2025 Sacred Heart Summer Camp

Event: Catholic Summer Camp
Theme: Put on the Armor of God!
Location: Archbishop Neale School
Dates: July 14 - 18, 2025, 9am-12noon

I grant permission for my child to participate in this activity or event. This activity will take place under the guidance and direction of the parish or school employees and/or volunteers from Sacred Heart Summer Camp.
Camper's Name Camper's Name First Last
Camper's Age
Sex
Parent/Guardian Name Parent/Guardian Name First Last
Primary Phone # Primary Phone # - ### - ### ####
Secondary Phone # Secondary Phone # - ### - ### ####
Camper's Current Residence Camper's Current Residence
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email (This email will receive a copy of this registration once submitted, and will be used to send more information and updates.)
Authorized Pick-Up

For the safety of our campers, we ask for a list of names of any individuals you approve to pick up your child.
Please list the full names of persons who are authorized to pick up your child, YOURSELF INCLUDED. Please list names in order of most likely to be picking up your child to least likely. If possible, please keep the list to 4 names or less - if you need to add or remove names after submission, contact a camp director, or you can inform a volunteer when your camper is dropped off for the day.
To us give your child the best experience, please answer the following questions:

Some of this information may need to be repeated later in the registration process for legal purposes.
Are there any considerations that we should know of in order to help your child have a great camp experience? (Examples: allergies, medical conditions, physical limitations, behavioral concerns, etc.)
This is a Catholic camp, so on Friday morning we celebrate Mass with all of our campers and volunteers! Since we know not all of our campers practice the same religion, please let us know: Has your child received First Holy Communion in the Catholic Church (or will have by July 2025)?

This is a Catholic camp, so on Friday morning we celebrate Mass with all of our campers and volunteers! Since we know not all of our campers practice the same religion, please let us know: Has your child received First Holy Communion in the Catholic Church (or will have by July 2025)? Yes No Not Catholic
Emergency Contact Info

In the event of an emergency, I hereby give permission to transport my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. In the event of an emergency, if you are unable to reach me at the number listed above, contact:
Emergency Contact (other than parent/guardian) Emergency Contact (other than parent/guardian) First Last
Relationship to Child
Phone Phone - ### - ### ####
Primary Care Physician or other provider of medical care:
Phone Phone - ### - ### ####
Family Health Plan Carrier
Policy #
PHOTO RELEASE

I give hereby grant permission to Sacred Heart Parish, La Plata, Archdiocese of Washington to use any photographs and quotations taken of my child during this event to assist in community awareness, educational efforts, related public relations purposed that may include brochures, posters, website, official social media, and print media. (No individual names will be included unless given permission by the parent/guardian for specified photographs.)
Photo Release:

Photo Release: I give permission. I do not give permission.
Parents/Guardians:

In the event my child is injured or requires immediate and/or emergency care and I cannot be contacted, I authorize the event leaders to act for me according to his/her best judgment (including treatment and/or transportation to area medical facilities). I also authorize area hospital medical personnel to act on my behalf in the event of an emergency and I cannot be contacted.

I know that all possible care and safely will be provided for my child, therefore in case of an accident, to the fullest extend allowed by law, I agree to RELEASE FROM LIABILITY, AND TO INDEMNIFY AND HOLD HARMLESS, the Archdiocese of Washington, Sacred Heart Parish, La Plata, associated priests, deacons, teachers, chaperones, or representatives.

I also agree to release from liability the Archdiocese of Washington, Sacred Heart Parish, La Plata, associated priests, deacons, teachers, chaperones, or representatives associated with the above event from any liability resulting from injury from, damage to - or damage caused by - my child at the event facility.

The Archdiocese of Washington, Sacred Heart Parish, La Plata; associated priests, deacons, teachers, chaperones, or representatives associated with the above event assume no liability for lost, stolen or damaged personal property.
Parent/Guardian Signature:

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Today's Date Today's Date / MM / DD YYYY
PAYMENT

Upon submitting this form, you will be directed to our payment page. The payment page can also be accessed through our main camp webpage. Refunds will be considered on a case-by-case basis.

2025 Sacred Heart Summer Camp

Event: Catholic Summer Camp Theme: Put on the Armor of God! Location: Archbishop Neale School Dates: July 14 - 18, 2025, 9am-12noon

Authorized Pick-Up

To us give your child the best experience, please answer the following questions:

Emergency Contact Info

PHOTO RELEASE

Parents/Guardians:

PAYMENT

Event: Catholic Summer Camp
Theme: Put on the Armor of God!
Location: Archbishop Neale School
Dates: July 14 - 18, 2025, 9am-12noon