
  Child 13
  
  Child's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field.
  
  This Child's T-Shirt Size REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Age (as of July 22, 2024) REQUIRED Please fill out this field. Please enter an integer (number).
  
  This Child's Health Problems
  
  This Child's Allergies and/or Diet Restrictions
  
  This Child's Physical Limitations
  
  This Child's Emotional or Behavioral Conditions (anxiety, depression homesickness, etc.)
  
  This Child's Medications
  
  Child's Bunkmate Please enter valid data.
  
  Our camp groups are divided into 7-9yrs, 10-12yrs, and 13-16yrs. Please take this into consideration when requesting a bunk mate.
  
  Child 14
  
  Child's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field.
  
  This Child's T-Shirt Size REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Age (as of July 22, 2024) REQUIRED Please fill out this field. Please enter an integer (number).
  
  This Child's Health Problems
  
  This Child's Allergies and/or Diet Restrictions
  
  This Child's Physical Limitations
  
  This Child's Emotional or Behavioral Conditions (anxiety, depression homesickness, etc.)
  
  This Child's Medications
  
  Child's Bunkmate Please enter valid data.
  
  Our camp groups are divided into 7-9yrs, 10-12yrs, and 13-16yrs. Please take this into consideration when requesting a bunk mate.
  
  Child 15
  
  Child's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field.
  
  This Child's T-Shirt Size REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Age (as of July 22, 2024) REQUIRED Please fill out this field. Please enter an integer (number).
  
  This Child's Health Problems
  
  This Child's Allergies and/or Diet Restrictions
  
  This Child's Physical Limitations
  
  This Child's Emotional or Behavioral Conditions (anxiety, depression homesickness, etc.)
  
  This Child's Medications
  
  Child's Bunkmate Please enter valid data.
  
  Our camp groups are divided into 7-9yrs, 10-12yrs, and 13-16yrs. Please take this into consideration when requesting a bunk mate.
- Family Doctor & Health Insurance Information
  
  Family Doctor Name Please enter valid data.
  
  Family Doctor Phone Maximum 20 characters Please enter a phone number.
  
  Health Insurance Company Please enter valid data.
- Emergency Contact Information
  
  Who we contact if parents cannot be reached
  
  Emergency Contact #1
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Relationship Please enter valid data.
  
  Contact #1 Home Phone Maximum 20 characters Please enter a phone number.
  
  Contact #1 Cell Phone Maximum 20 characters Please enter a phone number.
  
  Emergency Contact #2
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Relationship Please enter valid data.
  
  Contact #2 Home Phone Maximum 20 characters Please enter a phone number.
  
  Contact #2 Cell Phone Maximum 20 characters Please enter a phone number.
- Photo/Recording Release
  I give permission for any photograph, video, audio recording and/or likeness procured of my child(ren) (listed above) to be used by the Diocese of Marquette. These may be used for promotional purposes and reproduction in any type of media form. I understand and agree that the use of my photograph, video or audio recording, and/or likeness is not an invasion of privacy. Neither I nor anyone claiming to be speaking on my behalf will object to the Diocese of Marquette using this material.
  I Agree Please select this field.
- Medical Treatment Release
  As a parent/guardian of the child(ren) listed on this form, I do hereby authorize emergency medical treatment for said child(ren) by a licensed Medical Provider in case of serious accident or illness. This authority is granted after reasonable effort has been made to contact me or either of the Contact Persons listed on this form.
  I Agree Please select this field.
- Digital Signature REQUIRED Please fill out this field. Please enter valid data.
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