Student Name *

Campus *

Age *

Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Date of Birth *//

Parent's Mobile No. *

Parent's Email *

1st Parent/Guardian *

Name

Mobile No. *

Place of Work *

Work Phone *

2nd Parent/Guardian

Name

Mobile No.

Place of Work *

Work Phone

Name *

Relationship *

Telephone *

Mobile No. *

Child resides with *

1st Parent
2nd Parent
Guardian
Both

Child resides with : Others

Name and phone number(s) of person(s) other than parents allowed to pick up your child

1. Name and phone number(s) of person(s) other than parents allowed to pick up your child *

1. Mobile No. *

2. Name and phone number(s) of person(s) other than parents allowed to pick up your child *

2. Mobile No. *

5. Name and phone number(s) of person(s) other than parents allowed to pick up your child *

3. Mobile No. *

4. Name and phone number(s) of person(s) other than parents allowed to pick up your child *

4. Mobile No. *

5. Name and phone number(s) of person(s) other than parents allowed to pick up your child *

5. Mobile No. *

Any special instructions, such as custody or restraining orders must be attached to this application and discussed personally with the camp director. All information will be kept confidential

Please list any other information you’d like to include about your camper *

Please list any other information you’d like to include about your camper

Please list any other information you’d like to include about your camper (copy)

This is computer generated form, signature not required
This is computer generated form signature not required

Parent Authorization Form

Name of Camper *

Date / Time *//

The Filipino Institute does not discriminate on the basis of race, color, sex, religion or national origin. The Filipino Institute reserves the right at its sole discretion to refuse an application or dismiss a child from camp. No refund will be made of fees if the child has attended any portion of the camping period. Parent/Guardian's Acceptance *

I give the Filipino Institute permission to photograph and/or videotape my child for public relations and/or marketing purposes. Photos will remain archived at The Filipino Institute and can be used for promotional purposes without notification. Parent/Guardian's Acceptance *

I authorize the school management to act as the agent of the parents in any emergency situation or to administer basic first aid for the health and welfare of the camper involved. I am responsible for the expenses involved if the services of a physician or hospital are required. Please request a waiver for persons requesting exemption from medical treatment. Parent/Guardian's Acceptance *

Hospital preferred

This is computer generated form, signature not required
This is computer generated form signature not required

Learner’s Medical Information Form

The medical background of each camper is required as part of the school’s registration process. The school director must be advised in writing of any condition that would limit the camper’s/learner’s ability to participate in any program. *

Child's Name

Date of Birth *//

Child’s Pediatrician’s Name *

Phone No *

Date of Last Physical *//

Medical conditions *

List of past medical treatments *

Allergies: (Please put N/A if your child does not have an allergy)

Specific Activities to be restricted for health reasons:

I certify that the information on this form is true, accurate, and complete to the best of my knowledge. I am responsible for notifying the Filipino Institute in writing of any changes in the information supplied in this application that might affect my student’s scholarship eligibility. Parent/Guardian's Acceptance *

Date of Last Physical *//

This is computer generated form, signature not required
This is computer generated form signature not required

Summer Camp Registration Form

Name and phone number(s) of person(s) other than parents allowed to pick up your child

Any special instructions, such as custody or restraining orders must be attached to this application and discussed personally with the camp director. All information will be kept confidential

Parent Authorization Form

Learner’s Medical Information Form

Become An Instructor?

Summer Camp Registration Form

Name and phone number(s) of person(s) other than parents allowed to pick up your child

Any special instructions, such as custody or restraining orders must be attached to this application and discussed personally with the camp director. All information will be kept confidential

Parent Authorization Form

Learner’s Medical Information Form

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