Camp Kate Spring 2024 registration is now closed. We hope to see you at our next event.

CAMP KATE REGISTRATION FORM

Once you register, your information will remain in the Camp Kate database until you ask to be removed. We will continue to contact you about upcoming events, and we hope you will choose to join us again and again!

Please list ALL children that you would like to attend:

* Indicates required field

Child's Name*

Age*

Date of Birth*

Grade*

T-Shirt Size (Please specify Child or Adult Size)*

NEED TO ADD MORE CAMPERS?

T-Shirt Size (Please specify Child or Adult Size)

PRIMARY GUARDIAN INFORMATION

Select One*

Address*

Email Address*

Best Phone Number*

Type*

Will you be attending the Adult group sessions at camp? (Adult Session Info)*YesNo

WOULD YOU LIKE TO ADD A SECONDARY GUARDIAN?

SECONDARY GUARDIAN INFORMATION

Select One*

Address same as above

Address*

Email Address*

Best Phone Number*

Type*

Will you be attending the Adult group sessions at camp? (Adult Session Info)*YesNo

EMERGENCY CONTACT INFORMATION

Phone *

All known Allergies (if none, please write NONE)*

Other medical conditions (if none, please write none)*

INFORMATION REGARDING THE DECEASED

In the space below, tell us a bit about why you are registering for Camp Kate. Please be sure to include the name(s) of the deceased loved one(s), their relationship to the camper(s) and the date of their death.*

CAMP AGREEMENT AND RELEASE

I, parent/legal guardian of the above listed children, do hereby give my permission for the above listed children to attend Camp Kate events. Furthermore, I give my permission for my children to receive emergency medical care and release Camp Kate and its representatives from any and all liability in the event of accidental injury. I understand that if my child cannot follow the camp rules for proper behavior my child may be dismissed from the camp. If it is determined that my child has special needs beyond the the equipped abilities of the camp directors, then I will be advised as to what options are available.

Please agree to the Release Statement above:I agree

Camp Kate Spring 2024 registration is now closed. We hope to see you at our next event.

CAMP KATE REGISTRATION FORM

Once you register, your information will remain in the Camp Kate database until you ask to be removed. We will continue to contact you about upcoming events, and we hope you will choose to join us again and again!

Please list ALL children that you would like to attend:

* Indicates required field

Need more information? Contact us!

LONGLEAF HOSPICE FOUNDATION

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We value your privacy. Your personal information will be kept confidential and will never be sold to third parties. It will only be used for communications you request related to the services provided by Camp Kate.

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Onward

OCT 23, 2020