Summer Camps - Catholic High School

Looking for fun ways for your students to spend their time this summer? We have something for the artist, athlete and scholar at Catholic High School! Hope to see you on campus this summer!

For information on these and other summer programs at Catholic High School contact Kelly Barney, Assistant Athletic Director, at barneyk@chsvb.org

Camps are grouped by category: Athletic and Academic.

Athletic Camps: Boys Basketball (July & August), Boys Lacrosse, Field Hockey, Football, Girls Basketball, Soccer, and Volleyball.
Academic Camps: AP History, Chemistry, Chess, Chorus, Creative Writing, Rising Freshman English.

Disclaimer: For the most accurate / most up-to-date Summer Camp information, please see the tabs below.

Download Summer Camp Flyer

Athletic Summer Camps
Academic Summer Camps

Athletic Camps

JULY - Boys Basketball
AUGUST - Boys Basketball
Boys Lacrosse
Field Hockey
Football
Girls Basketball
Soccer
Volleyball

JULY - Boys Basketball

Required

Boys Basketball Summer Camp - 2023

Instruction from CHS Varsity Boys and Coaches

Contact: Bobby Steinburg - coachsteinburg@chsvb.org

Dates: July 17-21

Time: 9am - 2pm

Target Ages: Rising 2nd-9th grade boys

Fee: $200.00

Location: CHS Gym

CAMP PARTICIPANT INFORMATION

Participant Name*required

First Name

Last Name

Participant RISING grade (2023-2024 school year)*required

School Attending in the Fall (2023-2024 school year)

Health Information: Allergy Information, Health Concerns, Medication & dosage regularly taken*required

Please put N/A if this does not apply to you.

PARENT/GUARDIAN INFORMATION

Name*required

First Name

Last Name

Primary Parent/Guardian Email Address*required

Primary Parent/Guardian Phone Number*required

Primary Parent/Guardian Address*required

Please include Street Address, City, State, and Zip Code.

Secondary Parent/Guardian NameOPTIONAL

First Name

Last Name

OPTIONAL

Secondary Parent/Guardian Email Address

Secondary Parent/Guardian Phone Number

Secondary Parent/Guardian Address

Please include Street Address, City, State, and Zip Code.

MEDICAL CONSENT

Family Physician & Physician Phone Number*required

I hereby approve of my child's attendance at a summer camp at Catholic High School. I certify that he/she is in good health and is able to participate in the full camp program. I authorize the Clinic Directors and the Athletic Directors to act for me in securing medical treatment for my child in the event of an injury or sickness. I understand that should an emergency arise, I will be contacted immediately. If I am not available, I authorize you to contact:

Emergency Contact Name*required

First Name

Last Name

Emergency Contact Phone Number*required

Insurance Policy & Insurance Policy Number*required

CONSENTING PARENT NAME*required

First Name

Last Name

Payment Type*required

Card

Cash

Check

Fee

$200.00

Payment Information

Email*required

Provide an email address for the receipt.

Please select a payment type*required

Card

Billing Address*required

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Name*required

First

Last

Expiration*required

Month

Year

AUGUST - Boys Basketball

Required

Boys Basketball Summer Camp - 2023

Instruction from CHS Varsity Boys and Coaches

Contact: Bobby Steinburg - coachsteinburg@chsvb.org

Dates: August 7-11

Time: 9am - 2pm

Target Ages: Rising 2nd-9th grade boys

Fee: $200.00

Location: CHS Gym

CAMP PARTICIPANT INFORMATION

Participant Name*required

First Name

Last Name

Participant RISING grade (2023-2024 school year)*required

School Attending in the Fall (2023-2024 school year)

Health Information: Allergy Information, Health Concerns, Medication & dosage regularly taken*required

Please put N/A if this does not apply to you.

PARENT/GUARDIAN INFORMATION

Name*required

First Name

Last Name

Primary Parent/Guardian Email Address*required

Primary Parent/Guardian Phone Number*required

Primary Parent/Guardian Address*required

Please include Street Address, City, State, and Zip Code.

Secondary Parent/Guardian NameOPTIONAL

First Name

Last Name

OPTIONAL

Secondary Parent/Guardian Email Address

Secondary Parent/Guardian Phone Number

Secondary Parent/Guardian Address

Please include Street Address, City, State, and Zip Code.

