Mega Sports Camp (Summer Vibes) - July 5

General Information

Today's Date

Child's Name

Gender

Male Female

Date of Birth

Last School Grade Completed

Kindergarden (6 Years Old) 1st Grade 2nd Grade 3rd grade 4th Grade 5th grade 6th grade

Address

This address will receive a confirmation email

Mobile Phone

Emergency Phone

Mother/Guardian Name

Mother/Guardian Phone

Father/Guardian Name

Father/Guardian Phone

Mega Sports Camp - Sports

Please note: This year in Mega Sports Camp each sport will run for one week only.
If your child would like to attend more than one week, please choose their first, second, third, and fourth choices below.

First choices will be honored, all others will be placed on a waiting list. Limited space 30 children per week.

Please choose your child's preferred first choice below

First Choice

T̶h̶e̶ ̶A̶r̶t̶s̶ ̶(̶W̶e̶e̶k̶ ̶1̶ ̶J̶u̶l̶y̶ ̶5̶t̶h̶ ̶-̶7̶t̶h̶)̶ FULL B̶a̶s̶k̶e̶t̶b̶a̶l̶l̶ ̶(̶W̶e̶e̶k̶ ̶2̶ ̶J̶u̶l̶y̶ ̶1̶0̶t̶h̶ ̶-̶ ̶1̶4̶t̶h̶)̶ FULL S̶o̶c̶c̶e̶r̶ ̶(̶W̶e̶e̶k̶ ̶3̶ ̶J̶u̶l̶y̶ ̶1̶7̶t̶h̶ ̶-̶ ̶2̶1̶s̶t̶)̶ FULL C̶h̶e̶e̶r̶l̶e̶a̶d̶i̶n̶g̶ ̶(̶W̶e̶e̶k̶ ̶4̶ ̶J̶u̶l̶y̶ ̶2̶4̶t̶h̶ ̶-̶ ̶2̶7̶t̶h̶)̶ FULL

Second Choice T̶h̶e̶ ̶A̶r̶t̶s̶ ̶(̶W̶e̶e̶k̶ ̶1̶ ̶J̶u̶l̶y̶ ̶5̶t̶h̶ ̶-̶7̶t̶h̶)̶ B̶a̶s̶k̶e̶t̶b̶a̶l̶l̶ ̶(̶W̶e̶e̶k̶ ̶2̶ ̶J̶u̶l̶y̶ ̶1̶0̶t̶h̶ ̶-̶ ̶1̶4̶t̶h̶)̶ FULL S̶o̶c̶c̶e̶r̶ ̶(̶W̶e̶e̶k̶ ̶3̶ ̶J̶u̶l̶y̶ ̶1̶7̶t̶h̶ ̶-̶ ̶2̶1̶s̶t̶)̶ FULL C̶h̶e̶e̶r̶l̶e̶a̶d̶i̶n̶g̶ ̶(̶W̶e̶e̶k̶ ̶4̶ ̶J̶u̶l̶y̶ ̶2̶4̶t̶h̶ ̶-̶ ̶2̶7̶t̶h̶)̶ FULL

Third Choice T̶h̶e̶ ̶A̶r̶t̶s̶ ̶(̶W̶e̶e̶k̶ ̶1̶ ̶J̶u̶l̶y̶ ̶5̶t̶h̶ ̶-̶7̶t̶h̶)̶ B̶a̶s̶k̶e̶t̶b̶a̶l̶l̶ ̶(̶W̶e̶e̶k̶ ̶2̶ ̶J̶u̶l̶y̶ ̶1̶0̶t̶h̶ ̶-̶ ̶1̶4̶t̶h̶)̶ FULL S̶o̶c̶c̶e̶r̶ ̶(̶W̶e̶e̶k̶ ̶3̶ ̶J̶u̶l̶y̶ ̶1̶7̶t̶h̶ ̶-̶ ̶2̶1̶s̶t̶)̶ FULL C̶h̶e̶e̶r̶l̶e̶a̶d̶i̶n̶g̶ ̶(̶W̶e̶e̶k̶ ̶4̶ ̶J̶u̶l̶y̶ ̶2̶4̶t̶h̶ ̶-̶ ̶2̶7̶t̶h̶)̶ FULL

