2026 Summer Day Camp Enrollment Form

The Sal Summer Day Camp Enrollment Form

1707 W. Chestnut Expressway Springfield, MO 65802 (417)862-5509 x 113
Dates: May 26, 2026-August 14, 2026

Monday-Friday
Please read & complete ALL sections of this form!

SUMMER HOURS: 7am-6pm Monday-Friday. Each child must bring: spare change of clothes, spare swim suit, water bottle, & sunscreen prior to the start of Day Camp either at Day Camp Orientation or May 21 from 8:30am-4:30pm.

The Sal will be CLOSED on the following days:

Monday, May 25 (Memorial Day)

Friday, June 19 (Juneteenth Observ.)

Friday, July 3 (4th of July)

Friday, August 7 (ONLY open for children participating in the musical from 9am-7pm)

Grades Accepted: 1st-7th (going into these grades in Fall 2026)

WAITING LIST: ALL AGE GROUPS ARE CURRENTLY FULL WITH A WAITING LIST! If you register, your child will be placed on a waiting list at this time as of 3/25/26. If you'd like to be placed on the waiting list for these age groups, please complete the enrollment form!

If you have questions about our age requirements or anything on this enrollment form please contact Kelly at kelly.thomas@usc.salvationarmy.org or (417)862-5509 x113.
Weekly Fees are as follows:

$110 per child per week (State pay accepted & 1st weeks fee must be received by May 1). Invoices will be due at the first of the month for the upcoming month. Failure to pay your invoice by the 1st of the month will result in removal from our program! Invoice Due Dates: June 1, July 1, & Aug. 1
A note on submitting this form:

It is recommended that you complete this form on a computer or tablet. It does not work well to submit it on a cell phone. If you have issues completing the form you may email Kelly Thomas (Community Center Director) at kelly.thomas@usc.salvationarmy.org for assistance.
Day Camp Orientation

All NEW Day Camp Families must attend Day Camp Orientation from 6pm-7pm on Monday, May 18, 2026.

This includes at least one parent & any children attending day camp. Please do NOT bring extra family members!

During this time parents should bring their camper's change of clothes, sunscreen, & any medications we will dispense during day camp. We will also tour the camp areas, meet staff, go over day camp policies, answer parent questions, & much more.

Additional info will be emailed out after registration. We do our best to communicate with families with important updates. It is the parent's responsibility to read & understand emails sent to them by day camp staff in a timely manner. New families who do not attend orientation will not be able to attend Day Camp.

Returning Families:

Returning families are welcome to attend orientation on Monday, May 18 but may select to view our day camp info video, read the program handbook, & sign off that they understand all material & agree to follow our policies. They will also need to drop off their camper's change of clothes, sunscreen, & any meds between May 18-21 from 9am-6pm if they do not attend this orientation. Returning families who do not watch the video/handbook by May 18 OR attend orientation on May 18 will not be able to attend Day Camp.
Child's Details

Please complete one form for each child
Child's Name*

First NameLast Name
Child's Birth Date*

MonthDayYear
Child's Gender*
What school does your child attend?*
What grade will your child be going into Fall 2026? (We only accept kids entering grades 1st-7th in Fall 2026)*

1st2nd3rd4th5th6th7th
T Shirt Size (shirt included for all day campers to wear on field trips)*

Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult XL
Child Reside With?*
Parent Info
Primary Parent Name*

First NameLast Name
Primary Parent Phone Number*

Area CodePhone Number
Primary Parent Email Address*
We will use this email to communicate throughout the summer and send billing invoices to on a weekly basis.
Child's Address (Primary Parent)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Parent Occupation*
Primary Parent Work Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Parent Work Phone Number*

Area CodePhone Number
Primary Parent Work Schedule*
Secondary Parent Name

First NameLast Name
Secondary Parent Phone Number

Area CodePhone Number
Secondary Parent Email Address
example@example.com
Secondary Parent Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Secondary Parent Occupation
Secondary Parent Work Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Secondary Parent Work Phone Number

Area CodePhone Number
Enrollment Details

First week's fees of $110 per child per week are due by May 1, 2026. Failure to make the first payment by this date will cause removal from enrollment. Payments can be made at The Salvation Army main office at 1707 W. Chestnut Expressway. We accept cash, check, credit card, or money order. Any After School Program participants with an account balance must have their account paid off by May 1, 2026 before their registration will be considered for enrollment.
Weekly Fees are as follows: $110 per child/per week

