Summer Camp Registration - Creighton Prep

Please complete this form below to register for Creighton Prep Summer Camps. Fill out an individual form for each camper participating.

If you are using a gift certificate, please email TJ Fyfe at tfyfe@creightonprep.org for instructions on registering and redeeming.

Camper's Namerequired

First Name

Last Name

Camper's Graderequired

Grade for the 2022-2023 School Year

Parent/Guardian Name 1required

First Name

Last Name

Parent/Guardian Name 2

First Name

Last Name

Parent/Guardian Email Addressrequired

Primary Contact Phone Numberrequired

Include area code- numbers only- no spaces (Must contain only numbers)

Alternate Phone Number

Include area code- numbers only- no spaces (Must contain only numbers)

Street Addressrequired

Cityrequired

Staterequired

Zip Coderequired

Must contain only numbers

WaiverrequiredBy checking this box, you agree to the policies and procedures outlined in the waiver.

Creighton Preparatory School is not responsible for bodily injury or property damage sustained by participants. The participants need to be insured under their parent's health and accident or medical insurance coverage. I do hereby waive, release, absolve, indemnify and agree to hold harmless Creighton Preparatory School, the organizers, sponsors, participants and persons transporting me to or from activities; for any claim arising out of an injury to me whether the result of our negligence or from any other cause. In the event of a medical emergency affecting me, I hereby give my consent to seek emergency medical treatment. I do understand that no refunds will be issued.

By checking this box, you agree to the policies and procedures outlined in the waiver.

Child's T-Shirt Sizerequired

Payment Information

Emailrequired

Provide an email address for the receipt.

Please select a payment typerequired

Credit Card

Billing Addressrequired

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Namerequired

First

Last

Expirationrequired

Month

Year