Summer Camp Registration- Signature

Ages 5-12 years old

(Camper may be 4 if starting Kindergarten in 2022)
- May 30-June 2 : Color Combat: Is your team fierce? Do they take meeting benchmarks and breaking records to the next level? Lets bring out the competitive edge while having fun! Campers teams will face off in relays,wacky obstacles, while problem solving and building communication skills.
- June:5-9: Mad Scientist: Boom! Whoa! What was that?! We will find out in this wacky, weird, science themed week. We'll spend the week playing, learning, and doing the wild, strange, and unusal!
- June 12-16: Turf Wars: Who will rule the TURF?! This week is a blend of classic lawn games, field day competitions, and absurd head-to-head relays you can't even begin to imagine!
- *June:19-23: Sink or Swim!: This fun week is a great opportunity for children of all skill levels. It is designed to accommodate those just getting their toes wet all the way to the competitive swimmer. This Week is lead by our head swim coach/lead swim instructor and senior swim team.
- *June 26-30: NFC Ninjas: This camp offers a great opportunity to learn the basics of Isshinryu karate while building self-esteem and self-control. Campers will learn through conditioning, core-training, and self-defense.
- **July 3-7th: Stars and Stripes: Discover the land we call home! We will celebrate everything red, white and blue, from hometown heroes to firework crafts to exploring the American frontier. This week will be filled with stars and stripes galore with a little bit of geography and patriotic activities thrown in.- No camp on July 4th
- July 10-14:Disney: Train to be a warrior like Mulan or a superhero like Captain America. Join us for for a magical week of fairy tales and villian competitons. Special Disney Guest Campers in attendance this throughout week.
- July 17-21: Mission Impossible: Get your imagination flowing and learn to become a secret agent! We will uncover what it takes to unlock the agent in all of us by learning the science behind spying, using our brains in challenges and solving mysteries!
- July 24-28: MACH 1: This week will be full of activities for all fitness levels! We will learn about getting in shape, muscle groups, and maintaining physical fitness! it will be intense , but loads of FUN! Campers will experience circuits, obstacle courses, relays and participate in Kids in Motion classes!
- July 31- Aug 4: Summer Blowout: Ready, Set, Go! This week is all about celebrating the end of summer and welcoming a new school year. Each day will be a new theme and full of high-energy activities.
* Increased Rate will apply to account for specialty staff

Monday-Friday 8:30 a.m.- 5:30 p.m.

Campers must be picked up by 5:30 pm. There will be a $1 per minute fee assessed for every minute after 5:35 pm. This late fee is charged per camper.
Camp Fees are due 2 weeks prior to the start of camp.

Camp/Registration payments may be made at Our Camp Payment Site or in the club.
MEMBER

FULL-TIME: $165 DAILY: $35
NON-MEMBER

FULL - TIME: $185 DAILY: $40
Swim/Karate Speciality Camps

MEMBER: $185 NON-MEMBER: $200

DAILY: $40.00 DAILY: $45.00
Camp Fees are due 2 weeks prior to the start of camp.

Camp/Registration payments may be made at Our Camp Payment Site or in the club.
REGISTRATION FEE

(1X FEE PER SESSION)

$69.95/CAMPER $165/3 CAMPER HOUSEHOLD
BEFORE CARE (7:30a.m.- 8:30 a.m.)

Weekly: $25/camper 3+ camper household: $50 Day: $5/camper

Camper 1 Name*
Age*
Date of Birth*

MonthDayYear
Date
T-Shirt Size*
NOTE - Children need to be entering Kindergarten and cannot be over the age of 12 to be eligible to participate in day camp. Please contact the Summer Camp Director or Children's Director for more information.
Camper Swimming Ability*

Non-SwimmerBeginner Swimmer (can swim on front 20ft without flotation)Advanced Swimmer (can pass swim test)
Please list any allergies:
Please list any additional information about your child that would be useful for staff to know, or medication needed during camp day and directions on how to administer it:

Color: May 30-June 2
Science: Jun 5-9
Turf War: Jun 12-16
Select Days:Color
Select Days:Science
Select Days:Turf War
Swim: Jun 19-23
Ninja: Jun 26-30
USA: July 3-7
Select Days: Swim
Select Days: Ninja
Select Days: USA
Disney Jul 10-14
Mission Impossible: Jul 17-21
Mach 1: Jul 24-28
Select Days: Disney
Select Days: Mission
Select Days: Mach 1
Summer Block Party: July 31-Aug 4
Select Days: Block Party
Will you need before care for any days attending? (Camp director will confirm days).+

YESNOUnsure

Click to add additional camper
Camper 2 Name
Age
Date of Birth

MonthDayYear
Date
T-Shirt Size
Camper Swimming Ability

Non-SwimmerBeginner Swimmer (can swim on front 20ft without flotation)Advanced Swimmer (can pass swim test)
Please list any allergies:
Please list any additional information about your child that would be useful for staff to know, or medication needed during camp day and directions on how to administer it:

Color Combat: May 30- 2
Science: Jun 5-9
Turf Wars: Jun 12-16
Select Days: Color
Select Days: Science
Select Days: Turf War
Swim: Jun 19-23
Ninja: Jun 26-30
USA: Jul 3-7
Select Days: Swim
Select Days: Ninja
Select Days: USA
Disney: Jul 10-14
Mission Impossible: Jul 17-21
Mach 1: Jul 24-28
Select Days: Disney
Select Days:Mission
Select Days:Mach 1
Summer Block Party: July 31- Aug 4
Select Days: Block Party
Need to add another camper?

