Camp Subiaco

405 N. Subiaco Avenue
Subiaco, Arkansas 72865
Telephone:(479)934-1001
Email: lfreeman@subi.org

Camper's Application

Please fill out one form per camper

I wish to register my son for camp session:

* Select A Session: Select One... Week 1:June 17-23, 2012 Week 2:June 24-30, 2012 *
* T-Shirt Size: Select One... Child Small Child Medium Child Large Adult Small Adult Medium Adult Large *

Basic Instructions
Please look at the examples for how to fill out field information and turn "CAPS LOCK" off if you have it enabled. A red asterisks or red block beside a field indicates a required input is need in order to submit the application.

Camper's Information:
* Last Name: A value is required.(Ex: Smith)
* First Name: A value is required.(Ex: John)

* Home Address:
** City: * * State Select One... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming * 
* Zip :   A value is required.

Our camper has the same home address as the Parent or Guardian:

* Age At Camp Time: * 9 10 11 12 13 *

* Birth Date: Invalid formatMM/DD/YYYY

Religious Preference: Select One... Catholic Christian Other

Camper's Experience: Select One... First Timer Returning Camper

Name of School Attending:

* Grade Level Select One... 4 5 6 7 8 Please select a valid item.Please select an item.

My brother will be attending camp and his name is:  

If you are the guardian of the camper then place your name in the Father or Mother name space below.

Father's / Guardian's Name:
* Last Name: *A value is required.(Ex: Smith or N/A)
* First Name: *(Ex: John or N/A)

Subiaco Alumnus?    Class of: (Example: 2011)

Mother's / Guardian's Name:
* Last Name: *(Ex: Smith or N/A)
* First Name: * (Ex: Jane or N/A)

Pick only one option:
Our camper lives with both parents:
Our camper lives only with one parent:
Our camper lives with a guardian:

Contact Information:
(Enter same phone number in each field if only one exist)

* Home Phone: A value is required.Invalid format.

* Work Phone: A value is required.Invalid format.

* Cell Phone: A value is required.Invalid format.

* Email Address: A value is required.

Drop-Off/Pick-Up Information:

Please let us know if the Parent/Guardian will be dropping off and picking up the camper by checking the box below. If there will be someone else dropping off or picking up your camper then please provide the name of the responsible adult in the space provided.

* Drop-Off by:
Parent/Guardian   Other:

* Pick-up by:
Parent/Guardian    Other:

Roommate Request:

In the space provided below please provide the first and last name of the camper your son wishes to be a roommate with. Please understand that we will make an effort to accomodate your request.


*Not guaranteed and based on space availability - Providing more than one name would improve the selection process.

General Information:

1. The Camp Subiaco fee for one week of camp is $425 dollars. We offer a 10% discount for brothers attending camp together (cost for both would be $765). This camp is for boarders only. A minimum deposit of $100 dollars per camper per week (non-refundable) must be submitted with this application.

2. You can pay camp fees or deposit through our online pay option or by sending a check with this application to the office address listed at the top of this form. Please make your check payable to "Camp Subiaco", and do not send cash!

3. You will be asked to provide the camp registration number when paying online. Please print the Camp Registration Confirmation Form which is generated for you after you press the submit button below.

4. Your child's camp reservation is confirmed when we have received a completed registration form and the camp deposit fee. Your camper will be completely registered for camp once we receive your full payment.

5. After completing this registration form you will need to fill out the camper Medical History Form. The Medical History Form should be filled out and submitted online. A link to the medical history form is available below. If you are unable to submit Medical History Form online using your email provider, then please print a copy of a blank form and send it to our offices or have it brought to the day of registration.

• WEEK 1: Registration is on Sunday, June 17, 2012, from 1 p.m. until 5 p.m.; Campers should be picked up on Saturday, June 23 at noon.


• WEEK 2: Registration is on Sunday June 24, 2012, from 1 p.m. until 5 p.m.; Campers should be picked up on Saturday, June 30 at noon.

Parents are invited to attend the Mass and Talent Show held each Saturday morning starting at 9 a.m.

To Register for Camp:

Step 1: Print a copy of the application by selecting the "Print" button below. Save the printed copy of the Camp Registration Confirmation Form for your records and bring it to the first day of camp registration.

Step 2: Submit the Application online by selecting the "Submit" button below. If you have more than one camper attending camp then return to this form and fill out another one and submit an application for each camper. A Camp Registration Confirmation Form will be appear after you have registered your child, if nothing happens then you are missing data on this registration form. Please check out all fields and make sure that you have filled them all in.

Step 3: Fill-out the camper Medical History Form by selecting the "Medical Form" button below and submit it online. If you use MS Outlook to send email then you might have to open it in order to send the email.  Additionally, If you are unable to submit Medical History Form online using your email provider, then please print a copy of a blank form and send it to our offices or have it brought to the day of registration.

Step 4: Pay camp fees or the deposit fee by credit/debit card online using the "Pay Online" button on the Camp Registration Confirmation Form, or by selecting the " Pay Online" button on the main webpage menu bar. You may pay by check and should send the check along with a copy of this application to the office address listed above.

Copyright ©Camp Subiaco 2009-2012