{"id":37,"date":"2019-03-16T00:40:11","date_gmt":"2019-03-15T19:40:11","guid":{"rendered":"http:\/\/wp.andrewsmemorial.org\/camp\/?page_id=37"},"modified":"2021-03-12T14:17:21","modified_gmt":"2021-03-12T19:17:21","slug":"registration","status":"publish","type":"page","link":"https:\/\/andrewsmemorial.org\/camp\/registration\/","title":{"rendered":"Camper Registration"},"content":{"rendered":"\n<h4 class=\"has-text-align-center wp-block-heading\"><\/h4>\n\n\n<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-1154\"><form id=\"wpforms-form-1154\" class=\"wpforms-validate wpforms-form\" data-formid=\"1154\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/camp\/wp-json\/wp\/v2\/pages\/37\" data-token=\"6cc88bba45549d727ad49917cd95dc89\" data-token-time=\"1775540405\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-1154-field_28-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"28\"><label class=\"wpforms-field-label\" for=\"wpforms-1154-field_28\">Camp week <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-1154-field_28\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][28]\" required=\"required\"><option value=\"Junior 1 (June 22-26, 2026)\"  class=\"choice-1 depth-1\"  >Junior 1 (June 22-26, 2026)<\/option><option value=\"Teen 1 (June 22-26, 2026)\"  class=\"choice-2 depth-1\"  >Teen 1 (June 22-26, 2026)<\/option><option value=\"Junior 2 (July 20-24, 2026)\"  class=\"choice-3 depth-1\"  >Junior 2 (July 20-24, 2026)<\/option><option value=\"Teen 2 (July 20-24, 2026)\"  class=\"choice-4 depth-1\"  >Teen 2 (July 20-24, 2026)<\/option><\/select><\/div><div id=\"wpforms-1154-field_0-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"0\"><label class=\"wpforms-field-label\">Name <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-1154-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" required><label for=\"wpforms-1154-field_0\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1154-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" required><label for=\"wpforms-1154-field_0-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-1154-field_27-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"27\"><label class=\"wpforms-field-label\" for=\"wpforms-1154-field_27\">Gender <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-1154-field_27\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][27]\" required=\"required\"><option value=\"Male\"  class=\"choice-1 depth-1\"  >Male<\/option><option value=\"Female\"  class=\"choice-2 depth-1\"  >Female<\/option><\/select><\/div><div id=\"wpforms-1154-field_5-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-1154-field_5\">Age <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-1154-field_5\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][5]\" required=\"required\"><option value=\"8\"  class=\"choice-1 depth-1\"  >8<\/option><option value=\"9\"  class=\"choice-2 depth-1\"  >9<\/option><option value=\"10\"  class=\"choice-3 depth-1\"  >10<\/option><option value=\"11\"  class=\"choice-4 depth-1\"  >11<\/option><option value=\"12\"  class=\"choice-5 depth-1\"  >12<\/option><option value=\"13\"  class=\"choice-6 depth-1\"  >13<\/option><option value=\"14\"  class=\"choice-7 depth-1\"  >14<\/option><option value=\"15\"  class=\"choice-8 depth-1\"  >15<\/option><option value=\"16\"  class=\"choice-9 depth-1\"  >16<\/option><option value=\"17\"  class=\"choice-10 depth-1\"  >17<\/option><\/select><\/div><div id=\"wpforms-1154-field_26-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"26\"><label class=\"wpforms-field-label\" for=\"wpforms-1154-field_26\">Shirt Size <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-1154-field_26\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][26]\" required=\"required\"><option value=\"YM\"  class=\"choice-1 depth-1\"  >YM<\/option><option value=\"YL\"  class=\"choice-2 depth-1\"  >YL<\/option><option value=\"S\"  class=\"choice-3 depth-1\"  >S<\/option><option value=\"M\"  class=\"choice-4 depth-1\"  >M<\/option><option value=\"L\"  class=\"choice-5 depth-1\"  >L<\/option><option value=\"XL\"  class=\"choice-6 depth-1\"  >XL<\/option><option value=\"XXL\"  class=\"choice-7 depth-1\"  >XXL<\/option><option value=\"3X\"  class=\"choice-8 depth-1\"  >3X<\/option><\/select><\/div><div id=\"wpforms-1154-field_8-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-1154-field_8\">Address <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-1154-field_8\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][8]\" required><\/textarea><\/div><div id=\"wpforms-1154-field_1-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-1154-field_1\">Email <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-1154-field_1\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][1]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-1154-field_12-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-1154-field_12\">Parent\/Guardian Name<\/label><input type=\"text\" id=\"wpforms-1154-field_12\" class=\"wpforms-field-medium\" name=\"wpforms[fields][12]\" ><\/div><div id=\"wpforms-1154-field_29-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"29\"><label class=\"wpforms-field-label\" for=\"wpforms-1154-field_29\">Emergency Contact Telephone <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1154-field_29\" class=\"wpforms-field-small wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"(999) 999-9999\" name=\"wpforms[fields][29]\" required><\/div><div id=\"wpforms-1154-field_11-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-1154-field_11\">Church Name <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-1154-field_11\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][11]\" required><\/div><div id=\"wpforms-1154-field_10-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"10\"><label class=\"wpforms-field-label\" for=\"wpforms-1154-field_10\">Church Address<\/label><textarea id=\"wpforms-1154-field_10\" class=\"wpforms-field-medium\" name=\"wpforms[fields][10]\" ><\/textarea><\/div><div id=\"wpforms-1154-field_19-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"19\"><label class=\"wpforms-field-label\" for=\"wpforms-1154-field_19\">Medications taken regularly<\/label><textarea id=\"wpforms-1154-field_19\" class=\"wpforms-field-medium\" name=\"wpforms[fields][19]\" ><\/textarea><\/div><div