Page 9 - CJA High School Summer Camps

2022 Cor Jesu Summer Camp Registration

Register online at corjesu.org/camps. Or, complete the form below and mail it with a
check payable to Cor Jesu Academy; credit cards also accepted.
Mail by May 15, 2022, to Cor Jesu Academy; Attn: Summer Camps; 10230 Gravois Road;
Saint Louis, MO 63123. Registrations postmarked after May 15, 2022, will be charged
a $25/per camp late fee.

CAMPER’S FIRST AND LAST NAME

ADDRESS

CITY STATE ZIP

GRADE IN 2022-23 SCHOOL

PARENT/GUARDIAN NAME:

PARENT/GUARDIAN NAME

PARENT/GUARDIAN PRIMARY PHONE PRIMARY EMAIL
EMERGENCY CONTACT NAME PHONE RELATIONSHIP

My mom is a CJA graduate.
MOM’S NAME YEAR
2022 Camps Attending:
1. $
CAMP NAME FEE
2. $
CAMP NAME FEE
3. $
CAMP NAME FEE
4. $
CAMP NAME FEE
Camp T-shirt Size (please check one):
Youth L Adult S Adult M Adult L (no extra charge)
Late Fee (for registering after 5/15/22) $25 x = $
# OF CAMPS
A check payable to Cor Jesu Academy is enclosed. Total $
AMEX Discover VISA MasterCard

CARD NUMBER SECURITY CODE

SIGNATURE EXP. DATE
9