$110 per child per week (State pay accepted & 1st weeks fee must be received by May 1). Invoices will be due at the first of the month for the upcoming month. Failure to pay your invoice by the 1st of the month will result in removal from our program! Invoice Due Dates: June 1, July 1, & Aug. 1. We appreciate your attention to prompt & timely payments!
Is your child attending the entire summer or individual weeks?*

Entire Summer ***Will receive first priority*** (Allowed up to two weeks vacation, in writing at least one week prior)Individual Weeks ***Receive 2nd priority, no guarantee***(If available individual weeks requested will be granted after May 1)
Individual Week Sign Up (ONLY complete If you are needing a couple of weeks during the summer). These weeks are not guaranteed until after May 10 and will be granted in the order received, if available.

Week 1: May 26-May 29Week 2: June 1-5Week 3: June 8-12Week 4: June 15-18 (CLOSED June 19)Week 5: June 22-26Week 6: June 29-July 2 (CLOSED July 3)Week 7: July 6-10Week 8: July 13-17Week 9: July 20-24Week 10: July 27-31Week 11: August 3-7Week 12: August 10-14
Will you be applying for state child care assistance? (Paperwork must received by The Sal to begin charging subsidy rate). The Sal provider number is: 000497501. If you have a foster child who will be receiving state subsidy, please mark YES. We MUST have received your subsidy paperwork to start charging you the sliding fee rate!*

YesNo
Sal Day Camp Musical
Under the leadership of our Sal staff, the kids will be putting on a musical this summer. Do you grant permission for your child to audition for and/or assist with tech aspects (back stage- ie. scenery, costumes, props, etc.) of the show? If your child receives a part in the cast, please understand there will be an attendance requirement, parent may be asked to help provide some or part of the costume, & memorization expectation for participants which parents may have to assist their child with at home. The child must also be here for the performance on Fri., Aug. 7, 2026 at 2pm & 6pm.*

Yes, my child may participate in The Sal's Summer MusicalNo, my child may NOT participate in The Sal's Summer Musical
Emergency Contacts & Authorized Pick Ups

We only allow authorized family members & friends on this list to pick up registered children. Please provide contact information for two emergency contacts in the case that parent/guardian cannot be reached in an emergency. Please list first & last name of ANYONE authorized to pick your child up who has not already been listed.
Emergency Contact #1 Name (Not a parent or guardian)*

First NameLast Name
Emergency Contact #1 Phone Number*

Area CodePhone Number
Emergency Contact # 1 Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is this emergency contact authorized to pick up the child?*

YesNo
Emergency Contact #2 Name (Not a parent or guardian)*

First NameLast Name
Emergency Contact #2 Phone Number*

Area CodePhone Number
Emergency Contact #2 Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is this emergency contact authorized to pick up the child?*

YesNo
First & Last Name of anyone (not already listed) who is authorized to pick up your child from The Sal
Phone Number

Area CodePhone Number
First & Last Name of anyone (not already listed) who is authorized to pick up your child from The Sal
Phone Number

Area CodePhone Number
First & Last Name of anyone (not already listed) who is authorized to pick up your child from The Sal
Phone Number

Area CodePhone Number
First & Last Name of anyone (not already listed) who is authorized to pick up your child from The Sal
Phone Number

Area CodePhone Number
Health Information

The Salvation Army welcomes participation by children of all abilities. Every effort is made to provide reasonable accommodation, however, there may be instances where a child’s needs exceed the parameters of the scope of our program. The Salvation Army does not provide auxiliary, therapeutic, or medical services. (i.e., interpreter, one on one support, etc.) If the parents/guardians of a child with special needs who needs auxiliary support, secures auxiliary services, a further discussion of their participation can be scheduled.

If health or behavioral information is not disclosed on this enrollment form about your child, it is detrimental to our staff's ability to properly care for them, and may cause us to suspend their participation in our program.

Children, including those with behavioral and/or special needs, are expected to adhere to the following behavioral standards:

• Participants are prohibited from engaging in self-injurious behavior, behavior that intends to injure peers or staff, vandalism, destruction of property, elopement, and continuous refusal to follow staff directions.

