Summer Day Camp Registration 2026

Please Fill Out One Form Per Camper

Adult 1 is
Please provide 1-2 legal guardians and one emergency contact
Name*

First NameLast Name
Adult 1 Cell Phone Number*
Adult 1 Work Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
YesNo
Adult 2 is*
Please provide 1-2 legal guardians and one emergency contact
Name*

First NameLast Name
Adult 2 Cell Phone Number*
Adult 2 Work Phone Number*
YesNo
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
YesNo
Adult 3 is*
Please provide 1-2 legal guardians and one emergency contact
Name*

First NameLast Name
Adult 3 Cell Phone Number*
Adult 3 Work Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
YesNo
Additional person to whom the children may be released:

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number when child is in care
Please enter a valid phone number.Format: (000) 000-0000.

First Name*
Last Name*
Birth Date*

MonthDayYear
Gender*
YesNo
Grade Entering in Fall of 2026
Primarily At the Same Address as:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
T-Shirt Size*
Allergies (including medication reaction)?*
Please Describe
Epi -penInhalerEmergency Seizure MedicationRegularly Scheduled and Prescribed MedicationNone
Special Disabilities (if any)
Medical or Dietary Information Necessary in an Emergency Situation
Medication, Special Situation
Please list any medications or Special situations we should know about
Health Insurance Coverage for Child or Medical Assistance Benefits*
Policy Number*
Medical Provider Informaton*
Doctors 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
Permissions

Parent's Signature is required for each item below to indicate parental consent. **please note for campers in grades k-5 all of these permissions are required in order to attend camp**
Obtaining Emergency Medical Care*

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Admin. of Minor First-Aid Procedures*

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Walks and Trips

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Swimming

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Transportation by the Facility

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Wading

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KI Permission Slip

By signing this form, I indicate that I have read and understand the information made available to me regarding the distribution of KI pills at Coventry Christian Schools.
Yes- I DO want my child to be given potassium iodide (KI), whenInstructed by public health officials, in the event of a radioactiveemergency during school hours.No- I DO NOT want my child to be given potassium iodide (KI), wheninstructed by public health officials, in the event of a radioactiveemergency during school hours.
Parent/ Guardian Name*

First NameLast Name
Signature*

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Todays Date*

MonthDayYear
Date
Sunscreen Permission Slip

We require our campers to apply sunscreen for those times (i.e. swimming, outdoor play) when there will be extended exposure. Ideally we would like each camper to have their own marked bottle of sunscreen to apply when it is needed. Due to allergies we need permission to use other sunscreen if for some reason your camper does not have their sunscreen with them. Without this form or without sunscreen of their own, campers will not be allowed out in the direct sun for extended periods of time.
I grant the CCS SDC staff permission to apply the sunscreen that I will provide for my childI grant the CCS Summer Day Camp staff permission to apply othersunscreen to my child in the event that he/she does not have their own.I do not grant the CCS Summer Day Camp staff permission to apply othsunscreen to my child in the event that he/she does not have their own sunscreen on a day at Summer Day Camp. I understand that, without the protection of sunscreen, my child will not be allowed in the direct sunlight for extended periods of time.
Parent Name*

First NameLast Name
Signature*

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Date*

MonthDayYear
Date
Behavior Contract

Summer Day Camp 2026

SDC Mission Statement

Coventry Christian Summer Day Camp exists foremost to nurture young people in the faith, hope, and love of Jesus Christ. To be a fun safe environment for kids to express themselves, build friendships, as well as grow as children of God. Our goal as we go out into the community is to let our lights shine as children of God as we learn and grow little minds.

In an effort to make summer day camp a safe space for campers to play, learn, and make mistakes we have implemented the following behavior contract.

Campers are expected to conduct themselves in a manner that is kind and respectful of campers, staff and property.
- Campers who maliciously and intentionally injure other campers, staff, themselves, or school property will be given ONE warning. The warning will be both written, verbally, and in Tadpoles. The camper will be asked to be picked up immediately from camp by the parents. If this behavior occurs again the camper will be asked to leave and not return to summer day camp for the remainder of the summer.
- Campers who elope (run away) from staff members, rooms, or other locations as we travel will be asked to be picked up immediately. One warning will be given. The warning will be both written, verbally, and in Tadpoles. If this behavior occurs again the camper will be asked to leave and not return to summer day camp for the remainder of the summer.
- Foul language, cursing, and inappropriate content will not be tolerated. Campers' words should glorify God and lift others up, not break them down.
My signature below indicates that I understand if my camper does not comply with these rules he/she will no longer be able to participate in Summer day camp at Coventry Christian Schools.
Signature

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Name of Signer

First NameLast Name
Scheduling

Please indicate your intended schedule as well as start and end times below. **Please Note There is NO CAMP THE WEEK OF June 30th-July 4th **
What group would your camper be in?*
Start Time*
End Time*
YesNo
Week 1 June 15th -19th

Please select the days attending
Nursery
Toddlers
Twos
Threes
Pre-K
Eaglet/ Hawks/ Eagles
Week 2 June 22-26th

Please select the days attending
Nursery
Toddlers
Twos
Threes
Pre-K
Eaglet/ Hawks/ Eagles
There is no camp June 29th-July 3rd in observance of Independence Day!
Week 3 July 7th - 11th

Please select the days attending
Nursery
Toddlers
Twos
Threes
Pre-K
Eaglet/ Hawks/ Eagles
Week 4 July 13th -17th

Please select the days attending
Nursery
Toddlers
Twos
Threes
Pre-K
Eaglet/ Hawks/ Eagles
Week 5 July 20th-24th

Please select the days attending
Nursery
Toddlers
Twos
Threes
Pre-K
Eaglet/ Hawks/ Eagles
Week 6 July 27th- July 31st

Please select the days attending
Nursery
Toddlers
Twos
Threes
Pre-K
Eaglet/ Hawks/ Eagles
Week 7 Aug 3rd - 7th

Please select the days attending
Nursery
Toddlers
Twos
Threes
Pre-K
Eaglet/ Hawks/ Eagles
Week 8 Aug 10th - 14th

Please select the days attending
Nursery
Toddlers
Twos
Threes
Pre-K
Eaglet/ Hawks/ Eagles
Week 9 Aug 17th - 21st

Please select the days attending
Nursery
Toddlers
Twos
Threes
Pre-K
Eaglet/ Hawks/ Eagles

Please Fill Out One Form Per Camper

Permissions

KI Permission Slip

Sunscreen Permission Slip

Scheduling

Week 1 June 15th -19th

Week 2 June 22-26th

There is no camp June 29th-July 3rd in observance of Independence Day!

Week 3 July 7th - 11th

Week 4 July 13th -17th

Week 5 July 20th-24th

Week 6 July 27th- July 31st

Week 7 Aug 3rd - 7th

Week 8 Aug 10th - 14th

Week 9 Aug 17th - 21st