MEDICAL CONSENT

Family Physician & Physician Phone Number*required

Emergency Contact Name*required

First Name

Last Name

Emergency Contact Phone Number*required

Insurance Policy & Insurance Policy Number*required

CONSENTING PARENT NAME*required

First Name

Last Name

Payment Type*required

Card

Cash

Check

Fee

$200.00

Payment Information

Email*required

Provide an email address for the receipt.

Please select a payment type*required

Card

Billing Address*required

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Name*required

First

Last

Expiration*required

Month

Year

Boys Lacrosse

Required

Boys Lacrosse Summer Camp - 2023

Instruction from Varsity and JC Boys Lacrosse players and coaches.

Contact: Mark Hargrave - coachhargrave@chsvb.org

Dates: June 26-30

Time: 8am - 12pm

Target Ages: Rising 6th-12th grade

Fee: $150.00

Location: CHS lacrosse field

CAMP PARTICIPANT INFORMATION

Participant Name*required

First Name

Last Name

Participant RISING grade (2023-2024 school year)*required

School Attending in the Fall (2023-2024 school year)

Health Information: Allergy Information, Health Concerns, Medication & dosage regularly taken*required

Please put N/A if this does not apply to you.

PARENT/GUARDIAN INFORMATION

Name*required

First Name

Last Name

Primary Parent/Guardian Email Address*required

Primary Parent/Guardian Phone Number*required

Primary Parent/Guardian Address*required

Please include Street Address, City, State, and Zip Code.

Secondary Parent/Guardian NameOPTIONAL

First Name

Last Name

OPTIONAL

Secondary Parent/Guardian Email Address

Secondary Parent/Guardian Phone Number

Secondary Parent/Guardian Address

Please include Street Address, City, State, and Zip Code.

MEDICAL CONSENT

Family Physician & Physician Phone Number*required

Emergency Contact Name*required

First Name

Last Name

Emergency Contact Phone Number*required

Insurance Policy & Insurance Policy Number*required

CONSENTING PARENT NAME*required

First Name

Last Name

Payment Type*required

Card

Cash

Check

Fee

$150.00

Payment Information

Email*required

Provide an email address for the receipt.

Please select a payment type*required

Card

Billing Address*required

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Name*required

First

Last

Expiration*required

Month

Year

Field Hockey

Required

Field Hockey Summer Camp - 2023

Instruction from Varsity and Junior Varsity Field Hockey players and coaches.

Contact: Lyndsey Boyce and Kelly Barney - barneyk@chsvb.org

Dates: August 7-10

Time: 9am - 12pm

Target Ages: Rising 1st - 8th grade

Fee: $100.00

Location: CHS Field Hockey field

CAMP PARTICIPANT INFORMATION

Participant Name*required

First Name

Last Name

Participant RISING grade (2023-2024 school year)*required

School Attending in the Fall (2023-2024 school year)

Health Information: Allergy Information, Health Concerns, Medication & dosage regularly taken*required

Please put N/A if this does not apply to you.

PARENT/GUARDIAN INFORMATION

Name*required

First Name

Last Name

Primary Parent/Guardian Email Address*required

Primary Parent/Guardian Phone Number*required

Primary Parent/Guardian Address*required

Please include Street Address, City, State, and Zip Code.

Secondary Parent/Guardian NameOPTIONAL

First Name

Last Name

OPTIONAL

Secondary Parent/Guardian Email Address

Secondary Parent/Guardian Phone Number

Secondary Parent/Guardian Address

Please include Street Address, City, State, and Zip Code.

MEDICAL CONSENT

Family Physician & Physician Phone Number*required

Emergency Contact Name*required

First Name

Last Name

Emergency Contact Phone Number*required

Insurance Policy & Insurance Policy Number*required

CONSENTING PARENT NAME*required

First Name

Last Name

Payment Type*required

Card

Cash

Check

Fee

$100.00

Payment Information

Email*required

Provide an email address for the receipt.

Please select a payment type*required

Card

Billing Address*required

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Name*required

First

Last

Expiration*required

Month

Year

Football

Required

Football Summer Camp - 2023

Learn football skills and do football related workouts!

