Archbishop Hoban Summer Camp Registration

Students in various grades are invited to experience life at the Castle, gain additional instruction, continue advancing in skill and have tons of fun in Hoban’s academic and athletic camps.

{ binding displayValue, mode=oneTime }

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

{binding displayValue}

Student Information

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

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

{ binding displayValue, mode=oneTime }

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

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

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

{ binding displayValue, mode=oneTime }

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

{ binding displayValue, mode=oneTime }

{binding CurrentSchool_Label, source = {{ $context.parentContext.dataItem }} } {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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

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

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

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

How did you hear about Hoban Summer Camp? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Whom can we thank for the referral? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Camp Options

Date

Discount Code

Price

Item {binding ItemNumber}

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

{binding displayValue}

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

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

Permission to Participate

Media Release Waiver

Media Opt Out {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Check this box to opt out of the Media Release Waiver.

{# pageNumbers}

Emergency Medical Treament

{binding ConsentForEmergencyMedicalTreatmentForFormStudentInformationStudentName_Label, source = {{ $context.parentContext.dataItem }} } {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

I hereby give consent for the following medical care providers and hospital to be called.

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

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

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

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

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

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

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

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

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

Provide facts concerning the child’s medical history, including allergies, medications being taken and any physical impairment to which a physician should be alerted.

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

In the event of illness or injury requiring emergency treatment, I wish the camp and school pesonnel to take these actions.

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

{# pageNumbers}

Credit Card Authorization

{binding IUnderstandThatRegistrationFeesAreNonrefundableIAuthorizeArchbishopHobanHighSchoolToChargeFormOrderOrderAmountToTheCreditCardOnFileUponSubmissionOfThisRegistration_Label, source = {{ $context.parentContext.dataItem }} } {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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

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

{~ Payment_Block_Label}

{binding Group}
{binding Name} - {binding Description}	{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}	{binding displayValue}
{binding Name}:	{binding displayValue}	---

{{ Cognito.resources['payment-amount-due'] + ":" }} {binding displayValue}

{# pageNumbers}

Archbishop Hoban Summer Camp Registration

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}

{{ Cognito.resources['order-date-label'] }}: {binding displayValue}

{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{binding BillingName}

{binding BillingAddress.FullInternationalAddress}

{binding PhoneNumber}

{binding EmailAddress}

{binding Group}
{binding Name} - {binding Description}	{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}	{binding displayValue}
{binding Name}:	{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:	({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:	{binding displayValue}

Archbishop Hoban Summer Camp Registration

Students in various grades are invited to experience life at the Castle, gain additional instruction, continue advancing in skill and have tons of fun in Hoban’s academic and athletic camps.

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}

{{ Cognito.resources['order-date-label'] }}: {binding displayValue}

{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{binding BillingName}

{binding BillingAddress.FullInternationalAddress}

{binding PhoneNumber}

{binding EmailAddress}

{binding Group}
{binding Name} - {binding Description}	{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}	{binding displayValue}
{binding Name}:	{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:	({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:	{binding displayValue}

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

{binding displayValue}

Student Information

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

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

{binding CurrentSchool_Label, source = {{ $context.parentContext.dataItem }} } {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

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

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

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

How did you hear about Hoban Summer Camp? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Whom can we thank for the referral? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Camp Options

Date

Discount Code

Price

Item {binding ItemNumber}

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

{binding displayValue}

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

{binding displayValue}

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

Permission to Participate

Media Release Waiver

Media Opt Out {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Emergency Medical Treament

{binding displayValue}

I hereby give consent for the following medical care providers and hospital to be called.

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

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

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

{binding displayValue}

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

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

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

Credit Card Authorization

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

{binding displayValue}

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

{binding displayValue}

Archbishop Hoban Summer Camp Registration

Student Information

Camp Options

Item {binding ItemNumber}

Permission to Participate

Media Release Waiver

Emergency Medical Treament

Credit Card Authorization

{~ Payment_Block_Label}

Archbishop Hoban Summer Camp Registration

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-billing-info-header'] }}

Archbishop Hoban Summer Camp Registration

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-billing-info-header'] }}

Student Information

Camp Options

Item {binding ItemNumber}

Permission to Participate

Media Release Waiver

Emergency Medical Treament

Credit Card Authorization