Please fill out the form below, then hit the submit button. (* denotes a required field).
Child First Name: *
Child Last Name: *
Child Gender? * Male Female
Grade Student will enter: *
Parents First Name: *
Parents Last Name: *
Home Address: *
Home City: *
Home State: *
Home Zip Code: *
Email Address: *
Home Phone: (999-999-9999) *
Emergency Contact (other than parent listed above) #1
Name: *
Relationship to child: *
Work Phone: (999-999-9999) *
Cell Phone: (999-999-9999)
Name:
Relationship to child:
Home Phone: (999-999-9999)
Work Phone: (999-999-9999)
Choose an event below: *
Boy Scouts Merit Badge Workshop – Robotics $55 per child-May 18
Additional Event Information:
Release Check Box*
By checking this box, you indicate you are the parent and/or legal guardian of the child listed. You are further consenting to your permission to use the child’s photograph/image/and/or commentary by the University of St. Francis in its publications, videotaping, advertisements, brochures, Internet sites, etc. You agree that the University of St. Francis may use your child’s photo and/or commentary with or without your name for lawful purposes including the above. You further acknowledge that there is no agreement or promise on the part of the University to compensate you or your child in any way for the use of the photograph/image/in said manner. You hereby release the University from any and every claim, demand, right, or cause of action of whatever kind or nature, either in law or equity, arising from the use of your son/daughter(s) photograph/image.
Cancellation Policy:
Future Communications
YES, I would like to receive future communications regarding USF programs.
Please ADD TOGETHER your TOTAL AMOUNT DUE (Prices are listed next to the camp listing)
***Click on Continue to pay by Credit Card – You will be prompted to enter the amount due PLEASE WRITE DOWN THE AMOUNT DUE PRIOR TO HITTING THE CONTINUE BUTTON ***
***YOUR REGISTRATION IS NOT VALID UNTIL PAYMENT IS RECEIVED***
If you have any issues with this form, please contact the Solutions Office at solutions@stfrancis.edu