Summer Camp
Registration

                                                                                        

Summer Camp 2018 Registration:

Click here for full detailed registration brochure

Click here for Info Sheet & "What to Bring"

  • Registration Due May 11 with $175 deposit towards your summer camp cost                  CLICK HERE TO PAY YOUR REGISTRATION DEPOSIT ONLINE
  • Age: ages 3-11, must be potty trained
  • 9 weeks available, weekdays from June 25 - Aug. 24, 2017 (excludes July 4)
  • 9:00-3:00 each day
  • Before Care 8:00-9:00, and After Care 3:00-5:00, are available at additional rates (please call if you need additional care and we can see if we can make arrangements)
  • $175 per 5 day week, see detailed chart for other options
  • Share this info with friends, registrants need not be Calvary Academy students
 

# OF DAYS/WEEK

WEEKLY RATE
5 Day Week $175
3 Day Week $115

Before Care 8:00-9:00:  $5.00 or $2.50/half hour or any portion thereof

After Care 3:00-5:00:  $10.00 or $2.50/half hour or any portion thereof

PAYMENTS: Payments due monthly in advance, as follows:

  • For June, by May 18
  • For July, by June 8
  • For August, by July 10

 

REGISTRATION

 

Date of Registration Submission*
Child 1 Full Name*
Child 1 Birth Date*
Child 1 Gender *
Child 1 Grade in Sept.*
Child 1 Allergies *
Child 2 Full Name
Child 2 Birth Date
Child 2 Gender
Child 2 Grade in Sept.
Child 2 Allergies
Child 3 Full Name
Child 3 Birth Date
Child 3 Gender
Child 3 Grade in Sept.
Child 3 Allergies
First & Last Name(s) of Parent(s)/Guardian(s) Child Lives With*
Best phone # to reach 1st parent listed:*
2nd phone #
Best phone # to reach 2nd parent listed:
Best email to reach Parent 1:*
Best email to reach Parent 2:
Address Where Child Resides *
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
NAME of 1st Emergency Contact & Permission to Pick-Up*
Relationship to child
1st Emergency Contact Phone #*
NAME of 2nd Emergency Contact & Permission to Pick-Up
Relationship to child
2nd Emergency Contact Phone #
NAME of 3rd Emergency Contact & Permission to Pick-Up
Relationship to Child
3rd Emergency Contact Phone #
Select 5 Days/Week or 3 Days/Week Program *
SELECT WEEKS (BC=Before Care, AC=After Care) *
Comments:
Agreement: Children must be potty trained. If your child is prescribed an Epi-pen, 2 Epi-pens must be provided in order for your child to participate in this program, and staff trained in administering Epi-pens have permission to treat with the Epi-pen if needed. Field trips are at an additional cost. Registrants need not be Calvary Academy students. I agree to all provisions herein. I understand there are no refunds for missed days I have paid for, regardless of reason for absence. I agree to hold harmless Calvary Academy/Calvary Lighthouse, its affiliated organizations, employees, agents, representatives, volunteers and drivers, from any and all claims arising from my child’s participation in this program and field trips. In case of accident, illness, or other emergency, I give permission for staff to call emergency services or a licensed physician or dentist even if I am not able to be reached. I authorize and consent to any medical treatment deemed advisable in the best judgment of emergency services, a licensed physician or dentist. I agree to assume the financial responsibility for expenses incurred as a result of such services and for emergency medical transportation. Click link at top of page to pay your $175 registration deposit online. PRINT NAME IN BOX FOR SIGNATURE:*
Agreement: Children must be potty trained. If your child is prescribed an Epi-pen, 2 Epi-pens must be provided in order for your child to participate in this program, and staff trained in administering Epi-pens have permission to treat with the Epi-pen if needed. Field trips are at an additional cost. Registrants need not be Calvary Academy students. I agree to all provisions herein. I understand there are no refunds for missed days I have paid for, regardless of reason for absence. I agree to hold harmless Calvary Academy/Calvary Lighthouse, its affiliated organizations, employees, agents, representatives, volunteers and drivers, from any and all claims arising from my child’s participation in this program and field trips. In case of accident, illness, or other emergency, I give permission for staff to call emergency services or a licensed physician or dentist even if I am not able to be reached. I authorize and consent to any medical treatment deemed advisable in the best judgment of emergency services, a licensed physician or dentist. I agree to assume the financial responsibility for expenses incurred as a result of such services and for emergency medical transportation. Click link at top of page to pay your $175 registration deposit online. Type Name in box as signature:*