2024 Summer Camp Application

A completed application must be submitted for each camper separately.

"*" indicates required fields

1Student Info

2Mother Info

3Father Info

4Authorizations

5Emergency Contacts

6Consent

Mother/Female Guardian

Mother/ Female Guardian Name*

First Last

Marital Status*

Maiden Name*

Proof of Custody*

If divorced appropriate custody paperwork MUST be uploaded.

Max. file size: 50 MB.

Home Address*

Same as student

Street Address City State ZIP Code

Personal Email*

Home Phone*

Cell Phone*

Occupation*

Employer

Work Phone*

Work Email*

Work Address*

Street Address Address Line 2 City State ZIP Code

Father/Male Guardian

Father/Male Guardian Name*

First Last

Marital Status*

Proof of Custody*

If divorced appropriate custody paperwork MUST be provided.

Max. file size: 50 MB.

Home Address*

Same as student

Street Address City State ZIP Code

Personal Email*

Home Phone*

Cell Phone*

Occupation*

Employer

Work Phone*

Work Email*

Work Address*

Street Address Address Line 2 City State ZIP Code

The Office of Child Protection and Victim Assistance in the Catholic Diocese of Arlington provides opportunities to report abuse, heal from abuse, and find support. Additionally, this office works to ensure that all children and youth in programs throughout the diocese have a safe environment full of caring and responsible adults to watch over them.

The Office of Child Protection performs background checks and safe environment training for adults and youth in accordance with the requirements of the USCCB Charter on the Protection of Children. For more information visit their website at https://www.arlingtondiocese.org/child-protection/

Virginia Catholic Education Association accredited by the Virginia Council for Private Education

2024 Summer Camp Application

Student Information

Student Medical Information

Summer Camp Selection

Mother/Female Guardian

Father/Male Guardian

Emergency Contacts