*This form must be submitted by May 16, 2014 Name: Home Phone: Gender: MaleFemale Cell Phone: Date of Birth: Email: School: Year in School: FreshmanSophomoreJuniorSenior Are you a certified lifeguard? (not required): YesNo Are you certified in first-aid? (not required): YesNo In what year did you attend Loaves and Fishes as a camper? Parent or Guardian Name(s): In what hobbies, sports, work, or activities are you involved? Parent or Guardian(s) Cell #: Parent or Guardian(s) Email Address: Medical History: Do you have any allergies or medical conditions that we should know about? Explain. Dietary: Are there any foods you are allergic to or otherwise absolutely cannot eat?