• Participants must be able to feed & toilet themselves without any assistance from staff & regulate emotional responses without endangering others or themselves with minimal support from staff.
Select One:*

My child is in good health, is able to participate in group care, has no special health or medical requirements.My child is able to participate in group care but has special health or medical requirements as listed below.
Please list any allergies, special medical conditions, including chronic health problems (such as asthma, seizures), behavior disorders, special needs, etc. (if none write none or n/a)*
Child's Health Details
Medical Practioner Name*
Medical Practioner Phone Number*
Preferred Hospital Name*
Preferred Hospital Phone Number*
Does your child have an immunization record?*

YesNo
Attach a copy of your child's immunization record. You may also email a copy to kelly.thomas@usc.salvationarmy.org or bring a copy into our main office by May 1 at 1707 W. Chestnut Expressway. (Registration is not considered complete until we receive the child's immunization record.)
Will The Sal be dispensing medication to your child during Summer Day Camp?*

YesNo
If yes, please explain and provide a medical care plan (we will email you a copy of this form) to The Sal before start of day camp
Does your child have allergies or sensitivities?*

YesNo
If yes, please explain and provide a medical plan (we will email you a copy of this form) to The Sal before start of day camp
Does your child have any other medical conditions?*

YesNo
If yes, please explain and provide a medical plan (we will email you a copy of this form) to The Sal before start of day camp
Does your child have any food allergies or dietary restrictions?*

YesNo
If yes, please explain and provide a medical plan (we will email you a copy of this form) to The Sal before start of day camp
Behavioral Issues

At The Sal our staff strive to use positive behavior management techniques such as Conscious Discipline. We find that ongoing communication with kids and their families help support each child to have a great summer at The Sal. Please complete the questions below to help staff get know your child better in regards to his or her behavior. *PLEASE NOTE* Our staff are NOT trained in child restraint, if your child requires restraint for any reason we reserve the right to terminate their membership in our program.
What strategies are used to manage your child's behavior?*
What rewards work for good behavior with your child?*
What does your child dislike to do? What triggers behaviors for your child?*
How does he/she express anger or frustration?*
Please check all that apply. These behaviors DO NOT mean exclusion from The Sal Programs, however we are not trained in child restraint or to work with severe behavior issues. Please contact Kelly (kelly.thomas@usc.salvationarmy.org) to determine if this program is a good fit for your child if they have exhibited severe behaviors in the past.

Wanders/Runs awayInappropriate languageSelf InjuryDestroys propertyBitesInappropirate sexual behaviorNon-CompliantEats non-food itemsCollects items that do not belong to themPhysically aggressive (ie-pinches, scratches, hits, etc)Self Harm
Helpful techniques to manage these behaviors:
At school, does your child have one of the following (check all that apply and if possible provide it to The Sal prior to the start of Day Camp):

IEP (Individual Education Plan)BIP (Behavior Intervention Plan)Safety Plan
Health Permission Form

As the parent/guardian of the registered child, I give permission for the staff at The Salvation Army Summer Day Camp to apply a sunscreen product that is broad spectrum with SPF 30 or higher to my child, as specified below, when he/she will be playing outside or at the pool. The parent should provide a bottle of sunscreen which will be kept at The Sal. The Sal usually has extra Equate brand spray on & rub on SPF 45 available to use in an emergency. I understand that sunscreen may be applied to exposed skin, including but not limited to the face (except eyelids), tops of ears, nose, bare shoulders, arms and legs. The Sal may also administer bug spray (when provided by parents), hand sanitizer, unscented lotion, and Vaseline for chapped lips. I have read & checked all that apply to my child and signed below all applicable information regarding to the care of my child:
I understand I am required to provide sunscreen for my child to use while outside, however staff may use the sunscreen of the program’s choice following the directions and recommendations printed on the product container.*

YesNo
My child has had an allergic reaction to sunscreen.*

YesNo
If yes, what brand?
Staff may give my child hand sanitizer. (The Sal will provide)*

YesNo
Staff may give my child unscented lotion for dry skin. (The Sal will provide)*

