Submit Application Online: Summer Camp

STUDENT INFORMATION

First and Middle Name of Applicant REQUIRED Please fill out this field. Please enter valid data.

Last Name of Applicant REQUIRED Please fill out this field. Please enter valid data.

Birthday (Month/Day/Year) REQUIRED Please fill out this field. Please enter valid data.

Gender REQUIRED Please fill out this field.

Grade for 2023/24 REQUIRED Please fill out this field.

Age REQUIRED Please fill out this field. Please enter valid data.

Full Address (Street, City, State and Zip Code) REQUIRED Please fill out this field.

Which school district does your family reside in?

Please list the name of the Public School to which the students belongs Please enter valid data.

ETHNICITY: For statistical purposes only. Please choose one (Categories taken from US Census) Hispanic Non-Hispanic

SCHOOL INFORMATION

Student's current school name, city, state & dates attended REQUIRED Please fill out this field.

Are you aware of any special considerations required by your child that may impact his or her ability to participate in all aspects of the programs offered by Cathedral School of Saint Mary? REQUIRED Please fill out this field.

If the child has a diagnosed disability, are there any accommodations that have been recommended?

Please list any medications your child is currently taking

PARENT INFORMATION

Parents Marital Status

Student lives with:

Name of the Guardian & relationship Please enter valid data.

Mailings should be sent to

FATHER / GUARDIAN

Full Name Please enter valid data.

Full Address (Street, City, State and Zip Code) Please enter valid data.

Cell Phone Please enter valid data.

Date of Birth Please enter valid data.

Driver License # Please enter valid data.

Email Please enter valid data.

MOTHER / GUARDIAN

Full Name Please enter valid data.

Full Address (Street, City, State and Zip Code) Please enter valid data.

Cell Phone Please enter valid data.

Date of Birth Please enter valid data.

Driver License # Please enter valid data.

Email Please enter valid data.

EMERGENCY INFORMATION

Who has your permission to pick up your child ( Please write full name) REQUIRED Please fill out this field.

In case of emergency, who should we contact - CONTACT 1 (Full name, Phone number, Address and Driver License #) REQUIRED Please fill out this field.

Is there anybody who SHOULD NOT pick up your child? Please list and explain: REQUIRED Please fill out this field.

Has your child have any known allergies? Please enter valid data.

Please feel free to share anything else you would like for us to know about your child. REQUIRED Please fill out this field.

Week attending June 5 - 9 June 12 - 16 June 19 - 23 June 26 - 30 July 3 - 7 July 10 - 14 July 17 - 21 July 24 - 28