Contact: John Harlow - coachharlow@chsvb.org

Dates: July 10-13

Time: 8am - 11am

Target Ages: Rising 2nd - 9th grade

Fee: $150

*Note: CHS Students trying out for football will not be charged. Please mark "cash" for payment type.

Location: CHS Football Field

CAMP PARTICIPANT INFORMATION

Participant Name*required

First Name

Last Name

Participant RISING grade (2023-2024 school year)*required

School Attending in the Fall (2023-2024 school year)

Health Information: Allergy Information, Health Concerns, Medication & dosage regularly taken*required

Please put N/A if this does not apply to you.

PARENT/GUARDIAN INFORMATION

Name*required

First Name

Last Name

Primary Parent/Guardian Email Address*required

Primary Parent/Guardian Phone Number*required

Primary Parent/Guardian Address*required

Please include Street Address, City, State, and Zip Code.

Secondary Parent/Guardian NameOPTIONAL

First Name

Last Name

OPTIONAL

Secondary Parent/Guardian Email Address

Secondary Parent/Guardian Phone Number

Secondary Parent/Guardian Address

Please include Street Address, City, State, and Zip Code.

MEDICAL CONSENT

Family Physician & Physician Phone Number*required

Emergency Contact Name*required

First Name

Last Name

Emergency Contact Phone Number*required

Insurance Policy & Insurance Policy Number*required

CONSENTING PARENT NAME*required

First Name

Last Name

Payment Type*required

Card

Cash

Check

Fee

$150.00

Payment Information

Email*required

Provide an email address for the receipt.

Please select a payment type*required

Card

Billing Address*required

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Name*required

First

Last

Expiration*required

Month

Year

Girls Basketball

Required

Girls Basketball Summer Camp - 2023

Instruction from CHS Varsity Girls and Coaches

Contact: Billy Stokes - coachstokes@chsvb.org

Dates: July 24-28

Time: 9am - 2pm

Target Ages: Rising 2nd-9th grade girls

Fee: $150.00

Location: CHS Gym

CAMP PARTICIPANT INFORMATION

Participant Name*required

First Name

Last Name

Participant RISING grade (2023-2024 school year)*required

School Attending in the Fall (2023-2024 school year)

Health Information: Allergy Information, Health Concerns, Medication & dosage regularly taken*required

Please put N/A if this does not apply to you.

PARENT/GUARDIAN INFORMATION

Name*required

First Name

Last Name

Primary Parent/Guardian Email Address*required

Primary Parent/Guardian Phone Number*required

Primary Parent/Guardian Address*required

Please include Street Address, City, State, and Zip Code.

Secondary Parent/Guardian NameOPTIONAL

First Name

Last Name

OPTIONAL

Secondary Parent/Guardian Email Address

Secondary Parent/Guardian Phone Number

Secondary Parent/Guardian Address

Please include Street Address, City, State, and Zip Code.

MEDICAL CONSENT

Family Physician & Physician Phone Number*required

Emergency Contact Name*required

First Name

Last Name

Emergency Contact Phone Number*required

Insurance Policy & Insurance Policy Number*required

CONSENTING PARENT NAME*required

First Name

Last Name

Payment Type*required

Card

Cash

Check

Fee

$150.00

Payment Information

Email*required

Provide an email address for the receipt.

Please select a payment type*required

Card

Billing Address*required

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Name*required

First

Last

Expiration*required

Month

Year

Soccer

Required

Soccer Summer Camp - 2023

Instruction from CHS Varsity coach

Contact: Kevin Smith - coachksmith@chsvb.org

Dates: July 17-21

Time: 9am - 12pm

Target Ages: Rising 6th-12th grade

Fee: $100.00

Location: CHS soccer field

CAMP PARTICIPANT INFORMATION

Participant Name*required

First Name

Last Name

Participant RISING grade (2023-2024 school year)*required

School Attending in the Fall (2023-2024 school year)

Health Information: Allergy Information, Health Concerns, Medication & dosage regularly taken*required

Please put N/A if this does not apply to you.

PARENT/GUARDIAN INFORMATION

Name*required

First Name

Last Name

Primary Parent/Guardian Email Address*required

Primary Parent/Guardian Phone Number*required

Primary Parent/Guardian Address*required

Please include Street Address, City, State, and Zip Code.

Secondary Parent/Guardian NameOPTIONAL

First Name

Last Name

OPTIONAL

Secondary Parent/Guardian Email Address

Secondary Parent/Guardian Phone Number

Secondary Parent/Guardian Address

Please include Street Address, City, State, and Zip Code.

MEDICAL CONSENT

Family Physician & Physician Phone Number*required

Emergency Contact Name*required

First Name

Last Name

Emergency Contact Phone Number*required

Insurance Policy & Insurance Policy Number*required

CONSENTING PARENT NAME*required

First Name

Last Name

Payment Type*required

Card

Cash

Check

Fee

$100.00

Payment Information

Email*required

Provide an email address for the receipt.

Please select a payment type*required

Card

Billing Address*required

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Name*required

First

Last

Expiration*required

Month

Year

Volleyball

Required

Volleyball Summer Camp - 2023

Individual and team player development

Contact: Mike Brandwein - coachbrandwein@chsvb.org

Dates: July 17-20

Time: 2:30pm - 5:00pm

Target Ages: Rising 5th-8th grade girls and boys

Fee: $120.00

Location: CHS Gym

CAMP PARTICIPANT INFORMATION

Participant Name*required

First Name

Last Name

Participant RISING grade (2023-2024 school year)*required

School Attending in the Fall (2023-2024 school year)

Health Information: Allergy Information, Health Concerns, Medication & dosage regularly taken*required

Please put N/A if this does not apply to you.

PARENT/GUARDIAN INFORMATION

Name*required

First Name

Last Name

Primary Parent/Guardian Email Address*required

Primary Parent/Guardian Phone Number*required

Primary Parent/Guardian Address*required

Please include Street Address, City, State, and Zip Code.

Secondary Parent/Guardian NameOPTIONAL

First Name

Last Name

OPTIONAL

Secondary Parent/Guardian Email Address

Secondary Parent/Guardian Phone Number

Secondary Parent/Guardian Address

Please include Street Address, City, State, and Zip Code.

MEDICAL CONSENT

Family Physician & Physician Phone Number*required

Emergency Contact Name*required

First Name

Last Name

Emergency Contact Phone Number*required

Insurance Policy & Insurance Policy Number*required

CONSENTING PARENT NAME*required

First Name

Last Name

Payment Type*required

Card

Cash

Check

Fee

$120.00

Payment Information

Email*required

Provide an email address for the receipt.

Please select a payment type*required

Card

Billing Address*required

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Name*required

First

Last

Expiration*required

Month

Year

Academic Summer Camps

Academic Camps

AP History
Chemistry
Chess
Chorus
Creative Writing
Rising Freshman English

AP History

Required

AP History Summer Camp - 2023

Contact: Sarah Orleans - orleanss@chsvb.org

Dates: August

Time: 9am - 12pm

Target Ages: Rising 10th & 1th grade CHS students enrolled in AP History

Fee: $100.00

Location: CHS classroom

CAMP PARTICIPANT INFORMATION

Participant Name*required

First Name

Last Name

Participant RISING grade (2023-2024 school year)*required

School Attending in the Fall (2023-2024 school year)

Health Information: Allergy Information, Health Concerns, Medication & dosage regularly taken*required

Please put N/A if this does not apply to you.

PARENT/GUARDIAN INFORMATION

Name*required

First Name

Last Name

Primary Parent/Guardian Email Address*required

Primary Parent/Guardian Phone Number*required

Primary Parent/Guardian Address*required

Please include Street Address, City, State, and Zip Code.

Secondary Parent/Guardian NameOPTIONAL

First Name

Last Name

OPTIONAL

Secondary Parent/Guardian Email Address

Secondary Parent/Guardian Phone Number

Secondary Parent/Guardian Address

Please include Street Address, City, State, and Zip Code.

MEDICAL CONSENT

Family Physician & Physician Phone Number*required

Emergency Contact Name*required

First Name

Last Name

Emergency Contact Phone Number*required

Insurance Policy & Insurance Policy Number*required

CONSENTING PARENT NAME*required

First Name

Last Name

Payment Type*required

Card

Cash

Check

Fee

$100.00

Payment Information

Email*required

Provide an email address for the receipt.

