Adventure Camp -

Adventure Summer Camp Application 2024

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Grade 2024-2025

Shirt Sizes(YXXS - YXL, AS - 2XL):

Child's Name:

First

Middle

Last

DOB:

Address:

City

State

Zip Code

Mother's Name:

First

Last

Email:

Phone Number:

Father's Name:

First

Last

Email:

Phone Number:

Medical Information (include allergies to medications, foods, other substances, etc.):

Child’s Doctor Name:

Doctor's Phone Number:

Emergency Contact Name 1:

First

Last

Relationship:

Phone Number:

Emergency Contact Name 2:

First

Last

Relationship:

Phone Number:

I authorize BMA to allow authorized medical personnel to provide emergency medical care if neither I, my spouse, alternate contact(s), nor my child’s doctor can be located immediately. I give my permission for my child to take part in camp activities, including sports and field trips away from school premises. I absolve Bishop McManus Academy from all liability because of injury to my child at school, while transporting or during any of these camp-sponsored activities. I acknowledge the contagious nature of COVID-19 and that my child(ren) and I may be exposed to or infected by COVID-19 by enrolling my child(ren) in camp and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at BMA Summer Camp may result from the actions, omissions, or negligence of myself and others, including, but not limited to, BMA employees, volunteers, and program participants and their families.

I agree

Parent’s Signature

Type your name

Date: