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IC - Vacation Catechism Camp

DATE: JUNE 13TH - 17, 2022
- Grades: Kingerdarten - 5th Grade
  Time: 8:00 am to 12:15 pm
  
  Middle and high schoolers are needed and welcome!
  
  Cost: $15.00 per child for supplies and snacks, $35.00 for three or more children
  
  Each day will be an explortation of our faith through Scripture & Church Teaching using a hands-on style - listening, talking, making and moving.
  
  Please turn in form and fee by June 5th by mailing it to Immaculate Conception Church, P.O. Box 658, Cherokee, Iowa 51012, dropping it off at the parish office or completing it online.
  
  Contact Maylissa at 712-225-4606 or by email at maylissa@iccherokee.org with any questions.
- Registration
  
  Please fill out the online registration below, or if you prefer, you can download a PDF version of the registration form by clicking here.
- Online Registration
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  Number of Children REQUIRED Please fill out this field.
  
  Child 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade in Which the Child Will Be Entering the 2022-2023 School Year REQUIRED Please fill out this field.
  
  Child 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade in Which the Child Will Be Entering the 2022-2023 School Year REQUIRED Please fill out this field.
  
  Child 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade in Which the Child Will Be Entering the 2022-2023 School Year REQUIRED Please fill out this field.
  
  Child 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade in Which the Child Will Be Entering the 2022-2023 School Year REQUIRED Please fill out this field.
  
  Child 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade in Which the Child Will Be Entering the 2022-2023 School Year REQUIRED Please fill out this field.
  
  Child 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade in Which the Child Will Be Entering the 2022-2023 School Year REQUIRED Please fill out this field.
  
  Parent / Guardian Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent / Guardian Email Address REQUIRED Please fill out this field. Please enter an email address.
  
  Parent / Guardian Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Other Emergency Contact / Childcare Giver Name & Phone Number
  
  Special considerations of which we need to be aware (allergies, etc.)
  
  I hereby give my permission for my son(s)/daughter(s) to attend Vacation Catechism Camp, June 13-17, 2022, at Immaculate Conception Parish, in Cherokee, Iowa, including indoor and outdoor activites. I understand that all precautions will be taken, but in spite of this, accidents can happen and illness develop; therefore, I will not hold Immaculte Conception Church, Cherokee, Iowa, staff, or volunteers liable for any illness or accident occuring at Vacation Catechism Camp. In case of emergency, I can be reached at the above numbers. I hereby give my permission for emergency medical treatment.
  By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Agreement. By selecting "I Accept" using any device, means or action, you consent to the legally binding terms and conditions of this Agreement. You further agree that your signature on this document (hereafter referred to as your "E-Signature") is as valid as if you signed the document in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature, and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting agreement between you, Immaculate Conception Church and the Diocese of Sioux City. You further agree that each use of your email address and printed name equates to your E-Signature and constitutes your agreement to be bound by the terms and conditions of these Disclosures and Agreement as they exist on the date of your E-Signature on this form.
  
  Agreement REQUIRED I Agree Please fill out this field.
  
  Parent / Guardian Full Name Signifying Electronic Signature Please enter valid data.
  
  Date of Electronic Signature REQUIRED Please fill out this field. Please enter a date.
  
  TOTAL CHILDREN REQUIRED Please fill out this field.
  
  Total:
  
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IMMACULATE CONCEPTION - CHEROKEE
OUR LADY OF GOOD COUNSEL - HOLSTEIN

The Catholic Communities of

IC - Vacation Catechism Camp

DATE: JUNE 13TH - 17, 2022

Registration

Online Registration