Breath of God Summer Camp Registration
Please use this form to register for our summer camp. Camp runs 8:30am-1pm, Monday through Friday, July 3rd through July 28th. Breakfast and lunch included, absolutely free, through the Summer Food Program. The camp itself costs $10 a week per camper.

A regular day has breakfast at 8:30am and lunch at noon. Nine to noon we split into three age-based groups and rotate through four stations: reading, writing, math, and gym. After lunch, we head to the playground or park as a group overall.

Wednesdays we head to the pool in Patterson Park. Other days we'll sprinkle in other enrichment activities: environmental education with Patterson Park Audubon Center, zumba, yoga, acting, music, community gardening, heading to the SE anchor library... that's the lineup right now.

Parent(s)' Name(s)/Nombres de Padres
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Phone number/Número de teléfono
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Street of Residence/Calle de residencia
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City, State, Zip/Ciudad, Estado, Código
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Emergency Contact Name/Nombre del Contacto de Emergencia
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Emergency Contact Phone/Número del Contacto de Emergencia
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Emergency Contact Relationship to Child/Relación entre el Contacto de Emergencia y el Niño
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Children attending & Age / Niños asistiendo y Edad
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Weeks Participating / Semanas Participando
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My child(ren), listed above, has/have permission to attend and participate in the Breath of God & St. Paul Lutheran Church Summer camp. I understand and agree that St. Paul Evangelical Lutheran Church assumes no responsibility for transportation to and/or from the Summer Camp, nor assumes liability for any and all injuries that may occur while participating in this program. Mis niños, en la lista anterior, tienen mi permiso para asistir y participar en el Campamento del Verano por Breath of God y St. Paul Lutheran Church. Yo comprendo y estoy de acuerdo que St. Paul Evangelical Lutheran Church tiene ninguna responsabilidad para transportación por este programa, ni tiene ninguna responabilidad en caso de injurias/daños/heridas que ocurrirían durante este programa. My entering of my name and date below counts as my signature of this release of liability. Mi nombre y dato abajo constituya mi firma para esta liberación de responsabilidad.
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