Summer Spectacular Church Camp Registration 2017
It's time to register for St. Pauls Summer Camp! Each session is one week long and is available as a half day (9:00 am - noon) or full day (9:00 am - 3:00 pm). For children ages 2-4, only half days are available. Either full or half days are available for children ages 5-12. Cost: $55 for half day, $105 for full day (session 1 only) $90/week for half day, $175/week for full day. Session 1: July 5-7. Session 2: July 10-14. Session 3: July 17-21 Session 4: July 24-28. Payments are due upon sign up, but NO LATER than June 15.
Child's full name: *
Your answer
Child's date of birth: *
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Child's grade in school Fall 2017: *
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Does your child have any allergies or dietary restrictions?
Your answer
Does your child carry an epi-pen? *
Does your child have permission to walk home without adult supervision? *
Name of parent/guardian: *
Your answer
Phone number of parent/guardian: *
Your answer
Email address of parent/guardian: *
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Emergency contact name: *
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Emergency contact phone number: *
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Emergency contact's relationship to child: *
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Please check the session(s) you will attend: *
Required
As a parent or guardian of the child whose name appears above, I hereby give my consent for said child to participate in St. Pauls United Church of Christ off property trips to local parks, etc. at any time from July 5, 2017, to July 28, 2017. I understand that insurance of any kind will not be provided by St. Pauls United Church of Christ for accidents or injuries that may occur, from any cause whatsoever, in connection with any trips or outings. I agree to relieve from any responsibilities, and to hold harmless, St. Pauls United Church of Christ, its Camp Counselors, employees, and any other supervisors of such trip or outings whatsoever that may occur in connection with said activity. *
In the event of a medical emergency occurring to my child, I hereby authorize St. Pauls United Church of Christ, its CampCounselors and/or employees to act in loco parentis to my child. These individuals may authorize all necessary medical and/or surgical procedures that the medical authorities deem vital for the health of my child. I understand that every effort will be make to contact me immediately, and that medical or surgical procedures will be implemented only in the event that I cannot be contacted. *
I grant permission for St. Pauls United Church of Christ to use unidentified photograph(s) of my child for church-related programs or other print materials and display boards, as well the St. Pauls United Church of Christ website and Facebook page. *
Please type your name below as your signature and submit the form. Thank you! *
Your answer
To make your Summer Camp Payment, please go to www.spucc.org and at the top right, please hit "Give". On the next page, hit the button for "Donate Online Now" and then scroll down to "Venue Rental, Parking and Program Fees" and there is a space designated for Summer Camp. Thank you!
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