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2026 Camp Registration Card - Page 1

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UIW

2026 St. Anthony Catholic School

KRP Summer Camp Registration Card

Student Information

Student's Legal First Name*

Answer required for "Student's Legal First Name"

Student's Legal Last Name*

Answer required for "Student's Legal Last Name"

Date of Birth*

Answer required for "Date of Birth"

Age*

Answer required for "Age"

Grade entering in August of 2026

Answer required for "Grade entering in August of 2026"

Student's Home Address*

Answer required for "Student's Home Address"

Home Phone

Answer required for "Home Phone"

Question*

Answer required for "Question"

Parent Information

Mother's Name*

Answer required for "Mother's Name"

Phone*

Answer required for "Phone"

Street Address

Answer required for "Street Address"

Father's Name

Answer required for "Father's Name"

Phone Number*

Number Required

Street Address

Answer required for "Street Address"

Allergies*

Answer required for "Allergies"

Previous Camp, Day Care or School Experience

Answer required for "Previous Camp, Day Care or School Experience"

Please list names of alternate adults who are authorized to pick up your child in case of an emergency or illness. (MUST SHOW PICTURE ID)

Students will not be released to persons not listed on this card.

Name

Answer required for "Name"

Relationsnip

Answer required for "Relationsnip"

Phone

Number Required

Address

Answer required for "Address"

Name

Answer required for "Name"

Relationship

Answer required for "Relationship"

Phone

Number Required

Address

Number Required

Name

Answer required for "Name"

Relationship

Answer required for "Relationship"

Phone

Answer required for "Phone"

Address

Answer required for "Address"

I hereby grant my permission for emergency medical care to be given by the attending physician and or school personnel. I also give permissionfor EMS to be called and/or for my child to be transported as necessary by school personnel. I will not hold the school financially responsible for the emergency care and/or transportation of my child.

Signature of Parent/Guardian*

Signature Required

Physician*

Answer required for "Physician"

Question*

Number Required

Street Address

Answer required for "Street Address"

Hospital

Answer required for "Hospital"

Question

Number Required

Street Address

Answer required for "Street Address"

Photographs/Internet

Please answer*

Answer required for "Please answer"

Yes, my child's photograph may be used on the school website.

No, I do not want my child's photgraph used by the school.

Yes, my chid may use the internet with staff supervision.

No, I do not want my child to use the internet.

Confirmation Email

Confirmation Email *

Answer required for "Confirmation Email"