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 路 required
parent name
text 路 required
parent email
text 路 required
parent phone
text 路 required
parent address
textarea 路 required
camp name
text 路 required
camp location
textarea 路 required
camp type
select 路 required
session start
date 路 required
session end
date 路 required
session name
text 路 required
camper name
text 路 required
camper dob
date 路 required
camper age
text 路 required
camper gender
select 路 required
camper grade
text 路 required
tshirt size
select 路 required
emergency contact 1
text 路 required
emergency relationship 1
text 路 required
emergency phone 1
text 路 required
emergency contact 2
text 路 required
emergency relationship 2
text 路 required
emergency phone 2
text 路 required
physician name
text 路 required
physician phone
text 路 required
insurance provider
text 路 required
insurance policy
text 路 required
allergies
textarea 路 required
medications
textarea
medical conditions
textarea
dietary restrictions
select 路 required
dietary notes
textarea
tetanus date
date
otc authorization
select 路 required
swimming
select 路 required
swim level
select 路 required
photo release
select 路 required
transportation
select 路 required
authorized pickup
textarea 路 required
camp fee
text 路 required
refund policy
select 路 required
governing state
select 路 required
parent signer name
text 路 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.