Summer Camps Waitlist 1Contact Info2Emergency Info3Camps Camper InformationCamper's Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*(###)###-####Current Elementary SchoolFall '25-'26 SchoolList the school camper will be attending Fall 2025Grade Level '25-'26*Select One56789Date of Birth*MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Please enter Camper date of birth Emergency InformationPrimary Parental Contact Name*Email* A copy of this form will be sent to the email address listed for this contact.Phone (home)(###)###-####Phone (cell)(###)###-####Phone (work)(###)###-####Secondary Parental Contact Name*Email Phone (home)(###)###-####Phone (cell)(###)###-####Phone (work)(###)###-####Please list emergency contacts (other than parents):Emergency Contact 1 Name*Relationship to camperPhone(###)###-####Emergency Contact 2 Name*Relationship to camperPhone(###)###-####Please list any medications or special health situations we should be aware of during camp sessions: DominiCampDominiCamp WeeksPlease select the week(s) you would like to attend. Select all that apply. Prices are as follows: 3 weeks ($670), 2 weeks ($470) or 1 week ($260). All full day camp registrations include lunch catered by Sage Dining Services. 1st Week: June 2-6 2nd Week: June 9-13 3rd Week: June 16-20 Choose eight activities below in order of preference, starting with your first choice. Read descriptions of activities here.First ChoiceSelect First ChoiceDrama-RamaScience QuestLeadership WorkshopDo-"mini" ChefsJewels & GemsSports & Indoor GamesSafe at Home Safe Alone (grades 6-8 only)D-TV Video ProductionCreate, Make, Innovate (weeks 2 & 3 only)Jazz It UpMath ManiaArts & CraftsDomini-tectivesThe Write StuffSew FunDo-"mini" Master ChefsSecond ChoiceSelect Second ChoiceDrama-RamaScience QuestLeadership WorkshopDo-"mini" ChefsJewels & GemsSports & Indoor GamesSafe at Home Safe Alone (grades 6-8 only)D-TV Video ProductionCreate, Make, Innovate (weeks 2 & 3 only)Jazz It UpMath ManiaArts & CraftsDomini-tectivesThe Write StuffSew FunDo-"mini" Master ChefsThird ChoiceSelect Third ChoiceDrama-RamaScience QuestLeadership WorkshopDo-"mini" ChefsJewels & GemsSports & Indoor GamesSafe at Home Safe Alone (grades 6-8 only)D-TV Video ProductionCreate, Make, Innovate (weeks 2 & 3 only)Jazz It UpMath ManiaArts & CraftsDomini-tectivesThe Write StuffSew FunDo-"mini" Master ChefsFourth ChoiceSelect Fourth ChoiceDrama-RamaScience QuestLeadership WorkshopDo-"mini" ChefsJewels & GemsSports & Indoor GamesSafe at Home Safe Alone (grades 6-8 only)D-TV Video ProductionCreate, Make, Innovate (weeks 2 & 3 only)Jazz It UpMath ManiaArts & CraftsDomini-tectivesThe Write StuffSew FunDo-"mini" Master ChefsFifth ChoiceSelect Fifth ChoiceDrama-RamaScience QuestLeadership WorkshopDo-"mini" ChefsJewels & GemsSports & Indoor GamesSafe at Home Safe Alone (grades 6-8 only)D-TV Video ProductionCreate, Make, Innovate (weeks 2 & 3 only)Jazz It UpMath ManiaArts & CraftsDomini-tectivesThe Write StuffSew FunDo-"mini" Master ChefsSixth ChoiceSelect Sixth ChoiceDrama-RamaScience QuestLeadership WorkshopDo-"mini" ChefsJewels & GemsSports & Indoor GamesSafe at Home Safe Alone (grades 6-8 only)D-TV Video ProductionCreate, Make, Innovate (weeks 2 & 3 only)Jazz It UpMath ManiaArts & CraftsDomini-tectivesThe Write StuffSew FunDo-"mini" Master ChefsSeventh ChoiceSelect Seventh ChoiceDrama-RamaScience QuestLeadership WorkshopDo-"mini" ChefsJewels & GemsSports & Indoor GamesSafe at Home Safe Alone (grades 6-8 only)D-TV Video ProductionCreate, Make, Innovate (weeks 2 & 3 only)Jazz It UpMath ManiaArts & CraftsDomini-tectivesThe Write StuffSew FunDo-"mini" Master ChefsEighth ChoiceSelect Eighth ChoiceDrama-RamaScience QuestLeadership WorkshopDo-"mini" ChefsJewels & GemsSports & Indoor GamesSafe at Home Safe Alone (grades 6-8 only)D-TV Video ProductionCreate, Make, Innovate (weeks 2 & 3 only)Jazz It UpMath ManiaArts & CraftsDomini-tectivesThe Write StuffSew FunDo-"mini" Master ChefsOne shirt is included with each DominiCamp Registration. Shirts are distributed on the first day of camp. Additional shirts may be purchased for $15 each. Youth Medium Qty.Youth Large Qty.Adult Small Qty.Adult Medium Qty.Adult Large Qty.Adult XL Qty.Sports CampsNOTE: If you register for DominiCamp in conjunction with a Sports Camp, you will only be charged the DominiCamp rate. *Softball Camp will be at Harahan Playground. Optional transportation will be provided to and from Harahan Playground and Dominican. **Soccer Camp will be at Jefferson Indoor Sports. Optional transportation will be provided to and from Jefferson Indoor Sports and Dominican. ***Before and after camp service not available and lunch not provided during Basketball, Volleyball, and Soccer.Sports Camp Options Volleyball Camp: July 28-31, 12:30 pm - 4:00 pm, $165.00 One shirt is included with each camp registration. Shirts are distributed on the first day of camp. Additional shirts will be available for $15 each. Youth Medium Qty.Youth Large Qty.Adult Small Qty.Adult Medium Qty.Adult Large Qty.Adult XL Qty.Before registering, please make sure you have read the Registration Booklet linked online for additional information regarding registration, fees, before and after care, etc. After May 1, each camper must pay a $60 non-refundable registration fee. Program fees are due on or before Friday, May 10.CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.