Please select a payment type*required

Card

Billing Address*required

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Name*required

First

Last

Expiration*required

Month

Year

Chemistry

Required

Chemistry Summer Camp - 2023

Preparatory class to introduce the calculations students must master to be successful in chemistry

Contact: Jennifer McMullen - mcmullenj@chsvb.org

Dates: August 7-10

Time: 9am - 12pm

Target Ages: CHS students enrolled in Chemistry for the 2023-2024 school year

Fee: $100.00

Location: CHS classroom

CAMP PARTICIPANT INFORMATION

Participant Name*required

First Name

Last Name

Participant RISING grade (2023-2024 school year)*required

School Attending in the Fall (2023-2024 school year)

Health Information: Allergy Information, Health Concerns, Medication & dosage regularly taken*required

Please put N/A if this does not apply to you.

PARENT/GUARDIAN INFORMATION

Name*required

First Name

Last Name

Primary Parent/Guardian Email Address*required

Primary Parent/Guardian Phone Number*required

Primary Parent/Guardian Address*required

Please include Street Address, City, State, and Zip Code.

Secondary Parent/Guardian NameOPTIONAL

First Name

Last Name

OPTIONAL

Secondary Parent/Guardian Email Address

Secondary Parent/Guardian Phone Number

Secondary Parent/Guardian Address

Please include Street Address, City, State, and Zip Code.

MEDICAL CONSENT

Family Physician & Physician Phone Number*required

Emergency Contact Name*required

First Name

Last Name

Emergency Contact Phone Number*required

Insurance Policy & Insurance Policy Number*required

CONSENTING PARENT NAME*required

First Name

Last Name

Payment Type*required

Card

Cash

Check

Fee

$100.00

Payment Information

Email*required

Provide an email address for the receipt.

Please select a payment type*required

Card

Billing Address*required

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Name*required

First

Last

Expiration*required

Month

Year

Chess

Required

Chess Summer Camp - 2023

Contact: Laura Morse - morsel@chsvb.org

Dates: July 24 - 28

Time: 10am - 2pm

Target Ages: Rising CHS Freshmen (9th) - Seniors (12th)

Fee: $100.00

Location: CHS classroom

CAMP PARTICIPANT INFORMATION

Participant Name*required

First Name

Last Name

Participant RISING grade (2023-2024 school year)*required

School Attending in the Fall (2023-2024 school year)

Health Information: Allergy Information, Health Concerns, Medication & dosage regularly taken*required

Please put N/A if this does not apply to you.

PARENT/GUARDIAN INFORMATION

Name*required

First Name

Last Name

Primary Parent/Guardian Email Address*required

Primary Parent/Guardian Phone Number*required

Primary Parent/Guardian Address*required

Please include Street Address, City, State, and Zip Code.

Secondary Parent/Guardian NameOPTIONAL

First Name

Last Name

OPTIONAL

Secondary Parent/Guardian Email Address

Secondary Parent/Guardian Phone Number

Secondary Parent/Guardian Address

Please include Street Address, City, State, and Zip Code.

MEDICAL CONSENT

Family Physician & Physician Phone Number*required

Emergency Contact Name*required

First Name

Last Name

Emergency Contact Phone Number*required

Insurance Policy & Insurance Policy Number*required

CONSENTING PARENT NAME*required

First Name

Last Name

Payment Type*required

Card

Cash

Check

Fee

$100.00

Payment Information

Email*required

Provide an email address for the receipt.

Please select a payment type*required

Card

Billing Address*required

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Name*required

First

Last

Expiration*required

Month

Year

Chorus

Required

Chorus Summer Camp - 2023

How to improve your Acapella experience

Contact: Leslie Fenter - fenterl@chsvb.org

Dates: July 10-14

Time: 9am - 1pm

Target Ages: Rising 7th - 10th grade

Fee: $100.00

Location: CHS choral room

CAMP PARTICIPANT INFORMATION

Participant Name*required

First Name

Last Name

Participant RISING grade (2023-2024 school year)*required

School Attending in the Fall (2023-2024 school year)

Health Information: Allergy Information, Health Concerns, Medication & dosage regularly taken*required

Please put N/A if this does not apply to you.

PARENT/GUARDIAN INFORMATION

Name*required

First Name

Last Name

Primary Parent/Guardian Email Address*required

Primary Parent/Guardian Phone Number*required

Primary Parent/Guardian Address*required

Please include Street Address, City, State, and Zip Code.