YesNo
Staff may give my child Vaseline for chapped lips. (The Sal will provide)*

YesNo
About Your Child

The most important element in our partnership with you is honest and complete personal information about your child. In order to meet each camper's needs, we need as much relevant information as possible. Such information can be invaluable in helping your child make a smooth and happy transition from school to day camp. Having prior knowledge about a child’s background, an emotional upset, or a recent problem can be the crucial factor in helping us be sensitive to your child's needs. Since children often use their behavior rather than words to tell us what's bothering them, our having advance knowledge of sensitive issues helps us understand the message in a camper’s actions. This information will only be used by ourselves and your child’s team of day camp counselors and only with the utmost discretion. And should you wish that we share this information on a “need to know” basis only, we will respect your request. Lastly, we’ll certainly let you know if your child is having difficulty related to this information.
List any activities, hobbies, or interests that your child devotes time to.*
Have there been any changes in your child's home life during the past 12 months (including, but not limited to, the arrival of a new sibling, parents separation or divorce, new step-parent and/or blended family, death of family member, etc.)? If yes, please explain.*
Is there anything else we should know about your child?*
During day camp we go swimming twice per week at Grant Beach Pool. The water in most areas is around 3’- 4’ deep in the general swim area. How comfortable is your child with swimming?*

Very ComfortableSomewhat ComfortableNot Comfortable At All
Is your child allowed to take the swim test to go off the diving board/slides? This test is in deep water approx. 12-13 feet deep.*

YesNo
Parent Consent
I do give consent for my child to participate in any and all field trips given by The Sal. It is my understanding that I will be notified in advance of all such trips.*

YesNo
Do you consent to The Salvation Army to seek medical treatment for your child from a medical practitioner, hospital or ambulance in the event you can not be contacted?*

YesNo
Do you consent for The Sal to take photographs and videos of your child during normal activities and excursions?*

YesNo
Declarations
*

I agree to read The Sal Day Camp policies and procedures handbook (link available on The Salvation Army's website and will be emailed a copy upon enrollment) and agree to follow these as a condition of enrollment.
*

I understand The Salvation Army Summer Day Camp hours are 7am to 6pm Monday-Fridays and if I arrive after that time to collect my child, The Salvation Army may charge me a Late Collection Fee of $1 per minute late which I agree to pay within one week.
*

I agree to give two weeks notice of my child leaving The Sal Day Camp Program or equivalent fees may be charged
*

I hereby release The Salvation Army and its personnel of any responsibility for personal injury sustained by my child while in attendance at The Sal.
*

I understand that The Sal personnel reserve the right to terminate my child’s membership at any time it is determined that participation is unsatisfactory and that no refunds will be given.
*

I understand that I am responsible for paying any damage and/or replacement costs incurred by my child to Salvation Army property and/or equipment.
*

I agree to keep my child's information up to date, including but not limited to, phone numbers, address, email address, immunization, health information and family information.
*

I agree to collect or make arrangement for the collection of my child if they become unwell during day camp.
*

I agree to keep my child away from day camp if they display any symptom which would be considered contagious.
*

I am aware that fees are charged weekly and non-payment will result in cancellation of my child's enrollment.
*

I understand that The Sal Community Center and all programs and activities offered are sponsored by The Salvation Army and that Christian attitudes and values will be stressed.
*

I agree that I have been informed of the required health and safety inspections (form below) and that the inspection forms are available to review.
*

I declare the information provided in this form is true and correct
*

I declare that I am the applicant named in the form, and that all information and documents provided as part of my application are true and correct.
NOTE: This enrollment form is NOT considered complete until we receive the following items:

1. Immunization Records (hard copy or digital)

2. Food substitution form, medication authorization form, &/or IEP/Behavior Plan (if applicable)

3. First week's payment

These items MUST be turned in prior to your enrollment being considered complete!
Signature
Parents will be asked to sign this state required form at orientation/first day agreeing that they understand that The Sal is a religiously affiliated organization and they are inspected by the State of MO.
Should be Empty:

The Sal Summer Day Camp Enrollment Form

Dates: May 26, 2026-August 14, 2026

Weekly Fees are as follows:

A note on submitting this form:

Child's Details

Parent Info

Enrollment Details

Weekly Fees are as follows: $110 per child/per week

Sal Day Camp Musical

Emergency Contacts & Authorized Pick Ups

Health Information

Child's Health Details

Behavioral Issues

Health Permission Form

About Your Child

Parent Consent

Declarations