Participant First Namerequired

Participant Last Namerequired

Participant Date of Birthrequired

Street Addressrequired

City/Townrequired

State/Provincerequired

Zip Coderequired

Phone Numberrequired

Current schoolrequired

Grade for 2023-24required

Parish/Church

Mother's First Name

Mother's Last Name

Mother's Phone Number

Mother's Email Address

Father's First Name

Father's Last Name

Father's Phone Number

Father's Email Address

Emergency Contact (first & last name) and Relationshiprequired

Emergency Contact Phone Numberrequired

Is there additional information we should know about this participant?

Select program(s) below

HAP for rising 8th graders

Higher Achievement Program (HAP), July 1-26, 9 a.m. - 2:30 p.m., ($350)

Robotics (For rising 6th and 7th graders)

August 12-15, 10 a.m. - 2 p.m. WAITLIST

Video Game Design (For rising 6th and 7th graders)

June 24-27, 10 a.m. - 2 p.m. WAITLIST

Outdoor Adventure (For rising 6th and 7th graders)

Outdoor Adventure, July 22-25, 9 a.m. - 3 p.m. WAITLIST

Science Rocks (For rising 6th and 7th graders)

Science Rocks!, July 29-31, 9 a.m. - 3 p.m. ($200)

PREREGISTER: Sports Camps

For rising 5th - 9th Graders.

Baseball, June 24-27, (5th-6th: 9 a.m. - 12 p.m.) (7th-9th: 1 p.m. - 4 p.m.) ($150) Basketball, August 12-16, (4th-6th: 9 a.m. - noon) (7th-9th 12:30 p.m. - 3:30 p.m.) ($150) Hockey, July 8-12, 9 a.m. - 10 a.m. ($175) Lacrosse, July 22-24, 3 p.m. - 5:30 p.m. ($100) Rowing, August 5-9, 9 a.m. - noon ($125) Soccer, July 15-19, 3:30 p.m. - 5:30 p.m.($125) Volleyball, July 8-11, 2:45 p.m. - 5 p.m. ($100)

Please read the following information regarding HAP:

Your son must successfully complete 7th grade before coming to HAP.
HAP is not a substitute for summer school.

Please note that HAP is a four-week program. If a participant will miss more than two weeks please contact the program director. If at the time of application you know your son will miss a portion of HAP, please make note of it in the above "additional information" section of this application.

Please read the following information regarding all summer programs at Canisius:

By completing and submitting this application, the participant and his parents/guardians agree that the participant will be punctual each day. The participant agrees to be cooperative and sportsmanlike in all activities. The participant pledges that he will abide by all rules and regulations governing the summer programs. The participant also agrees that he will conduct himself as a gentleman at all times and exhibit proper behavior in all settings and activities. Bullying, harassing, and/or prejudicial statements or actions, and any other improper behavior will not be tolerated and may lead to dismissal from the program.

Transportation to Canisius is not provided. Participants must provide their own lunches each day (which will be refrigerated).

Permission 1*

By checking the box below, parents/guardians of the participant named in the application give permission for their son to go by bus to Stransky, our West Seneca athletic complex, and any designated destinations involved in our workshops.

Yes

Permission*

By checking this box, you acknowledge that the parents/guardians of the participant listed on the application are giving Canisius High School permission to use any pictures or video taken during the course of our summer programs in any future publications or online.

Yes

Text Messages

I would like to receive text notification messages from the Canisius High School office of admission. You can reply STOP to cancel, HELP for help. Msg&data rates may apply.

Enter cell phone number

Or, check box if cell phone is the same as the phone number you previously entered

Same as above

Please send a confirmation email to the address below*: