2018 PreFuel Summer Camp Application
****PREFUEL SUMMER CAMP IS NOW FULL****

Join us for a fun-filled summer learning about Jesus, playing games, making crafts, learning new skills, and so much more!

This application is the first step in pre-registration. Once your application has been processed you will receive an invoice for your $10 application fee through Brightwheel. If you do not yet have an account with us you will also receive an invitation to join Brightwheel, our system for parent communication and billing. Your spot in camp will not be secured until you have a received a confirmation email from The Philadelphia Project and we have received your application fee of $10 through Brightwheel.

DETAILS:

- June 18-July 27 (6 weeks)
- 8:30 AM - 3:00 PM*
- $60/week (Application fee: $10)**
- Age 3-5 (entering Kindergarten) ***
- Lunch and snack are provided, however you may choose to pack your child's lunch daily
- Please pack a labeled water bottle daily for your child
- Aftercare is available until 6pm for an additional $35/week

*No early drop off for camp
**Please note your child's application will not be considered until the $10 application fee is paid
***Must be potty-trained before June 18, 2018 in order to attend

If you have any questions, please contact Christina Gann at preschool@thephiladelphiaproject.com. We are looking forward to a fun-filled summer with your camper!

Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Gender *
Child's Date of Birth *
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Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Mother's Name *
Your answer
Mother's Address *
Your answer
Mother's Main Phone *
Your answer
Mother's Email *
Your answer
Father's Name *
Your answer
Father's Email *
Your answer
Father's Main Phone *
Your answer
Weeks Attending *
Required
Aftercare Needed $35/wk, we do not prorate daily for aftercare (please select weeks aftercare is needed) *
Required
Child's Allergies *
Your answer
Activity Restrictions *
Your answer
I understand that my child must be 3 before June 18, 2018 and must be potty-trained to attend PreFuel Summer Camp *
Insurance Policy # *
Your answer
I give The Philadelphia Project permission to use individual photos or video of my child for marketing and creative purposes. (must check yes in order to participate) *
Liability Release: I agree to waive my claim for liability against PreFuel and The Philadelphia Project, including its employees and representatives, and release them from liability in connection with transportation to PreFuel. Further, I assume full responsibility for any damage to persons and/or property caused by my child. *
Medical Emergency Release: In case of emergency or injury to my student, I hereby authorize the school to act in the best interest of my child. I further consent and will be responsible for any medical and/or dental treatment that may be advisable at the discretion of any physician or dentist. I understand that I will be personally notified if it becomes necessary for my child to be returned home and/or require health treatment. *
Activities Authorization: My Child indicated on this form has my permission to attend all activities sponsored by PreFuel and The Philadelphia Project (TPP) from June 26, 2017 to July 30, 2017. This consent form gives permission to seek whatever medical attention is deemed necessary, and releases TPP and its staff of any liability against personal losses of named child. *
Child's T-shirt Size *
School Attending in Sept 2018
Your answer
Special Needs: If necessary, describe in detail the nature and severity of any physical and/or psychological ailment, illness, propensity, weakness, limitation, handicap, disability, or condition to which your child is subject and of which the staff should be aware, and what, if any, action of protection is required on account thereof. Include names of medications and dosages that must be taken. If none, please enter "NONE" *
Your answer
Illnesses: Please list and explain any major illnesses the child has experienced during the last year. If none, please write "NONE". *
Your answer
Physician's Name, Number & Address *
Your answer
I hereby give permission for my child to attend supervised walking field trips *
I am interested in learning more about signing my child up for Soccer Shots this summer! *
I would like my child to eat the provided lunches each day. *
Approved Adult Pick-Ups & Phone Numbers (please add at least 2 approved adults that your child may be released to) *
Your answer
How did you find out about PreFuel Summer Camp?
Your answer
Electronic Signature: I/We the undersigned have legal custody of the child named above, a minor, and have given our consent for him/her to attend events organized by PreFuel/TPP. I/We understand that there are inherent risks involved in any ministry or athletic event, and I/we hereby release PreFuel/TPP, its pastors, staff, and representatives from any and all liability for any injury, loss, or damage to person or property that may occur during the course of my/our child’s involvement. In the event that s/he is injured and requires the attention of a doctor, I/we consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel designated by PreFuel/TPP, I/we agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I/We also acknowledge that we will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by the health insurance provider. Further, I/we affirm that the health insurance information provided above is accurate at this date and will, to the best of my/our knowledge, still be in force for the student named above. I/we also agree to bring my/our child home at my/our own expense should they become ill or if deemed necessary by the PreFuel/TPP staff member. *
Your answer
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