Camp Session

Choose the Summer Session you would like to apply for below:

Select Session: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Camper

Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Birthday {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Camper Age {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Gender {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Did your child read our brochure? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Does your child agree to abide by the camp's guidelines? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Mother's Phone Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Father's Phone Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Camper Medical Information

Enter camper specific medical information below.

Does the camper have allergies? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Please list all known allergies (including food and medications): {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Are there any medical conditions we should be aware of? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

If yes, please list below: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Is camper current on immunizations? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Date of Last Tetanus Shot: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Insurance Company: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Insurance Policy Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Insurance Company Phone: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

If the camper currently on any prescription medication? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

If yes, please list below: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

If yes, I hereby give Camp Hosanna Senior Staff permission to administer prescriptions listed above: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

I give the camp permission to administer the following to my child, if necessary: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Parental Consent

By entering your name below you are agreeing to allow this to serve as your electronic signiture and thereby are giving the camper your written permission to attend the selected camp session. This electronic signiture serves as your legal signature.

I have read this form and give my consent for the child named below to attend Camp Hosanna. In case of an emergency, I understand every effort will be made to contact parents or guardians of campers. In the event I cannot be reached, I hereby give permission to the Senior Camp Staff and Physician selected by Senior Camp Staff to hospitalize and secure proper treatment for my child as named below:

Camper Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

I will not hold the property owners of which Camp Hosanna is located, or anyone connected to Camp Hosanna, liable for injuries that might incur at Camp Hosanna.

Liability Release: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

I hereby give my permission for any pictures taken, that may include my child, to be used for future camp uses.

Photography Consent: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Electronic Signature

Parent/Guardian Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Date Signed {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Summer Camp Registration

Camp Session

Choose the Summer Session you would like to apply for below:

Camper

Camper Medical Information

Enter camper specific medical information below.

Parental Consent

By entering your name below you are agreeing to allow this to serve as your electronic signiture and thereby are giving the camper your written permission to attend the selected camp session. This electronic signiture serves as your legal signature.

Electronic Signature

Summer Camp Registration

Camp Session

Choose the Summer Session you would like to apply for below:

Camper

Camper Medical Information

Enter camper specific medical information below.

Parental Consent

By entering your name below you are agreeing to allow this to serve as your electronic signiture and thereby are giving the camper your written permission to attend the selected camp session. This electronic signiture serves as your legal signature.

Electronic Signature

Summer Camp Registration

Camp Session

Choose the Summer Session you would like to apply for below:

Camper

Camper Medical Information

Enter camper specific medical information below.

Parental Consent

By entering your name below you are agreeing to allow this to serve as your electronic signiture and thereby are giving the camper your written permission to attend the selected camp session. This electronic signiture serves as your legal signature.

Electronic Signature