2026 Summer Camp Registration Form

Summer Camp General Information (K3-6th Grade)

June 1 - July 24 Open from 7:00 AM - 5:00 PM
- All 3-year-olds must be potty trained ***not in pull-ups or having regular bathroom accidents***
- A snack will be provided for your child each day. Please send a lunch, extra snack, and water bottle with your child each day. Breakfast may be brought from home. A refrigerator and microwave are available.
- K3 through Kindergarten must bring a mat, blanket, pillow, and extra change of clothes for nap time. Children may leave mats as long as they are attending summer camp.
- All medicines must be given to the camp supervisor with clear, written instructions from the parents.
- No child, regardless of age, is to go to or from the car alone. The parent must walk in/out with the child. The camp is not responsible for any child who is not properly released to the camp supervisor.
- Permission for the child to leave camp with anyone other than the parent must be given in writing to the supervisor. If for any reason the parent is not able to pick up the child, the parent must call the school office or summer camp phone and give a description and name of the person picking up the child.
- Parents must write the child's name on all belongings (lunch box, napping items, toys, etc.).
- Parents will be notified in advance of all field trips. Parents are encouraged to attend such events.
- The camp supervisor will use discipline to maintain control of camp activities. If a behavioral problem cannot be corrected, parent may be asked to withdraw the child.

Dress Code
Girls: Below-the-knee length dresses, skirts, skorts, or culottes (leggings/pants do NOT add to length, the actual dress or skirt MUST Be below the knee)

No shorts, backless shirts, tank tops, see-through material/mesh, or clothing with inappropriate, questionable, or worldly pictures/slogans. Shoes are required.

Boys: Long pants, jeans, wind pants, or knee-length shorts. No tank tops, see-through material/mesh, or clothing with inappropriate, questionable, or worldly pictures/slogans. Shoes are required.

If your child is not dressed according to our dress code policy, TCA Summer Camp workers reserve the right to ask you to take your child home to change their clothing to correctly follow our dress code policy.

TCA Summer Camp is a service provided by Temple Christian Academy, which is a ministry of Temple Baptist Church. We ask that you please adhere to our dress code policy. Failure to comply with these guidelines will result in your child being dismissed from the program

Summer Camp Fee Schedule

Registration Fee: $100 per child (Non-refundable)

Fee includes camp shirt, field trip costs, and camp activity and material costs.

Payment is required on the Monday of each week.

Weekly Rate	1 Child - $80	Half-Day Weekly Rate	1 Child - $50
	2 Children - $148		2 Children - $85
	3 Children - $212		3 Children - $105
	4 Children - $250		4 Children - $130

Daily Rate	1 Child - $25	Half-Day Daily Rate	1 Child - $20
	2 Children - $40		2 Children - $25
	3 Children - $55		3 Children - $35
	4 Children - $70		4 Children - $45

LATE FEE: Children must be picked up by 5:00 PM. A late fee of $7.50 will be charged per child every 15-minute increment past 5:00 PM. NO EXCEPTIONS. Late fees must be paid the following Monday.

The above-mentioned fees are standard. We cannot reimburse you for sickness, etc. If your child has a serious illness lasting several days, please contact the school office for special financial arrangements.

If a child is dropped off in the morning and picked up by noon, the parent will be charged the half-day rate; however, if the child is picked up after 12:00 noon, a full day will be charged.

Summer Camp Registration Form

General Information
Child's Name

First NameLast Name
Child's Gender
Child's Birthdate

MonthDayYear
Date
Child’s Shirt Size
Grade child just finished
Child's weight **used for emergency personnel, if needed**
Mother's Name

First NameLast Name
Father's Name

First NameLast Name
If parents are separated or divorced, with whom does the child live?
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother's Phone

Area CodePhone Number
Mother's Email
example@example.com
Father's Phone

Area CodePhone Number
Father's Email
example@example.com
What is the preferred communication choice?
Emergency Contact #1

First NameLast Name
Phone Number

Area CodePhone Number
Relation to child
Emergency Contact #2

First NameLast Name
Phone Number

Area CodePhone Number
Relation to child
The following are authorized by me to pick up my child from TCA summer care.

