OPA Camp Registration Form

Thank you for completing your OPA Camp registration form on-line! You will receive a confirmation, that it was received by the church office after it is submitted. By submitting this form, you agree that the Greek Orthodox Community of Greater Salt Lake will register your child(ren) for this camp. By authorizing such participation by the minor, you agree to assume the risk associated with his/her participation and agree not to allege or attempt to impose any liability on the Church Community in the event of any damage, injury, or loss resulting from such participation.

Camper 1

First Name

Last Name

Birthdate

MM

DD

YYYY

Grade attended school year 2022-2023

Camper 2

First Name

Last Name

Birthdate

MM

DD

YYYY

Grade attended school year 2022-2023

Camper 3

First Name

Last Name

Birthdate

MM

DD

YYYY

Grade attended school year 2022-2023

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent Email

Mother's Name

Fathers Name

Mother's Day Phone

(###)

###

####

Father's Day Phone

(###)

###

####

Mother's Cell

If different from above

(###)

###

####

Father's Cell

If different from above

(###)

###

####

Person's authorized to pick up child(ren)

Emergency Contact

Specify any allergies

Is your child on any medications

No

Yes (if so, please specify below)

Payments in the form of cash or check will be accepted.
Please mail your check made payable to OPA Camp to:
OPA CAMP
c/o 2440 Scenic Drive
Salt Lake City, Ut 84109