Chalice Camp Registration: August 7th to 11th, 2017
Summer Day Camp with Unitarian Universalist Values
Identity and Justice: Bay Area Region
This year's camp curriculum celebrates our various identities. We will also examine how identities, especially race, have been used to harm and oppress people and learn tools of resistance as religious people to that oppression.

August 7th to 11th
Program runs from 9:00 am to 5:00 pm

For children entering 1st through 6th grades
Counselors in Training (entering 7th, 8th, 9th and 10th) contact Laila at If it's your first year you need to apply. All years after you just need to let me know you are coming.

Lake Temescal: Streamside Site
Next to Highway 24/Highway 13 interchange in Oakland on the South side of the park. Parking and drop off accessible from Broadway Terrace See map below.

Monday to Friday 9 am – 5 pm
Extended care 8:30 am – 5:30 pm

Camp Costs
Registration: $350 until April 1st. $375 after April 1st.
CIT are half price
for 9 am – 5 pm
$40 extended care fee for
8:30 am – 5:30 pm
partial scholarships are available

Deposit $100 with your registration form.
The balance is due by August 1st

Pay using paypal at or send a check payable to First Unitarian Church of Oakland to Sheri Prud'homme at 2223A Woolsey St. Berkeley, CA 94705

Map of Lake Temescal Streamside Site
Child's name
Your answer
Child's age
Your answer
Your answer
Parent or guardian: name
Your answer
Parent #1: best phone
Your answer
Parent #1: email
Your answer
Parent or guardian: name
Your answer
Parent #2: best phone
Your answer
Parent #2: email
Your answer
congregation child attends, if any
Your answer
Grade entering in Fall of 2016
T-shirt size
List any medicines your child takes regularly.
Your answer
List your child's food restrictions or allergies.
Your answer
Does your child have an iep? 504 plan? or any accommodations in school?
Your answer
Tell us anything else that you want us to be aware of.
Your answer
What hours do you want?
List all the additional people authorized to pick up your child
Your answer
Health Insurance carrier
Your answer
Health insurance policy number
Your answer
ONLY FOR Counselors in Training: Is your child able to attend the staff training on August 6th from 1:00 to 5:00 pm?
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms