2026 SUMMER CAMP REGISTRATION

2026 SUMMER CAMP REGISTRATION

Hours of Operation: Monday - Friday 8:00am to 6:00 pm Location: 11300 NW 41st, Miami, FL 33178 (Gym) (305) 890- 4912 (Sports) (786) 371 - 9919 miami.summercamp305@gmail.com
Camper Information*

First NameLast Name
Please select whether camper is a student at AcadeMir Charter School East *
If your answer is NO, please provide the name of the school your camper attends below: *
Date of Birth*

MonthDayYear
Date
Age*
Camper T-Shirt Size*
Parents or Guardian 1 Information*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parents or Guardian 2 Information*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com

Emergency Contact Information

First NameLast Name
Relationship to Camper
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Medical and Insurance Information
Allergies (if any):
Current Medications (if any):
Health Insurance Provider:
Health Insurance Policy Number:

Rows	WEEK CAMPER WILL ASSIST
June 8th - June 12th
June 15th - June 19th
June 22nd - June 26th
June 29th - July 3rd
July 6th - July 10th
July 13th - July 17th
July 20th - July 24th
July 27th - July 31st
August 3rd - August 7th

Camp Activities

Please select two (2) weekly activities that the camper will participate in.Note: Campers may choose either two half-day activities (one AM and one PM) or one full-day activity per week. (Swimming is offered as an AM-only activity.)*

Rows	GYM	SPORTS	ARTS & CRAFTS	SWIMMING	DANCE
June 8th - June 12th
June 15th - June 19th
June 22nd - June 26th
June 29th - July 3rd
July 6th - July 10th
July 13th - July 17th
July 20th - July 24th
July 27th - July 31st
August 3th - August 7th

Gym	Sports
Tumbling	Soccer
Ninja Warriors	Basketball
Gymnastics	Volleyball
Cheerleading	Fifa Games
Bounce House Games

Arts & Crafts

For an additional weekly $20.00 your camper will be able to participate in various Arts & Crafts activities during the week: Drawing, Painting, Playdoh crafts, and Building Projects.

Dance

Dance through summer with music, movement, and confidence!
Our summer camp dance classes are perfect for all levels and focus on fun, creativity, and self-expression. Campers will learn exciting routines and take the stage in weekly shows, giving them the chance to shine and celebrate their progress each week.
Swimming

Our summer camp swimming program offers a safe, supportive experience where campers can swim, play, and build confidence in the water. All activities are professionally supervised, with trained staff and a lifeguard on duty at all times to ensure every child’s safety.
Lunch

This year we have received the help from Miami-Dade County Summer Meals! Miami-Dade will be providing Lunch and Snacks for our campers for the entire camp this summer at NO COST!
Free Lunch provided by Miami-Dade County Summer MealsCamper will bring lunch/snacks from home

Payment Authorization Form
Credit Card Information:

Please upload clear images of the front and back of the credit card you will be using on the final page. Below, select the option(s) you are authorizing to be charged to this card.
Summer Camp Package per WeekPromotion: 5 or more Weeks in AdvanceRegistration ($75.00)Additional Weekly Arts & Crafts ($20.00 per week)
I authorize Power Tumble USA to draft payments from my account. I may cancel my automatic billing at any time by contacting the Academy. I am an authorized agent to execute this payment authorization. I indemnify and hold the service provider, the bank, and Merchant harmless from damage, loss or claim resulting from all authorized actions hereunder. Please note that any payment received with credit or debit cards will be charged a convenience fee of 4%.

Note: Please note that If you authorize a payment it will become non-refundable but can be credited towards gym activities. All payments and class registrations are non-refundable, including in the event of natural disasters or other unforeseen circumstances. We appreciate your understanding and encourage you to reach out if you have any questions or concerns regarding this policy.
Parent Name*

First NameLast Name
Date Signed*

MonthDayYear
Date
Initials*

Acknowledgment, Liability Waiver & Consent

I am fully aware and understand the risk, including the risk of catastrophic injury, as well as other damages and losses associated with participation in a sport activity. This includes "OPEN DAY, TRIAL CLASSES, CHEERLEADING, DANCE, GYMNASTICS OR TUMBLING PRACTICE, SOCCER, SWIMMING, BASKETBALL, ARTS & CRAFTS, AND ANY OTHER TRYOUTS". I further acknowledge and consent to my child and/or myself being involved in a sport where there can be an accident or injury and will take full financial responsibility for any loss or damages. I further agree that POWER TUMBLE USA, ACADEMIR SCHOOLS, and KICKOFF LLC, along with the employees, agents, officers and directors of this organization shall not be liable for any losses or damages occurring as a result of my child's or my participation in athletic activity. This includes "OPEN DAY, TRIAL CLASSES, CHEERLEADING, DANCE, GYMNASTICS OR TUMBLING PRACTICE, SOCCER, SWIMMING, BASKETBALL, ARTS & CRAFTS, AND ANY OTHER TRYOUTS" I have read and understand the rules and policies and will follow and comply with all of them. I realize that failure to comply could mean my child's or my denial to participate at TUMBLE USA and/or its "OPEN DAY, TRIAL CLASSES, CHEERLEADING, DANCE, GYMNASTICS OR TUMBLING PRACTICE, SOCCER, SWIMMING, BASKETBALL, ARTS & CRAFTS, AND ANY OTHER TRYOUTS". There will be no refund if a child or I am removed from "OPEN DAY, TRIAL CLASSES, CHEERLEADING, DANCE, GYMNASTICS OR TUMBLING PRACTICE, SOCCER, SWIMMING, BASKETBALL, ARTS & CRAFTS, AND ANY OTHER TRYOUTS", for failure of following the rules. All payments and class registrations are non-refundable, including in the event of natural disasters or other unforeseen circumstances. We appreciate your understanding and encourage you to reach out if you have any questions or concerns regarding this policy. All minor participants must be signed in by a parent, legal guardian or other adult chaperone before allowance in the gym. A note giving "permission to attend OPEN DAY, TRIAL CLASSES, CHEERLEADING, DANCE, GYMNASTICS OR TUMBLING PRACTICE, SOCCER, SWIMMING, BASKETBALL, ARTS & CRAFTS, AND ANY OTHER TRYOUTS while respecting and caring for gym equipment" will suffice if you are not a member of POWER TUMBLE USA, ACADEMIR SCHOOLS, and KICKOFF LLC. A membership requires enrollment in POWER TUMBLE USA, ACADEMIR SCHOOLS, and KICKOFF LLC, a signed release form on file, and up-to-date paid tuition. I also understand that POWER TUMBLE USA, ACADEMIR SCHOOLS, and KICKOFF LLC retains the right to use any photographs, videotapes, motion picture recordings, or any other record of events for publicity, advertising, or any other legitimate purpose.
Parent Name*

First NameLast Name
Date Signed*

MonthDayYear
Date
Signature*

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2026 SUMMER CAMP REGISTRATION

Medical and Insurance Information

Camp Packages

Discount Opportunities

Summer Sessions:

Entire Week:

Day by Day Camp Attendance:

Camp Activities

Dance

Swimming

Lunch

Payment Authorization Form

Credit Card Information:

Acknowledgment, Liability Waiver & Consent

Rows	MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY
June 8th - June 12th
June 15th - June 19th
June 22nd - June 26th
June 29th - July 3rd
July 6th - July 10th
July 13th - July 17th
July 20th - July 24th
July 27th - July 31st
August 3rd - August 7th
N/A