SayPro Registration Form Template for Summer Camps
The SayPro Registration Form Template is designed to streamline the process of enrolling participants in SayPro’s summer camps. This form captures essential details, including personal information, medical history, and consent to ensure the safety and well-being of each participant. The form also serves as a legal agreement for camp policies, rules, and emergency contact information.
This standardized template is flexible and can be customized for each camp session, but it follows a consistent structure to ensure that all necessary data is gathered effectively.
SayPro Summer Camps Registration Form
1. Participant Information
This section captures the participant’s personal details, including their name, age, contact information, and emergency contacts.
- Full Name of Participant: ___________________________
- Date of Birth (MM/DD/YYYY): _________________________
- Age: __________
- Gender: ☐ Male ☐ Female ☐ Non-binary ☐ Prefer not to say ☐ Other: ________________
- Home Address:
- Street: ________________________________
- City: ________________________________
- State: ________________________________
- Zip Code: ___________________________
- Phone Number (Parent/Guardian): ______________________
- Phone Number (Participant, if applicable): ___________________
- Email Address (Parent/Guardian): ________________________
- Email Address (Participant, if applicable): ____________________
- Preferred Contact Method: ☐ Phone ☐ Email ☐ Text Message
2. Emergency Contact Information
Provide contact details for a person who can be reached in case of an emergency during the camp session.
- Emergency Contact Name: ________________________________
- Relationship to Participant: ________________________________
- Phone Number: __________________________
- Alternative Phone Number: _______________________
3. Medical Information
Gathering medical information ensures that staff members are informed of any specific needs or precautions that may be required for the participant’s safety.
- Primary Care Physician Name: ____________________________
- Physician’s Phone Number: _______________________________
- Allergies (Food, Medicine, Environmental, etc.):
- ☐ No known allergies
- ☐ Yes (Please specify): ________________________
- Current Medications (if applicable):
- ☐ None
- ☐ Yes (Please list): ________________________
- Medical Conditions/Concerns (e.g., asthma, diabetes, epilepsy, etc.):
- ☐ None
- ☐ Yes (Please specify): ________________________
- Has the participant had any recent injuries, surgeries, or illnesses?
- ☐ No
- ☐ Yes (Please specify): ________________________
- Special Dietary Requirements (e.g., vegetarian, gluten-free, lactose intolerant, etc.):
- ☐ None
- ☐ Yes (Please specify): ________________________
- Insurance Provider: ________________________________
- Policy Number: ________________________________
4. Camp Selection
Allow participants to choose which camp they will attend. This section can be adjusted based on the camp offerings for each session.
- Camp Session:
- ☐ Session 1: Youth Leadership (Dates: [insert dates])
- ☐ Session 2: Environmental Sustainability (Dates: [insert dates])
- ☐ Session 3: Creative Arts and Sports (Dates: [insert dates])
- ☐ Session 4: Personal Development & Team Building (Dates: [insert dates])
5. Consent & Liability Waiver
This section provides necessary legal consent, acknowledging that parents/guardians are aware of the camp activities and agree to the terms and conditions.
- Consent for Participation: I, the undersigned, consent to the participation of my child/ward in the SayPro Summer Camp program and understand the nature of the camp’s activities. I acknowledge that there are inherent risks involved in the camp’s activities, and I accept full responsibility for any accidents, injuries, or losses that may occur during the camp session.
- Parent/Guardian Signature: ________________________________
- Date: _____________________
- Medical Release Consent: I, the undersigned, give permission to camp staff and medical personnel to administer emergency medical treatment in the event of an injury or illness during the camp session. I authorize the camp staff to take necessary medical action as deemed appropriate in case of an emergency.
- Parent/Guardian Signature: ________________________________
- Date: _____________________
- Photo/Video Release: I, the undersigned, give permission for photos and videos of my child/ward taken during the camp to be used in promotional materials, including brochures, websites, and social media, for SayPro.
- ☐ Yes, I consent.
- ☐ No, I do not consent.
- Parent/Guardian Signature: ________________________________
- Date: _____________________
- Behavioral Expectations Agreement:
I agree to abide by SayPro’s camp policies, rules, and guidelines, including but not limited to rules on behavior, safety, and respect for other participants and camp staff. I understand that failure to comply with these rules may result in my child/ward being asked to leave the camp without refund.- Parent/Guardian Signature: ________________________________
- Date: _____________________
6. Registration Fees
Provide a breakdown of any applicable camp fees, payment instructions, and financial assistance options.
- Camp Fee: $_____________
- Payment Deadline: [insert date]
- Early Bird Registration Discount (if applicable): $_____________
- Total Due: $_____________
- Payment Method:
- ☐ Credit Card
- ☐ Check (Payable to SayPro)
- ☐ Online Payment Portal
- ☐ Scholarship/Financial Aid (if applicable)
- Scholarship/Financial Aid Information (if applicable):
Please attach additional forms or documentation if applying for a scholarship.
7. Additional Information
This section allows parents/guardians to provide any extra information that might be helpful for the camp staff to know.
- How did you hear about SayPro Summer Camps?
☐ Website
☐ Social Media
☐ Referral (Name of referrer): ______________
☐ Other: _______________________ - Any other relevant information or special requests?
8. Acknowledgement and Signature
This section confirms that the parent/guardian has completed the registration form accurately and agrees to the terms outlined.
By signing below, I confirm that I have provided accurate and truthful information on this form, and I understand and accept the terms and conditions of participation in the SayPro Summer Camps.
- Parent/Guardian Name: ________________________________
- Relationship to Participant: ____________________________
- Parent/Guardian Signature: ____________________________
- Date: _____________________
Instructions for Submission
- Please submit the completed registration form to [Insert contact details/online portal link].
- Registration will only be complete upon receipt of the signed form and payment.
- For any inquiries, contact us at [Insert contact details].
This SayPro Registration Form Template serves as a comprehensive tool to collect essential participant information, medical details, and consent for summer camp activities. It ensures the safety, legal protection, and smooth operation of each camp session while fostering transparent communication with parents and guardians.
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