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SJHA 2021 Sports Camp Registration

Sports Camp flyer

Family Last Name*

Answer Required

Student's First Name*

Answer Required

Gender*

Answer Required

Female

Male

Grade Entering Sept. 2021*

Answer Required

Date of Birth*

Answer Required

Email address*

Answer Required

Home Address*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Cell phone*

Number Required

Parent / Legal Guardian #1 Full Name*

Answer Required

Parent / Legal Guardian #1 Work Phone*

Number Required

Parent / Legal Guardian #1 Cell Phone*

Answer Required

Parent / Legal Guardian #2 Full Name*

Answer Required

Parent / Legal Guardian #2 Work Phone*

Number Required

Parent / Legal Guardian #2 Cell Phone*

Number Required

Other adults authorized to pick up at dismissal.

Adult #1 Full Name

Answer Required

Adult #1 Relationship to Student

Answer Required

Adult #1 Cell Phone

Number Required

Adult #2 Full Name

Answer Required

Adult #2 Relationship to Student

Answer Required

Adult #2 Cell Phone

Number Required

In the event of an emergency who should be notified first:*

Answer Required

Allergies or special needs:*

Answer Required

I certify that the information provided above is accurate.*

Answer Required

Yes

Form respondent's full name*

Answer Required

If your child is not a student at SJHA an up to date medical from their Doctor must be submitted. This must be submitted by June 21, 2021 to be checked by our nurse. You can contact [email protected] for questions.

Select your camp and make your payment here https://secure.etransfer.com/SJHA/SportCamps.cfm to complete your registration payment.

Confirmation Email

Confirmation Email *

Email Required