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Summer Camp Registration

- Please complete this form for each camper you registering.
- The maximum number of form submissions has been reached. This form is currently not available.
  
  Camper's First Name: REQUIRED Please fill out this field. Please enter valid data.
  
  Camper's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth: REQUIRED Please fill out this field. Please enter valid data.
  
  Age: REQUIRED Please fill out this field. Please enter valid data.
  
  Grade as of 9/2021: REQUIRED Please fill out this field. Please enter valid data.
  
  Parent/Guardian Name: REQUIRED Please fill out this field. Please enter valid data.
  
  Street 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.
  
  Home Telephone: REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Emergency Contact #1 - Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact #1 - Phone: REQUIRED Please fill out this field. Please enter valid data.
  
  Permission Release: I hereby give my consent for medical treatment deemed necessary by medical personnel designated by school authorities and/or for transportation to an emergency room for treatment of any illness/injury resulting from his/her athletics participation.
  I Agree Please select this field.
  
  Medical Release Form
  
  Please print the Medical Release Form and have the camper's physician complete and sign the form. This form can be submitted via email or handed in on the first day of camp.
  
  Please click here for the Medical Release Form
  
  Please Select Your Camps
  
  Week #1: June 28 - July 2, 2021
  
  Week #2: July 5 - July 9, 2021
  
  Week #3: July 12 - July 16, 2021
  
  Week #4: July 19 - July 23, 2021
  
  Week #5: July 26 - July 30, 2021
  
  SJB Athletes - Is the camper a member any of the following SJB teams: Basketball, Cheer, Football, Kickline, Lacrosse, Running, Soccer, Softball, Tennis, Wrestling, Volleyball
  Instructions
  Current SJB Athlete
  
  Please Select Size For Camp Tee Shirt REQUIRED XXL XL L M S Please fill out this field.
  
  Please contact SJB Athletics if you have questions regarding payment for summer camps.
  Athletics@sjbdhs.org
  (631) 587-8000 ex164
  
  Total:
  
  Submit
  
  Proceed to Payment
  
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