Family & Childcare
Camp Registration and Waiver
Summer/day camp registration form with liability waiver and medical authorization. Single signer (parent).
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# Camp Registration and Waiver **Registration Date:** ___________ This Camp Registration and Waiver ("Agreement") is submitted by: **Parent/Guardian:** ___________ ("Parent") **Parent Email:** ___________ **Parent Phone:** ___________ **Parent Address:** ___________ ## 1. Camp Information **Camp Name:** ___________ **Camp Location:** ___________ **Camp Type:** ___________ **Session Dates:** ___________ to ___________ **Session Name/Number:** ___________ ## 2. Camper Information **Camper Name:** ___________ **Date of Birth:** ___________ **Age at Time of Camp:** ___________ **Gender:** ___________ **Grade (upcoming):** ___________ **T-Shirt Size:** ___________
Fields (43)
registration date
date · required
parent name
text · required
parent email
text · required
parent phone
text · required
parent address
textarea · required
camp name
text · required
camp location
textarea · required
camp type
select · required
session start
date · required
session end
date · required
session name
text · required
camper name
text · required
camper dob
date · required
camper age
text · required
camper gender
select · required
camper grade
text · required
tshirt size
select · required
emergency contact 1
text · required
emergency relationship 1
text · required
emergency phone 1
text · required
emergency contact 2
text · required
emergency relationship 2
text · required
emergency phone 2
text · required
physician name
text · required
physician phone
text · required
insurance provider
text · required
insurance policy
text · required
allergies
textarea · required
medications
textarea
medical conditions
textarea
dietary restrictions
select · required
dietary notes
textarea
tetanus date
date
otc authorization
select · required
swimming
select · required
swim level
select · required
photo release
select · required
transportation
select · required
authorized pickup
textarea · required
camp fee
text · required
refund policy
select · required
governing state
select · required
parent signer name
text · required
Send this template with cryptographic proof
Every signed document gets PAdES-LTA digital signatures, dual RFC 3161 timestamps, and a tamper-proof evidence package sealed in WORM storage.