A parent or legal guardian must register a child for camp. Youth ministers, parish staff, family members or friends may not register on the parent's behalf.

Cabin Registration

Please make sure you are selecting the appropriate cabin registration. A waiting list will open when tickets have sold out.

Registration

Male Camper ($350.00) [6 remaining]
Female Camper ($350.00) [5 remaining]

Coupon Code

Total

$0.00

Camper's Information

Youth's Name

Sex

Male
Female

Date of Birth

High School Graduation Year

Parish

T-Shirt Size (unisex adult sizes)

Please list any friends with whom your child would like to share a cabin or small group.

We will do our best to accommodate friend requests, but we cannot guarantee that all requests will be met.

Parent/Legal Guardian Information

Name

Phone Number

I would like to receive emails and texts about upcoming youth events.

If checked, you will be added to our Flocknote group.

Address

Medical Information

Emergency Contact Name

Relationship to Child

Emergency Contact Phone Number

Family Doctor

Family Doctor's Phone Number

Health Plan Carrier

Health Plan Policy Number

Please list any food allergies or dietary restrictions your child may have. Be specific.

Other Allergies

Please list any medications your child is currently taking.

Please list any medical conditions your child may have.

Please list any physical restrictions your child may have.

Is your child subject to chronic homesickness, emotional reactions to new situations, sleepwalking, bed wetting, fainting?

Other Information

Is there anything else you would like us to know about your child?

How did you hear about D-Camp?

Consent Forms

Please read through these agreements and check the box below.

Parental Consent

I (the parent/guardian), grant permission for my child (participant), to participate in this diocesan event that requires transportation away from the parish site. This activity will take place under the guidance and direction of diocesan employees and/or volunteers. As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor (participant).

I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend the parish/school listed above, its officers, directors, employees and agents, and the Catholic Diocese of Sioux Falls, its employees and agents, chaperons, or representatives associated with the event, from any claim arising from or in connection with my child's participation or attendance at the event or in connection with any illness or injury (including death) or cost of medical treatment in connection therewith, and I agree to compensate the parish/school, its officers, directors and agents and the Catholic Diocese of Sioux Falls, its employees and agents and chaperons, or representatives associated with the event for reasonable attorney’s fees and expenses which may incur in any action brought against them as a result of such injury or damage, unless such claim arises from the negligence of the parish/diocese.

I hereby give permission for images of my child (participant), captured during the above named event, through video, photo and digital camera, to be used solely for the purposes of promotional material and publications within the parish/school and/or the Catholic Diocese of Sioux Falls, and waive any rights of compensation or ownership thereto.

I hereby warrant that to the best of my knowledge, my child (participant) is in good health, and I assume all responsibility for the health of my child.

In the event of an emergency, I hereby give permission to transport my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. In the event of an emergency, if you are unable to reach me at the numbers at the number listed, contact the emergency contact listed.

In the event it comes to the attention of the parish, its officers, directors and agents and the Catholic Diocese of Sioux Falls, chaperones, or representatives associated with the activity that my child becomes ill with symptoms such as headache, vomiting, sore throat, fever, diarrhea, I understand that I will be contacted.

I have read and agree to the terms above.

Date Field

Please read through each paragraph and check the boxes, if applicable.

My child is taking medication at present. My child will bring all such medications necessary, and such medications will be in their original container. Names of medications and concise directions for seeing that the child takes the medications, including dosages and frequency of dosage are notated above.

Check only if applicable. Must be filled out by the parent or guardian

No medication of any type, whether prescription or non prescription, may be administered to my child unless the situation is life-threatening and emergency treatment is required.

Check only if applicable. Must be filled out by the parent or guardian

I hereby grant permission for non-prescription medication (i.e. non-aspirin products such as acetaminophen or ibuprofen, throat lozenges, cough syrup) to be given to my child, if deemed appropriate.

Check only if applicable. Must be filled out by the parent or guardian

Cancellation Policy

Please be aware that our policies regarding cancellations are as follows: If the diocese has to cancel an event, all fees will be fully reimbursed. Due to overwhelming demand and the need for advance planning, we require a definite commitment from participants. If an unforeseen conflict arises and a camper is no longer able to attend, please contact our office as soon as possible. A partial refund of all but $50 may be given if we are able to secure a replacement from the waitlist. Two weeks prior to each camp, all fees are non-refundable.

I have read and agree to the terms above.

Billing Information

Name

Credit Card

Visa
Mastercard
American Express
Discover

Address

Mobile Phone Number

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Junior High D-Camp

Cabin Registration

Camper's Information

Parent/Legal Guardian Information

Medical Information

Other Information

Consent Forms

Billing Information