Summer Madness

Camp Dates:  June 25 - June 29

Camper $190

Peer Minister $75

Family Last Name
Parents' First Names
Parent Email
Street Address
City
State
Zip Code
Primary Phone
Emergency Phone

Please indicate below if your child is a Camper or Peer Minister.

A Camper is a youth that will be entering 6th, 7th, 8th or 9th grade in the 2018-2019 school year.

A Peer Minister is a youth that will be entering 10th grade-college in the 2018-2019 school year.

Child's Full Name
Date of Birth

Please specify 2018-2019 School Year Grade.

Specify Adult T-shirt size

Place with sibling?

Child's Email (Mandatory for Peer Minister)
Child's Cell Phone (Mandatory for Peer Minister)
Allergies / Special Circumstances / Other Special Requests
Child #2 Full Name
Date of Birth

Please specify 2018-2019 School Year Grade.

Specify Adult T-shirt size

Place with sibling?

Child #2 Email (Mandatory for Peer Minister)
Child #2 Cell Phone (Mandatory for Peer Minister)
Allergies / Special Circumstances / Other Special Requests
Child #3 Full Name
Date of Birth

Please specify 2018-2019 School Year Grade.

Specify Adult T-shirt size

Place with sibling?

Child #3 Email (Mandatory for Peer Minister)
Child #3 Cell Phone (Mandatory for Peer Minister)
Allergies / Special Circumstances / Other Special Requests

DRIVERS/CHAPERONES REQUIRED

All parents NEED to offer at least two (2) shifts for the first registered camper/peer minister and one (1) shift for each additional camper/peer minister during the week.  You may have someone take one or more of your shifts.  If you are able, please volunteer for additional shifts.  Please contact us about any special circumstances.  (You will be emailed the Sign Up Genius Link shortly.)

All drivers MUST be STAND certified and have licenses cleared through the Archdiocese of Baltimore (We will make arrangements for you to receive this certification if you are not already).

Name of Chaperone/Driver

Are you STAND certified?

Child care is available in the morning for drivers/chaperones.

Will you need child care?

If yes, please specify name and age of child(ren) needing child care.

How many passenger seats in vehicle (minus driver)?

Archdiocese of Baltimore Permission Form and Release

In consideration of the wholesome recreational and learning experience in which my child(ren) will participate, I as parent or guardian of my child(ren), do hereby agree to allow my child(ren) to participate in Summer Madness from June 25-29, 2018 at St. Andrew by the Bay and service/social sites included in the Summer Madness program.
 
In consideration of the opportunity for my child(ren) to participate in the program, I agree to RELEASE AND HOLD HARMLESS AND INDEMNIFY St. Andrew by the Bay, the Roman Catholic Bishop of Baltimore and his successors, a Corporation Sole, and all their agents, servants and employees from any liability, claims, demands and causes of action arising out of or relating to any loss, damage or injury sustained in connection with or arising out of my child(ren)'s participation in the program.
 
Parents/guardians of participants are advised that photographs or videotape of participants may be used in publications, websites or other materials produced from time to time by St. Andrew by the Bay (Participants would not be identified, however, without specific written consent).  Parents/guardians who do not wish their child(ren) to be photographed or filmed should so notify the Division in writing.  Please note that the Division has no control over the use of photographs or film taken by media that may be covering the event in which your child(ren) participate(s).

After you hit the submit tab, please be patient and wait for the "thank you;" it may appear to be frozen, but it takes a few minutes to process.