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2023 Camper Registration Part II

"*" indicates required fields

NEW CAMPER REGISTRATION PROCESS.
READ ENTIRELY BEFORE STARTING THE APPLICATION!


1. Registration must be completed by a Parent or Legal Guardian of the camper.

2. Entire Registration is online and in two parts.
  • Part I is for camper information, to submit camper birth certificate and for camp selection.
  • After Part I is processed and payment is made, Part II is to submit a copy of health insurance ID, medical clearance form and provide camper health information.

3. All entries will be processed in order of submission of the application and accuracy/validity of submitted documentation.

4. Camper application will be processed after Part I but a Camper is not enrolled until completion and acceptance of Part II of the application.

5. If any of the submitted information or documentation is inaccurate or cannot be validated, the application will be moved to the end of the waitlist.
To avoid getting waitlisted, please take the time to submit accurate & valid information!


6. Space is limited so the best chance for enrollment is to provide complete, accurate, and valid information in a timely manner. No applications or documents will be accepted after the due date.

7. All correspondence will be via parent's email address on this registration form. Please make sure to check your spam folder if you do not see a confirmation email in your inbox after this submission.

8. Multiple registrations for same camper name and birthdate combination are not allowed.

9. All Registrations will be voided if dispute is filed with Stripe, credit card company or bank.

10. All submitted information is stored on a secure website.

For more information, please contact onlinereg@vrajyouth.net or visit our website at www.vrajyouth.net.

Hidden
This field is not editable and carried over from Part I of the application.
This field is not editable.
Hidden
This field is not editable
This field is not editable. The application will show the email address from Part I of the application.
Parent/Guardian Name*
This field is not editable. The application will show the name from Part I of the application.
This field is not editable. The application will show the contact number from Part I of the application.
Hidden
Home Address*
This field is not editable and carried over from Part I of the application form.
Camper Name*
This field is not editable. The application will show the name from Part I of the application.
This field is not editable. The application will show the birthdate from Part I of the application.
MM slash DD slash YYYY
Camper Gender*
This field is not editable. The application will show the birthdate from Part I of the application.
Hidden
This field is not editable. It is passed from Part I form.
Hidden
This field is not editable and carried over from Part I of the application.
Hidden
This field is not editable and carried over from Part I of the application.
Hidden
This field is not editable and carried over from Part I of the application.
Hidden
This field is not editable and carried over from Part I of the application.
Only 1 file upto 2MB in size is allowed. A free mobile app such as DocScan by IFUNPLAY can be used to scan your document as pdf to meet 2MB size requirement.
Max. file size: 128 MB.
Only 1 file upto 2MB in size is allowed. A free mobile app such as DocScan by IFUNPLAY can be used to scan your document as pdf to meet 2MB size requirement.
Max. file size: 128 MB.
Does the camper have moderate to severe asthma or allergies?*
Only 1 file upto 2MB in size is allowed. A free mobile app such as DocScan by IFUNPLAY can be used to scan your document as pdf to meet 2MB size requirement.
Max. file size: 128 MB.
1 file upto 2MB in size is allowed. Make sure that the information on Health Insurance ID matches the health insurance related fields above. A free mobile app such as DocScan by IFUNPLAY can be used to scan your document as pdf to meet 2MB size requirement.
Max. file size: 2 MB.
1 file upto 2MB in size is allowed. A free mobile app such as DocScan by IFUNPLAY can be used to scan your document as pdf to meet 2MB size requirement.
Max. file size: 2 MB.

Camper Health Information

Check all of the following allergy or medical conditions that apply:*
Note that any allergies or medical conditions noted here must match what's on the Medical Clearance Form provided by a Physician.
Does your child take any medication for allergies, medical condition, or otherwise?*
Note that any prescription medicine noted here must match what's on the Medical Clearance Form provided by a Physician.
Is there a need to bring this medication at camp?*
If yes, parent to provide all prescription medicine.
Are there any limitations/ restrictions of physical activities at camp due to allergies/medical condition?*
Has your child been hospitalized, taken to the emergency room, or visited a doctor due to an allergic reaction or for any medical condition in last three years?*
Does the child have ADHD or other related disorder that camp counselors and adult volunteers need to be aware of for the safety of the child and others.*
If yes, we will contact you for additional information.
Consent*
- I give permission for my child to receive the above medication as directed.
- I understand that food may be cross-contaminated. Vraj camp has no physician and is located in rural Pennsylvania with Emergency facility approximately 45 minutes away. My child is trained (if he/she is prescribed) to administer all regular and emergency medications, including Epipen, without any adult supervision.
- I will send all his/her regular and emergency medication with him/her to Vraj Camp.
- I assume complete financial and other responsibility for all and every health and accident related expense for my child while he/she is at Vraj premises or on any excursions that he/she may take part in while attending Vraj Camp.
- I undertake to hold the Vraj temple organization, all its employees, volunteers, counselors and campers harmless against any action that may arise out of any occurrence involving during Vraj camp.
Emergency Contact Name - 1*
Must be different than parent information provided in Part I of the application. Both emergency contacts and numbers MUST be different.
Emergency Contact Name - 2*
Must be different than parent information provided in Part I of the application. Both emergency contacts and numbers MUST be different.
Cell Phone Policy*
Campers are NOT permitted to possess a cell phone for any reason at camp. In case your child is found carrying a cell phone, please understand that the phone will be confiscated and $500 will be charged to receive the phone back. Please review the detailed cell phone policy at Camper Registration.
I am interested in volunteering at and/or attending:*
Vraj Youth Outreach events benefit our Vraj community. Volunteering at Vraj Temple events can qualify you to request an early camper registration token for 2020 camps. Select all events that you can volunteer at. Please visit vrajyouth.net for detailed information.
Parent Signature*
This field is not editable.
This field is for validation purposes and should be left unchanged.

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