Summer Blast Day Camp- July 14th
Summer Blast Day Camp is a daylong event for kids going into kindergarten through 6th grade. This is a chance for kids to experience and learn new skills in drama, art and sports in a safe and fun environment. Kids will be given a chance to learn clay crafting, make a tie dye t-shirt, play soccer and field games, as well as learn improv and other drama skills.
Breakfast/Drop off time 7am-9am (Open drop off time)
Event 9am-5pm (lunch included)
5pm starts dinner following the day's activities for everyone in the family. 
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Email *
Child's Name (First and Last) *
Child's Age/Grade *
Child's Shirt Size *
Street Address *
Parent/Guardian Name *
Email *
Phone Number *
Emergency Contact Name (Must Be Different Than Parent/Guardian) *
Emergency Contact Phone Number *
Does this child have any allergies, dietary restrictions or medical conditions we should be aware of?
If "Yes" please explain.
Does your child have any physical, mental or behavioral needs that we should be aware of?
If "Yes" please explain.
Liability and Photo Waiver (Full Name Required) *
I recognize the possibility of physical injury and the potential transmission of illnesses associated with Staples Alliance Church student programs and activities. I hereby release, discharge, and otherwise indemnify Staples Alliance Church, its employees and associated personnel, including volunteers, and those facilities and their employees and personnel used in any activities, against any claim by or on behalf of the participant as the result of his/her participation in the activities, including transportation to and from these activities.  I understand that pictures may be taken of my child during this event and by signing below agree that they may be used for promotional purposes. By typing your full name, you are signing and agreeing to the above statement.
Do you have a church that you regularly attend? *
Where do you attend church on a regular basis? (If answered no to the last question skip this one.)
How did you hear about Summer Blast Day camp? *
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