MARVINLOUS STEAM-IN-MOTION SUMMER CAMP REGISTRATION

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The Marvinlous Summer Camp is an eight (8) week program with a STEM/STEAM theme, and caters to campers grades rising Kindergarten to rising 8. The hours are 7:00am through 6:00pm, Monday through Friday, with Friday field trip activities.

The cost is $200 per 1st camper, $175 per 2nd sibling, and $150 per 3rd sibling. Non-refundable registration fee is $100/per family, with a non-refundable Field Trip fee of $50 per camper. The daily schedule and camp handbook will be posted on the website camp page.

PLEASE COMPLETE A SEPARATE REGISTRATION PER CAMPER.

Please select the desired camp(s) by completing this form for each camper, make a total, then make payment on the Givlify Payment Link on the website camp page.

Email *

Camper Full Legal Name: LAST, FIRST, MIDDLE *

Camper Address: Street > City > State > Zip *

Camper Date of Birth (MM/DD/YYYY) *

Camper Gender *

Camper Allergies? If any, please list them. *

Camper Health Conditions? If yes, please list them. ALSO: Please include doctor's name and phone number. *

Camper Rising Grade as of Fall, 2026 *

PARENT/GUARDIAN: Full Name *

PARENT/GUARDIAN: Cellphone *

PARENT/GUARDIAN: Email *

PARENT/GUARDIAN: Relation to Camper *

EMERGENCY CONTACT: Full name > Cellphone > Email *

All Campers: Please select your planned weeks for attendance (all that apply). *

Week1: June 15-19

Week2: June 22-26

Week3: June 29 - July 3

Week4: July 6-10

Week5: July 13-17

Week6: July 20-24

Required

Rising 4-8 Grade Campers: Please select your STEAM camps for a headcount in the EdTech Coaching "STEAM in Motion" portion of the camp. *

Week1: Engineering Design & Build (June 15-19)

Week2: Science Explorers and Space Exploration (June 22-26)

Week3: Green Electrical Energy (June 29 - July 3)

Week4: FIRST LEGO League Robotics I & II (July 6-10)

Week5: Math In Motion and Art &Design Lab (July 13-17)

Week6: MakerSpace Designers (July 20-24)

Not Applicable

Required

CONSENT & AGREEMENT *

I certify that the above information is correct to the best of my knowledge.

I give permission for my camper to be photographed for internal use and/or social media.

I DO NOT give permission for my camper to be photographed for internal use and/or social media. 3

I give permission for my camper to attend sponsored Field Trips.

I DO NOT give permission for my camper to attend sponsored Field Trips and will keep my camper at home.

SUBMISSION OF THIS FORM CONSTITUTES MY DIGITAL SIGNATURE.

I agree to attendance expectations provided in the camp handbook, Marvinlous Summer Camp Handbook.

Required

Instructions for Payment Options:

After submitting this form for each camper, total your contribution, then visit the Marvin AME Zion Church website (mamez.org) and follow these steps to pay online using Givelify. Cash payments are welcomed, along with money orders. No checks please. (No Response Required)

Click on the PAYMENT BUTTON on the summer camp website.

Choose "OTHER" for the gift amount.

Enter the dollar amount you are paying.

Select MARVINLOUS SUMMER CAMP for "Gift Purpose".

Select "Add Message" and add your child(ren)'s name(s) and what the payment is for.

A copy of your responses will be emailed to the address you provided.

Submit

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