id=\"wpforms-1154-field_20-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"20\"><label class=\"wpforms-field-label\" for=\"wpforms-1154-field_20\">Last Tetanus shot<\/label><input type=\"text\" id=\"wpforms-1154-field_20\" class=\"wpforms-field-medium\" name=\"wpforms[fields][20]\" placeholder=\"mm\/dd\/yyyy\" ><\/div><div id=\"wpforms-1154-field_15-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-inline\" data-field-id=\"15\"><label class=\"wpforms-field-label\">Known Allergies <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1154-field_15\" class=\"wpforms-field-required\" data-choice-limit=\"4\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1154-field_15_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][15][]\" value=\"None\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1154-field_15_1\">None<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-1154-field_15_3\" data-rule-check-limit=\"true\" name=\"wpforms[fields][15][]\" value=\"Food\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1154-field_15_3\">Food<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-1154-field_15_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][15][]\" value=\"Insect Sting\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1154-field_15_2\">Insect Sting<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-1154-field_15_4\" data-rule-check-limit=\"true\" name=\"wpforms[fields][15][]\" value=\"Medication\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1154-field_15_4\">Medication<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-1154-field_15_5\" data-rule-check-limit=\"true\" name=\"wpforms[fields][15][]\" value=\"Penecillin\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1154-field_15_5\">Penecillin<\/label><\/li><\/ul><\/div><div id=\"wpforms-1154-field_16-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-1154-field_16\">Known reactions (if applicable)<\/label><textarea id=\"wpforms-1154-field_16\" class=\"wpforms-field-medium\" name=\"wpforms[fields][16]\" ><\/textarea><\/div><div id=\"wpforms-1154-field_17-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-1154-field_17\">Known Treatments (if applicable)<\/label><textarea id=\"wpforms-1154-field_17\" class=\"wpforms-field-medium\" name=\"wpforms[fields][17]\" ><\/textarea><\/div><div id=\"wpforms-1154-field_18-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-1154-field_18\">Activity Restrictions<\/label><textarea id=\"wpforms-1154-field_18\" class=\"wpforms-field-medium\" name=\"wpforms[fields][18]\" ><\/textarea><\/div><div id=\"wpforms-1154-field_2-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-1154-field_2\">Special requests <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-1154-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" required><\/textarea><\/div><div id=\"wpforms-1154-field_21-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"21\"><label class=\"wpforms-field-label\">I indemnify and save Camp Deer Lake and its affiliates, employees, and agents harmless from any liability or medical payments resulting from my child&#039;s participating in this camp or other activities during his\/her stay at Camp Deer Lake. I further understand Camp Deer Lake does not provide medical insurance coverage for my child and that any medical expenses incurred will be paid by either my own medical insurance or myself.  I hereby grant permission for my child to attend camp, to participate in all camp activities, and to be treated by a licensed medial professional in the event of any injury, accident, illness, or other situation that may require medical attention.  I affirm that the medical information provided here is both complete and correct.  I grant permission for my child&#039;s picture to be used in our promotional publications if selected.  <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1154-field_21\" class=\"wpforms-field-required\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1154-field_21_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][21][]\" value=\"I understand and accept the terms stated throughout this application form.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1154-field_21_1\">I understand and accept the terms stated throughout this application form.<\/label><\/li><\/ul><\/div><div id=\"wpforms-1154-field_22-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"22\"><label class=\"wpforms-field-label\">Parent\/Guardian Signature <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-1154-field_22\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][22][first]\" required><label for=\"wpforms-1154-field_22\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1154-field_22-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][22][last]\" required><label for=\"wpforms-1154-field_22-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-recaptcha-container wpforms-is-recaptcha wpforms-is-recaptcha-type-invisible\" ><div class=\"g-recaptcha\" data-sitekey=\"6Lf3xZ8UAAAAALiIvE60AX9GlbM-3PmeLcdlAA8g\" data-size=\"invisible\"><\/div><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"1154\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/andrewsmemorial.org\/camp\/wp-json\/wp\/v2\/pages\/37\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-1154\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_crdt_document":"","jetpack_post_was_ever_published":false,"footnotes":""},"class_list":["post-37","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/PbwKJP-B","_links":{"self":[{"href":"https:\/\/andrewsmemorial.org\/camp\/wp-json\/wp\/v2\/pages\/37","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/andrewsmemorial.org\/camp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/andrewsmemorial.org\/camp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/andrewsmemorial.org\/camp\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/andrewsmemorial.org\/camp\/wp-json\/wp\/v2\/comments?post=37"}],"version-history":[{"count":49,"href":"https:\/\/andrewsmemorial.org\/camp\/wp-json\/wp\/v2\/pages\/37\/revisions"}],"predecessor-version":[{"id":1432,"href":"https:\/\/andrewsmemorial.org\/camp\/wp-json\/wp\/v2\/pages\/37\/revisions\/1432"}],"wp:attachment":[{"href":"https:\/\/andrewsmemorial.org\/camp\/wp-json\/wp\/v2\/media?parent=37"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}