Summer Fine Arts Programs

Please complete one form for each child attending camp.

Camper First Name REQUIRED Please fill out this field. Please enter valid data.

Camper Last Name REQUIRED Please fill out this field. Please enter valid data.

Camper Birthday REQUIRED Please fill out this field. Please enter valid data.

Grade Entering for the 2025-2026 School Year REQUIRED

The student must be enrolled at PJP II for school year 2021-2022.

2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade Please fill out this field.

I am registering for: REQUIRED Grades 2-3 Grades 4-6 Please fill out this field.

Will your child attend the Saints Summer Camp after Art Camp? REQUIRED Yes No Please fill out this field.

Pickup Policy REQUIRED I understand that on field trip days (July 30) for Saints Summer Camp I will have to pick my child up from Art Camp at 12:00 if my child is scheduled for Saints Summer Camp in the afternoon. Please fill out this field.

Best Phone Number REQUIRED Please fill out this field. Please enter valid data.

Family Email Address REQUIRED Please fill out this field. Please enter valid data.

Parent/Guardian Name 1 REQUIRED Please fill out this field. Please enter valid data.

Parent/Guardian Name 2 REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact and Phone Numbers REQUIRED

Please list name, relationship, phone #. Example: Mary Smith, grandmother, 555-555-5555

Please fill out this field.

Medical Information REQUIRED

Does your child suffer from any allergies, illness or other medical condition? If yes, please detail below.

Please fill out this field.

Insurance Company REQUIRED Please fill out this field. Please enter valid data.

Policy Number REQUIRED Please fill out this field. Please enter valid data.

Preferred Hospital REQUIRED

Please note that during an emergency, emergency dispatch may not allow for a choice in hospital.

Please fill out this field. Please enter valid data.

Pick Up Information REQUIRED

Please list who can and cannot pick up your child (ren)

Please fill out this field.

In a medical emergency, I/we hereby authorize the camp/school representative to obtain or administer emergency care and to seek emergency medical assistance for our child if we cannot be reached. I/We also authorize, if circumstances require, the emergency department physician, family physician, or school physician to provide initial examination and treatment.

Medical Release REQUIRED

In a medical emergency, I/we hereby authorize the camp/school representative to obtain or administer emergency care and to seek emergency medical assistance for our child if we cannot be reached. I/We also authorize, if circumstances require, the emergency department physician, family physician, or school physician to provide initial examination and treatment.

I/We Agree Please fill out this field.

PHOTOGRAPH RELEASE

Parent/Legal Guardian of the children listed on the registration form hereby give the Archdiocese of Philadelphia, its successors and assigns and those acting with its authority, the unqualified right and permission to reproduce, copyright, publish, circulate or otherwise use any school pictures and video of my child produced by the Archdiocese of Philadelphia and Pope John Paul II RCES & Summer programs. This authorization and release covers the use of said camp pictures and video in any published form, including but not limited to newsletters, websites, social media, and any other media of advertising publicity. I also understand that our school may be identified by name and I fully understand that this is a complete release of all claims against the Archdiocese of Philadelphia or any other person, firm or corporation by reason of any such use of such school pictures. I hereby warrant that I am free to give this permission. I also understand that Pope John Paul II RCES & Summer Programs cannot be held responsible for photographs/video recordings taken by other parents during open performances.

Photo Release REQUIRED

I give my permission for my child to be photographed. These photos may be put on the camp website or used to help promote the summer camp.

Yes No Please fill out this field.

I/We give permission for Pope John Paul II RCES to charge my/our FACTS account for camp tuition and fees.

Account Charge REQUIRED

I give my permission for my child to be photographed. These photos may be put on the camp website or used to help promote the summer camp.

Yes No Please fill out this field.

PARTICIPATION AGREEMENT AND RELEASE
We (I), Parent/Legal Guardian of the child(ren) listed on the registration form
give permission for the child(ren) to participate in the Pope John Paul II Art Summer Camp to which includes all related programs or events. In consideration for our (my) son’s/daughter’s participation and intending to be legally bound, we (I) and our (my) son/daughter agree and understand that we assume risk in full for our (my) son’s/daughter’s participation in the Summer Programs and with full knowledge of the risk inherent in such an activity, we release and hold harmless Pope John Paul II Regional Catholic Elementary School, affiliated parishes, the Archdiocese of Philadelphia, and its priests, religious, teachers, aides, employees, agents, administrators, and any official representatives, from any and all liability, damages, or claims for any and all personal injury, bodily injury, and/or property damage arising or related to our (my) son’s/daughter’s participation. We (I) and our (my) son/daughter understand and agree to abide by all rules and regulations established by Pope John Paul II Regional Catholic Elementary School pertaining to the Summer Programs and school code of conduct.

Camp Participation Agreement REQUIRED

In a medical emergency, I/we hereby authorize the camp/school representative to obtain or administer emergency care and to seek emergency medical assistance for our child if we cannot be reached. I/We also authorize, if circumstances require, the emergency department physician, family physician, or school physician to provide initial examination and treatment.

I/We Agree Please fill out this field.

POPE JOHN PAUL II REGIONAL
CATHOLIC ELEMENTARY SCHOOL

2875 Manor Road
West Brandywine, PA 19320
Office-610.384.5961

Pope John Paul II RCES
has been named a 2024
Archdiocesan School

of Distinguished Instruction.
ruction!

Summer Fine Arts Programs

PHOTOGRAPH RELEASE