Summer Sports Camp 
This year's camp will be again taking place at the CHURCH OF ELEVEN22 San Pablo Campus! We will be playing all kinds of fun PE style games. This includes: Line tag, gaga ball, basketball, four square, kickball, our popular Dodgeball  Tournament, and so much more. We have a staff of teachers and coaches to help all kids feel included and have a great time. We also teach sportsmanship from a biblical view. We will encourage each child to use the gifts God has given them. 

If you are signing up multiple kids you will need to fill out a separate for for each child. THANK YOU!
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Email *
Camper's Name *
What grade will your child be in for the up coming year 2024-2025 *
What school does your child attend *
Picking Your Camp Session
Below you will click which camp session you want your child to attend. You can register your child for multiple weeks on this 1 form. ***Please make note of the available grade levels for that particular week as it varies slightly by week. Also the grade levels its referring to is for the 2024-25 school year. There is no extended day available. Camp pick up each day is BY 3pm.
Week 1: May 28th - May 31st
Grades Available this week: Rising 1st thru Rising 7th
**Please note this is a 4 day week
Week 2: June 3rd - June 7th
Grades Available this week: Rising 1st - Rising 6th
Week 3: June 10th - 14th
Grades Available this week: Rising 1st - Rising 6th
Week 4: June 17th - 21st
Grades Available this week: Rising 1st - Rising 7th
Week 5: June 24th - June 28th
Grades Available this week: Rising 1st - Rising 6th
If you are a staff member of Providence School or Church of 1122 there are discounts available. If so, please verify by listing your job title below
PAYMENT INFO - PLEASE READ ALL!!!
After you submit this form you will be directed to a payment page. Please note business VENMO is our PREFERRED payment method (as there are less fees). If you can do VENMO click that option below and we will contact you directly for payment (in that case just ignore the link for payment that will come after you submit this form.)

If you do want to pay with a credit/debit you will receive a link to enter card info after you submit this form.  Please note that the charge is for GRACE SLIDES LLC (which is our company name)!!
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Parent Name *
Parent's Phone Number *
Additional Emergency Contact with phone number *
Parent's Email *
Additional people allowed to pick up camper
Medical history / allergies we need to be aware of
Is this your child's 1st time at the Mr. Crowley's Summer Sports Camp? We just like to know so we can make them feel extra welcomed!
Clear selection
Anything you need to tell us? (like for example if your child is coming late, leaving early, missing a day, coming from another camp etc)
CAMP WAIVER AGREEMENT
The undersigned parent, guardian, or legal representative, hereby, consents to the participation of my child in “Summer Sports Camp” presented by Grace Slides LLC and all associated activities. For and in consideration of the child being allowed to participate in this camp, other valuable consideration, the undersigned parent, guardian, or legal representative on behalf of the child and the child’s parents, personal representatives, assigns, heirs, and next of kin, do hereby release and hold harmless the Grace Slides LLC, Church of Eleven22, all organizers of this camp, all volunteers, chaperons, employees, and agents of the said parties, and their personal representatives or assigns from any loss or damage on account of any injury to the person or personal property of the child, or death, caused by negligence or otherwise, while the said child is engaged in the above stated camp and any activities of the camp. The undersign expressly agrees that this release, wavier, and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the State of Florida and that if any portion of this agreement is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. The undersigned parent, guardian, or legal representative further acknowledge that he/she is authorized to enter this agreement on behalf of the child, child’s parents, personal representatives, assigns, heirs, and next of kin. 

I further authorize any representative of this camp to obtain medical treatment for my child in the unlikely event of injury or illness during this program, and I agree to pay any expenses incurred for such treatment. 
I have read, understand, and agree to the above agreement and authorization:
 *
PARENTAL CONSENT: 
I understand that I need to be available by phone during the camp day in case the staff needs to reach me. I understand if my child has  difficulties with showing positive behavior, following rules or is showing signs of sickness he/she may be asked to leave camp. 
 *
Required
I give Summer Sports Camp permission to take pictures/video of the groups that my child may be in to be used for camp promotional purposes only. *
A copy of your responses will be emailed to the address you provided.
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