Immaculate Conception High School

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Summer Camp 2020

Please complete the form below. Required fields are marked with an asterisk *

Parent/Guardian Contact Information

Camper's Information

Camper's Sex:
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Camper's Grade as of September 2020:*
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Does your child have any allergies (food, medication or environmental)*
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Does your child have any medical conditions (asthma, seizures, headaches, anxiety, etc)?*
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Emergency Contact Information

Please provide contact information for a responsible adult in case we cannot reach the parent/guardian.

I give my child permission to attend the Blue Wolf Summer Camp at Immaculate Conception High School in Lodi, New Jersey.  I understand my child will be at Immaculate Conception High School from 9:00 A.M. - 2:00 P.M. I understand that I, or whoever picks up my child at 2:00 P.M., must come into the ICHS cafeteria to sign them out.