Camper 3 Name
Age
Date of Birth

MonthDayYear
Date
T-Shirt Size
Camper Swimming Ability

Non-SwimmerBeginner Swimmer (can swim on front 20ft without flotation)Advanced Swimmer (can pass swim test)
Please list any allergies:
Please list any additional information about your child that would be useful for staff to know, or medication needed during camp day and directions on how to administer it:

Color Combat: May 30-3
Science: Jun 5-9
Turf Wars: Jun 23-16
Select Days:Color
Select Days: Science
Select Days: Turf War
Swim: Jun 19-23
Ninja: Jun 26-30
USA: Jul 3-7
Select Days: Swim
Select Days: Ninja
Select Days: USA
Disney: Jul 10-14
Mission Impossible: Jul 17-21
Mach 1 :Jul 24-28
Select Days: Disney
Select Days: Mission
Select Days: Mach 1
Summer Block Party: Jul 31- Aug 4
Select Days: Block Party

Parent/Guardian 1*

First NameLast Name
Relationship to Child*
E-mail*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone*
Home Phone
Work Phone
Where would you like to be reached while your child is at camp?*

Cell PhoneHome PhoneWork Phone
Are you a Member?*

Add additional Parent
Parent/Guardian 2

First NameLast Name
Relationship to Child
E-mail
Cell Phone
Home Phone
Work/School Phone
Home Address Same as Parent/Guardian 1?

Yes
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Where would parent/guardian 2 like to be reached while your child is at camp?

Cell PhoneHome PhoneWork Phone

Parents cannot be listed as emergency contacts. List the name of at least one person who can be contacted in the event of an emergency or illness if you cannot be reached. Any person listed should be able to assist in contacting you. At least one person listed must be within one hour of the center/home, able to take responsibility for the child in case the parent/guardian cannot be contacted and should be at least 18 years of age. The first emergency contact must live no more than 1 hour away and be over the age of 18.
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*
Secondary Phone Number
Relationship to Child*

Add additional emergency contact
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number
Secondary Phone Number
Relationship to Child

Authorized Pick-Up

Please list below any additional persons authorized to pick-up child(ren). Provided QR will be required uppon check out. (Parents/ER contacts do not need to be listed)
Name
Relationship
Name
Relationship
Name
Relationship

Please Read the Following Policies Carefully.
Liability Release

I release National Fitness Center, Court South, and its assignees to use the likeness of (e.g group photos of campers, action shots of campers, etc) and quotes by campers for various publications including but not limited to: local newspapers, commercials, nfc1.com, National Fitness Social Media pages, newsletters, and brochures.

IN CONSIDERATION OF BEING ALLOWED TO PARTICIPATE IN ANY OF THE FOLLOWING, PROGRAMS/ACTIVITIES: SWIMMING, MARTIAL ARTS, DANCE, TUMBLING, CHEERLEADING, BASKETBALL COURT ACTIVITIES, AND ANY OTHER SPORT OR FITNESS RELATED EVENT, THE UNDERSIGNED:

Agrees that the parent(s) or legal guardians will instruct the minor participant that prior to participating, he or she should inspect the facilities, class, and equipment to be used, and if the participant believes anything is unsafe, or too difficult, he or she will immediately advise his or her coach/ instructor or supervisor of such conditions and refuse to participate.

Acknowledge and fully understand that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions, or negligence, but also from the actions, inactions, or negligence of others, the rules of play, training, or the conditions of the premises or any equipment used. Furthermore, that there may be other risks not known to us or not reasonably foreseeable at this time.

Assume all the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability, or death.

Release, waive, discharge, and covenant not to sue National Fitness Center, their other affiliated clubs, their respective administrators, directors, agents, coaches, and other employees of the organization, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and leaders of the premises used to conduct the event, all of which are hereinafter referred to as "releases" from any and all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the release or otherwise.

Realizing that a sudden illness or accident may occur, I hereby ask the Camp Director and Club Manager to use their best judgment in such cases in caring for my child(ren). In the event that I cannot be reached in an emergency, I hereby give permission for National Fitness Center to seek appropriate medical care for my child(ren), including consultation or care by a physician and transportation to a medical care facility/hospital.
Date Signed*

MonthDayYear
Date
How Did You Hear About Us?*
Parent/ Guardian Signature*

Clear
Should be Empty:

Ages 5-12 years old

Monday-Friday 8:30 a.m.- 5:30 p.m.

BEFORE CARE (7:30a.m.- 8:30 a.m.)

Authorized Pick-Up

Liability Release