Secondary Parent/Guardian NameOPTIONAL

First Name

Last Name

OPTIONAL

Secondary Parent/Guardian Email Address

Secondary Parent/Guardian Phone Number

Secondary Parent/Guardian Address

Please include Street Address, City, State, and Zip Code.

MEDICAL CONSENT

Family Physician & Physician Phone Number*required

Emergency Contact Name*required

First Name

Last Name

Emergency Contact Phone Number*required

Insurance Policy & Insurance Policy Number*required

CONSENTING PARENT NAME*required

First Name

Last Name

Payment Type*required

Card

Cash

Check

Fee

$100.00

Payment Information

Email*required

Provide an email address for the receipt.

Please select a payment type*required

Card

Billing Address*required

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Name*required

First

Last

Expiration*required

Month

Year

Creative Writing

Required

Creative Writing Summer Camp - 2023

Students will learn poetry and creative writing, and create a creative writing portfolio.

Contact: Laura Morse - morsel@chsvb.org

Dates: July 31- August 4

Time: 10am - 2pm

Target Ages: Rising CHS Freshmen (9th) - Seniors (12th)

Fee: $100.00

Location: CHS classroom

CAMP PARTICIPANT INFORMATION

Participant Name*required

First Name

Last Name

Participant RISING grade (2023-2024 school year)*required

School Attending in the Fall (2023-2024 school year)

Health Information: Allergy Information, Health Concerns, Medication & dosage regularly taken*required

Please put N/A if this does not apply to you.

PARENT/GUARDIAN INFORMATION

Name*required

First Name

Last Name

Primary Parent/Guardian Email Address*required

Primary Parent/Guardian Phone Number*required

Primary Parent/Guardian Address*required

Please include Street Address, City, State, and Zip Code.

Secondary Parent/Guardian NameOPTIONAL

First Name

Last Name

OPTIONAL

Secondary Parent/Guardian Email Address

Secondary Parent/Guardian Phone Number

Secondary Parent/Guardian Address

Please include Street Address, City, State, and Zip Code.

MEDICAL CONSENT

Family Physician & Physician Phone Number*required

Emergency Contact Name*required

First Name

Last Name

Emergency Contact Phone Number*required

Insurance Policy & Insurance Policy Number*required

CONSENTING PARENT NAME*required

First Name

Last Name

Payment Type*required

Card

Cash

Check

Fee

$100.00

Payment Information

Email*required

Provide an email address for the receipt.

Please select a payment type*required

Card

Billing Address*required

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Name*required

First

Last

Expiration*required

Month

Year

Rising Freshman English

Required

Rising Freshmen English Summer Camp - 2023

Students will work on drafting an argumentative essay.

Contact: Laura Morse - morsel@chsvb.org

Dates: August 7-11

Time: 10am - 2pm

Target Ages: Rising CHS Freshmen (9th)

Fee: $100.00

Location: CHS classroom

CAMP PARTICIPANT INFORMATION

Participant Name*required

First Name

Last Name

Participant RISING grade (2023-2024 school year)*required

School Attending in the Fall (2023-2024 school year)

Health Information: Allergy Information, Health Concerns, Medication & dosage regularly taken*required

Please put N/A if this does not apply to you.

PARENT/GUARDIAN INFORMATION

Name*required

First Name

Last Name

Primary Parent/Guardian Email Address*required

Primary Parent/Guardian Phone Number*required

Primary Parent/Guardian Address*required

Please include Street Address, City, State, and Zip Code.

Secondary Parent/Guardian NameOPTIONAL

First Name

Last Name

OPTIONAL

Secondary Parent/Guardian Email Address

Secondary Parent/Guardian Phone Number

Secondary Parent/Guardian Address

Please include Street Address, City, State, and Zip Code.

MEDICAL CONSENT

Family Physician & Physician Phone Number*required

Emergency Contact Name*required

First Name

Last Name

Emergency Contact Phone Number*required

Insurance Policy & Insurance Policy Number*required

CONSENTING PARENT NAME*required

First Name

Last Name

Payment Type*required

Card

Cash

Check

Fee

$100.00

Payment Information

Email*required

Provide an email address for the receipt.

Please select a payment type*required

Card

Billing Address*required

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Name*required

First

Last

Expiration*required

Month

Year

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2023 Summer Camps