March 17, 2016

Register-email

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Don’t Wait Register Today!

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[av_contact email=’stmichaelscamp@sasktel.net’ title=’Online Registration’ button=’Submit’ on_send=” sent=’Your Registration Information has been sent!’ link=’manually,http://’ subject=’Registration From St. Michael’s Camp’ autorespond=’St. Michael’s Camp has successfully received your registration information.’ captcha=” form_align=” color=”]
[av_contact_field label=’Name’ type=’text’ check=’is_empty’ options=” multi_select=” width=”][/av_contact_field]
[av_contact_field label=’Gender’ type=’select’ options=’Male,Female’ check=’is_empty’ width=’element_half’ multi_select=”][/av_contact_field]
[av_contact_field label=’Type of Camp’ type=’select’ options=’Youth Camp, Teen Camp’ check=’is_empty’ width=’element_third’][/av_contact_field]
[av_contact_field label=’Birthday’ type=’datepicker’ options=” check=’is_empty’ width=’element_half’ multi_select=”][/av_contact_field]
[av_contact_field label=’Parent/Guardian’ type=’text’ options=” check=’is_empty’ width=” multi_select=”][/av_contact_field]
[av_contact_field label=’Mailing Address’ type=’text’ options=” check=’is_empty’ width=” multi_select=”][/av_contact_field]
[av_contact_field label=’City/Town’ type=’text’ options=” check=’is_empty’ width=’element_third’ multi_select=”][/av_contact_field]
[av_contact_field label=’Province’ type=’text’ options=” check=’is_empty’ width=’element_third’ multi_select=”][/av_contact_field]
[av_contact_field label=’Postal Code’ type=’text’ options=” check=’is_empty’ width=’element_third’ multi_select=”][/av_contact_field]
[av_contact_field label=’Home Phone’ type=’text’ options=” check=’is_phone’ width=’element_half’ multi_select=”][/av_contact_field]
[av_contact_field label=’Mobile Phone’ type=’text’ options=” check=’is_phone’ width=’element_half’ multi_select=”][/av_contact_field]
[av_contact_field label=’E-Mail’ type=’text’ options=” check=’is_email’ width=” multi_select=”][/av_contact_field]
[av_contact_field label=’Emergency Contact’ type=’text’ options=” check=’is_empty’ width=’element_two_third’ multi_select=”][/av_contact_field]
[av_contact_field label=’Emergency Contact Number’ type=’text’ options=” check=’is_phone’ width=’element_third’ multi_select=”][/av_contact_field]
[av_contact_field label=’Church’ type=’select’ options=’Ukrainian Catholic, Roman Catholic, Other’ check=’is_empty’ width=’element_third’ multi_select=”][/av_contact_field]
[av_contact_field label=’Home Parish’ type=’text’ options=” check=” width=’element_third’ multi_select=”][/av_contact_field]
[av_contact_field label=’Priest’ type=’text’ options=” check=” width=’element_third’ multi_select=”][/av_contact_field]
[av_contact_field label=’Sacremental History’ type=’select’ options=’Baptism , Confirmation , Confession , Holy Communion’ multi_select=’aviaTBaviaTBmulti_select’ check=” width=”][/av_contact_field]
[av_contact_field label=’Health and Dietary Concerns: (Please include all medications to be used at camp)’ type=’textarea’ options=” check=” width=” multi_select=”][/av_contact_field]
[av_contact_field label=’Are all immunizations, including tetanus, up to date?’ type=’select’ options=’Yes,No’ check=” width=’element_third’ multi_select=”][/av_contact_field]
[av_contact_field label=’Please include any other additional information or concerns you feel that the director or camp counsellors should have’ type=’textarea’ options=” check=” width=” multi_select=”][/av_contact_field]
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