Choosing to Excel Summer Camp Registration 24

Mandatory Parent Meeting
**For your child to attend camp, you must attend a mandatory

parent informational meeting. If you cannot attend, please have a

representative on the call who will be responsible to provide with all the

information shared.

Parent Meeting:

Sunday, June 2 at 6:00 p.m. via Zoom

*Zoom link will be sent to email used during online registration
Activities include volleyball, basketball, board games, arts & crafts, competitions, reading, dance, talent show, field trips, and more!

Camper and Parent/Guardian Information
Camper’s Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Gender*
Will your camper be picked up from camp or will they be walking home?*

Picked upWalking HomeBoth
Any allergies, conditions, etc. we should know about?
Ex; Peanut allergy, diabetes, etc.
Parent/Guardian Information
Full Name *

First NameLast Name
E-mail*
example@example.com
Cell Number *

Area CodePhone Number
Work Number*

Area CodePhone Number
Company*
Emergency Contact Information
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Additional Comments
Liability Waiver and Media Release

Please read the following and SIGN if you agree to the statement: My signature below indicates my approval for my child to attend all the Excel off-site activities and outings. As a parent/guardian, I acknowledge and accept the risk of physical injuries associated with any special activity. I accept the personal financial responsibility for all bodily or personal injury sustained during camp activities. Furthermore, the parent/guardian of the above child releases Choosing to Excel, K-Life, and any of its workers/representatives from any liability for injuries sustained in camp activities and outings. I also agree that this is a media release for the use of advertisement for Choosing to Excel. We understand that Choosing to Excel is a non-profit organization that promotes optimal health and character building for all youth.
Signature of parent/guardian

Clear

Summer Camp Registration Payment

Registration for ages 7-9 boys$250.00

Covers 1 camper for 5 weeks (Includes all activities & outings)

Quantity

Registration for ages 7-9 girls$250.00

Covers 1 camper for 5 weeks (Includes all activities & outings)

Quantity

Registration for ages 10-11 boys $250.00

Covers 1 camper for 5 weeks (Includes all activities & outings)

Quantity

Registrations for ages 10-11 girls$250.00

Covers 1 camper for 5 weeks (Includes all activities & outings)

Quantity

Registration for ages 12-15 boys$250.00

Covers 1 camper for 5 weeks (Includes all activities & outings)

Quantity

Registration for ages 12-15 girls $250.00

Covers 1 camper for 5 weeks (Includes all activities & outings)

Quantity

Total $0.00

Paying/Paid via Cash/Check CashApp ($ExcelPM) Registration is not secured until payment is made.

CashCheckOther
Should be Empty:

Camper and Parent/Guardian Information