Camp IO Registration (CIT)

Please fill out the registration form below. Fields with an asterisk (*) are required.

Why do you want to be a CIT? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

What qualifications do you have that would make you a good CIT? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Parent/Guardian 1 {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

Parent/Guardian 2 {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

Child 1 {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Child 1 Birth Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Does Child 1 have any health concerns? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Please list health concerns for Child 1. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Does Child 1 have a 504 or IEP plan? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Please list diagnosis for Child 1 {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Child 2 {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Child 2 Birth Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Does Child 2 have any health concerns? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Please list health concerns for Child 2. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Does Child 2 have a 504 or IEP plan? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Please list diagnosis for Child 2 {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

No Child 2, please click Next.

Child 3 {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Child 3 Birth Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Does Child 3 have any health concerns? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Please list health concerns for Child 3. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Does Child 3 have a 504 or IEP plan? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Please list diagnosis for Child 3 {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

No Child 3, please click Next.

Child 4 {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Child 4 Birth Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Does Child 4 have any health concerns? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Please list health concerns for Child 4. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Does Child 4 have a 504 or IEP plan? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Please list diagnosis for Child 4 {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

No Child 4, please click Next.

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

{binding displayValue}

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

{binding displayValue}

Emergency Contact Phone (Other) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Authorized Person to Pick-Up Camper(s) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

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

{binding displayValue}

Authorized Person Phone (Other) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

If Other, please specify. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

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

Participation Agreement

I hereby give permission for my child to participate in the above registered program at IO Workshop - Mélong Ling. While all reasonable precautions will be taken to ensure my child’s safety and to prevent any injuries from occurring, I will agree to waive all claims against any person connected with IO Workshop - Melong Ling. I agree that IO Workshop - Melong Ling has permission to have my child transported and to receive any and all emergency health care attention needed. IO Workshop - Melong Ling reserves the right to remove any child from our program for any reason at any time and NO refunds or credits will be issued for any child so removed! This is for the safety and well being of all students and staff.

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

{binding displayValue}

Refund Policy/Cancellation/Receipts

All payments are non-refundable. You will receive credit, based on the amount paid. Credits may be applied toward any IOW-ML programs. Credits do not expire! If you sign up your child for any IOW-ML program and change your mind, you are still liable for payment. All receipts for IOW-ML will be provided after the activity associated with that payment has ended.

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

{binding displayValue}

Child 1 Camp Weeks {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Child 2 Camp Weeks {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Child 3 Camp Weeks {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Child 4 Camp Weeks {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}