Fourth Choice T̶h̶e̶ ̶A̶r̶t̶s̶ ̶(̶W̶e̶e̶k̶ ̶1̶ ̶J̶u̶l̶y̶ ̶5̶t̶h̶ ̶-̶7̶t̶h̶)̶ B̶a̶s̶k̶e̶t̶b̶a̶l̶l̶ ̶(̶W̶e̶e̶k̶ ̶2̶ ̶J̶u̶l̶y̶ ̶1̶0̶t̶h̶ ̶-̶ ̶1̶4̶t̶h̶)̶ FULL S̶o̶c̶c̶e̶r̶ ̶(̶W̶e̶e̶k̶ ̶3̶ ̶J̶u̶l̶y̶ ̶1̶7̶t̶h̶ ̶-̶ ̶2̶1̶s̶t̶)̶ FULL C̶h̶e̶e̶r̶l̶e̶a̶d̶i̶n̶g̶ ̶(̶W̶e̶e̶k̶ ̶4̶ ̶J̶u̶l̶y̶ ̶2̶4̶t̶h̶ ̶-̶ ̶2̶7̶t̶h̶)̶ FULL

Allergies/Medical Conditions

If your child does not suffer from any form of allergies type in NONE.

Food Allergies

Other Allergies

Medical Conditions (Asthma, Lactose Intolerant, ADHD, etc.)

Is your Child on Medication?

Please List Below the Names of Persons to Whom We May Release Your Child To:

Please list three people that can pick up your child in case you are unable to do so. In case of an emergency all three people will be contacted in the order given below.

#1 Name

#1Phone

#2 Name

#2 Phone

#3 Name

#3 Phone

Permission to go Home Alone

By checking YES, you give Church of the Revelation permission to release your child at the end of Mega Sports Camp each day for the entirety of the Camp. The camp dates are July 5th - July 28th. At the beginning of each day, your child will be given a wristband indicating that they are allowed to be released.

My Child is allowed to go home on his/her own

Yes No

Consent for Promotional Purposes/Advertising

I give permission to a release of my child's image (photo/video) to Church of the Revelation/Mega Sports Camp.

Signature of Parent/Guardian

Date

Waiver Release

I, the undersigned, parent/guardian, do hearby grant permission for my son/daugther, named above, to attend the camp/clinic. In order that my child may receive the proper medical treatment in the event that he/she may sustain injury or illness during Mega Sports Camp, I hereby authorize the camp staff to obtain or provide medical treatment for my child for such injury or illness during the camp, and I hereby hold the camp staff and sponsoring organization(s), as well as its representatives, harmless in the exercise of this authority.

I further understand that there is always a possiblilty that my child may sustain physical illness or injury while at the camp. If this occurs, I hereby authorize the camp staff and representatives to refer my child to a medical treatment center (hospital, etc.) I further acknowledge and understand that I will be responsible for any medical bills that may be incurred on behalf of my son/daugther for physical illness or injury that he/she may sustain during the camp.

Understanding that there is always a possibility that my child may sustain physical illness or injury, I acknowledge and understand that my child is assuming the risk of such physical illness or injury by his/her participation, and I further release the sponsoring organization and its representatives from any claims for personal illness or injury that my child may sustain during camp. I further acknowledge and understand that my child will be responsible for his/her failure to abide by the rules and regulations of the camp. We acknowledge that this event will have a spiritual emphasis.

Medical Insurance Company

Policy Number

Insurer's Name on the policy

Physician's Name

Emergency Contact Name

Mobile Phone

Signature of Parent/Guardian

Mega Sports Camp (Summer Vibes) - July 5 - 28, 2023

Description

Mega Sports Camp (Summer Vibes) - July 5 - 28, 2023

Description

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