* each authorized person must present a valid photo ID*

If more than two authorized pick-ups are needed, please call the office and let us know.
Authorized Pick Up #1

First NameLast Name
Authorized Pick Up #2

First NameLast Name

Medical Information
Is your child on any medication?
If yes, what medicine?
Dosage amount?
Is the Medicine to be administered during summer camp hours?
Does your child have any allergies?
If yes, what allergies?
Can TCA administer medicine (if necessary) such as Tylenol, Benedryl, Tums, etc?
In the event of illness or injury to my child which requires emergency medical treatment, TCA will contact the following doctor if the parents cannot be reached.
Doctor

First NameLast Name
Doctor's Office Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Doctor's Office Phone

Area CodePhone Number
Emergency Room of my choice:
I hereby release the TCA Summer Camp Program from any claim arising out of the doctor's actions.

TCA Summer Camp Guidelines and Discipline Policy
Camp participants and guardians are expected to exhibit appropriate behavior at all times while at camp. In order to provide all children and staff with a camp experience tha tis safe and enjoyable, the following guidelines have been developed. A caring and positive approach will be taken regarding discipline. Camp staff will reinforce appropriate behaviorthrough positive reinforcement, firm statements, and redirection of activity. All campers must understand and follow the guidelines set forth. Please review these guidelines with your child.
- Talk in a pleasant manner. Foul language, put downs and bullying will not be accepted.
- Be safe! Always obey camp rules and staff.
- Treat all equipment and supplies with proper care and respect.
- Show respect for the property, staff, and fellow campers.
- Running and excessive shouting while indoors is not allowed.
- Aggressive behavior that is threatening to the child, staff or others will not allowed.
- Have a positive attitude and have fun!
Listed below are discipline procedures for campers and guardians who are exhibiting unacceptable behavior. Depending on the severity of the behavior, we may skip a particular step (ie. threatening or aggressive behavior will not be tolerated).

Step 1: Verbal Warning

Step 2: Time Out or Time Away from the Group. During a time out, a camper may have to sit out from activities including games, crafts, or a special event. Parents will be notified.

Step 3: Sent Home If a child persists in unacceptable behavior, a parent or guardian will be called and will be required to pick the child up from camp with a written notice.

*After 3 Send Home notices, the child will be dropped from Summer camp and will not be permitted to sign up for TCA Summer Camp in the future. Failure to support staff and camp policies will result in immediate and permanent dismissal from the Summer Camp program.

No refunds will be given. Please review these rules with your child prior to the first day of camp. The staff will review these rules with your child at the beginning of each week as well. Thank you in advance for your cooperation. We hope to have a great summer!

Acknowledgement
- I give my permission for my child to take part in all TCA Summer Camp activities, including sports and camp-sponsored trips away from the school property provided that I am informed in advance.
- I absolve TCA Summer Camp from all liability to me or my child because of injury to my child at TCA Summer Camp or during any TCA Summer Camp activity.
- I give TCA my permission to photograph, video, and record my child for promotional reasons. I also give permission for TCA to post pictures or videos of my child on social media or school website to promote TCA and the Summer Camp program.
- I understand that discipline will be used to maintain control of camp activities. I have read and discussed the TCA Summer Camp Guidelines and Discipline Policy with my camper. Discipline options include but are not limited to removal from the program for the day/week/entire program, quiet time, and corporal punishment (as a last resort).
- I assume all financial responsibility for my child's payment and fees at TCA Summer Camp Program.
  1. Registration Fee: $100 per child (non-refundable). All payments must be kept current. Payments are due on Monday of each week.
  2. Late fees: A late fee will be charged per child every 15-minute increment past 5:00 pm. NO EXCEPTIONS. Late fees must be paid the following Monday.
Signature
Today's Date

MonthDayYear
Date

How did you hear about our summer program?

Other
Should be Empty:

Summer Camp General Information (K3-6th Grade)

Dress Code

Summer Camp Fee Schedule

Summer Camp Registration Form

Medical Information

TCA Summer Camp Guidelines and Discipline Policy

Acknowledgement