| Elyria Catholic High School

Camp(s) Selection(s)

Parent/Guardian Information

First Name REQUIRED Please fill out this field. Please enter valid data.

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

Street Address REQUIRED Please fill out this field. Please enter valid data.

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

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Email REQUIRED Please fill out this field. Please enter an email address.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Please respond to the following statements.

I hereby waive and release the camp from any and all liabilities for any injuries or illness incurred while at camp. Please select this field.

We grant permission for the photographs or recorded work to be used in media presentations that are made available to other education institutions or through a cable television station or network. We further grant permission for photographs to be used in media, social media, or on the school website. We understand that our child's image, name, work product, school and grade may be revealed in the presentation(s), but that no other information about our child will be revealed without prior consent.

I agree to the above... REQUIRED Yes No Please fill out this field.

Camper 1 Info

First Name REQUIRED Please fill out this field. Please enter valid data.

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

Email Please enter an email address.

Elementary School Please enter valid data.

Grade (entering Fall 2022) REQUIRED Please fill out this field. Please enter valid data.

Age Please enter valid data.

Shirt Size (adult sizing)

Physical Concerns (please enter N/A if you have none) REQUIRED Please fill out this field.

Camper 2 Info (if you have more than two campers, please repeat this form for 3+campers)

First Name Please enter valid data.

Last Name Please enter valid data.

Email Please enter an email address.

School Please enter valid data.

Grade (entering Fall 2021) Please enter valid data.

Age Please enter valid data.

Shirt Size (adult sizing)

Physical Concerns (please enter N/A if none)

Camp(s) Selection(s)

EC Girls Basketball (Grades 3-9) 0.0 – None 75.0 – 1 child, June 20-23| 9:00- 11:30AM 150.0 – Two children, June 20-23 | 9:00- 11:30pm

EC Girls Volleyball (Grades 3-6) 0.0 – None 75.0 – 1 child, June 13 - 16 | 9 - 11: 30 am 150.0 – Two children, June 13 - 16 | 9:- 11:30 am

EC Girls Volleyball (Grades 7 - 9) 0.0 – None 75.0 – 1 child, June 13 - 16 | 1 - 4 pm 150.0 – Two children, June 13 - 16 | 1 - 4 pm

EC Boys All Day Camp (Football & Basketball) (Basketball ONLY is June 27 - June 30) 0.0 – None 125.0 – 1 child, June 27 -July 1 | 9:00 - 3:00 pm 250.0 – Two children, June 27 -July 1 | 9:00 - 3:00 pm

EC Boys Half Day Camp, Football 0.0 – None 85.0 – 1 child, June 27 -July 1 | 9 - 11:30 am 170.0 – Two children, June 27 -July 1 |9 - 11:30 am

EC Boys Half Day Camp, Basketball 0.0 – None 85.0 – 1 child, June 27-June 30| 12:30 - 3:00 pm 170.0 – Two children, June 27 -June 30 | 12:30 - 3:00 pm

EC Boys Basketball Shooting Camp 0.0 – None 50.0 – 1 child, July 14 -July 15 | 9 - 11 am

Girls & Boys Soccer (Grades 5-8) 0.0 – None 75.0 – 1 child, July 19 - July 21 | 6:00 - 8:00 pm 150.0 – Two children, July 19- July 21 | 6:00 - 8:00 pm