----Camp Registration Form----

Participant Information

Health Insurance

COVID-19 Vaccination

Additional Comments

To be filled by every participant. Only the first 100 (one hundred) registrations will be accepted.
Participant Information

Particpant's Name
Gender		Male Female
Date of Birth Age		Month Date Year years
Please select the level that you belong to (if unsure, skip):		Level 1 Junior (6 - 7 years) Level 1 Senior (8 - 10 years) Level 2 (11 - 14 years) Level 3 (15 - 20 years)
Parent's Name
Street Address
City
State
ZIP Code
Phone (Home)
Phone (Work)
Phone (Cell)
Parent's E-Mail
Participant's E-Mail
Health Insurance
I hereby authorize the Sikh Youth Gurmat Camp authorities to consent to emegency medical or surgical treatment of the youth and to routine (non-surgical) medical care, if required. The Health Insurance information is provided below:
Name of the Health insurance
Address of the Health insurance
ID
Emergency Tel #
COVID-19 Vaccination
This is a fully vaccinated camp. All campers attending camp must have received their final dose of an approved COVID-19 vaccine at least 14 days prior to the first day of camp and have proof of vaccination.
Date of first dose of COVID-19 vaccine:
Date of second dose of COVID-19 vaccine:
Additional Comments
Any additional comments that you may want to make:
Upon submitting the form to GHISS, you will receive a link to the payment page where you must pay a donation of $275/youth. Please note that the registration is not complete till we receive the payment.

For further information or to receive a complete registration package, contact: Gurdeep Singh President, GHISS P.O. Box 151 Boyds, MD 20841 Tel: (301) 528 2222 E-mail: sikhstudies@gmail.com

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