Take Your First Steps Towards Camp Adventure!
At Camp Adventure, children ages 5 to 12 will experience an unforgettable week(s) filled with outdoor exploration, hands on learning, and nonstop adventure. Each day includes exciting activities like animal encounters, planetarium exploration, safari rides through wetlands, nature discovery, team challenges, zip lining, playground fun, and our iconic super slide. Camp Adventure is designed as a two part experience, with Weeks 1, 3, and 5 sharing one theme and Weeks 2, 4, and 6 continuing the journey with new discoveries and activities. While each week can stand alone, we encourage families to register for two consecutive weeks so campers can enjoy the full adventure. Throughout the summer, children will build friendships, grow in confidence and faith, and create memories in God’s creation. Register before May 23rd to get our early bird discount of $125 per-week! Any camper registrations that come in after May 23rd will be subject to our standar rate of $150 per week.
Camper Information
Full Name
*
First Name
Last Name
Age
*
Please Select
5
6
7
8
9
10
11
12
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Please Select
Male
Female
Grade
*
Please Select
1st
2nd
3rd
4th
5th
6th
7th
Allergies or Other Concerns
*
Date Selection
(Note: Our summer camp follows a two-week content rotation: weeks 1, 3, and5 share one set of activities, while weeks 2, 4, and 6 feature asecond set)
Which weeks will your child be attending camp?
*
Week 1 (June 22nd-26th)
Week 2 (June 29th-July 3rd)
Week 3 (July 6th-10th)
Week 4 (July 13th-17th)
Week 5 (July 20th-24th)
Week 6 (July 27th-31st)
Primary Emergency Contact Information
Primary Contact Name
*
First Name
Last Name
Relationship to Camper
*
Please Select
Mother
Father
Sister
Brother
Cousin
Aunt
Uncle
Grandmother
Grandfather
Friend
Other
Email Address
*
example@example.com
Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Home Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Work Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Authorized Pickup Person?
*
Yes
No
Secondary Emergency Contact Information
Contact Name
*
First Name
Last Name
Relationship to Camper
*
Please Select
Mother
Father
Sister
Brother
Cousin
Aunt
Uncle
Grandmother
Grandfather
Friend
Other
Email Address
*
example@example.com
Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Home Number
Please enter a valid phone number.
Format: (000) 000-0000.
Work Number
Please enter a valid phone number.
Format: (000) 000-0000.
Authorized Pickup Person?
*
Yes
No
Additional Authorized Person for Pick Up
Contact Name
*
First Name
Last Name
Relationship to Camper
*
Please Select
Mother
Father
Sister
Brother
Cousin
Aunt
Uncle
Grandmother
Grandfather
Friend
Other
Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Additional Authorized Person for Pick Up
Contact Name
*
First Name
Last Name
Relationship to Camper
*
Please Select
Mother
Father
Sister
Brother
Cousin
Aunt
Uncle
Grandmother
Grandfather
Friend
Other
Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Additional Authorized Person for Pick Up
Contact Name
*
First Name
Last Name
Relationship to Camper
*
Please Select
Mother
Father
Sister
Brother
Cousin
Aunt
Uncle
Grandmother
Grandfather
Friend
Other
Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Doctor's Information
Insurance Carrier
*
Policy Number
*
Family Doctor's Name
*
First Name
Last Name
Doctor's Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Early or Late Care
Campers can be dropped after 8:30 AM for free and be picked up before 3:30 PM for free. Drop off before 8:30 AM counts as 'early care' and pickup after 3:30 PM counts as 'late care. For every half hour that children are either dropped off before 8:30 AM or picked up after 3:30 PM, an additional $5 will be added to the campers account.
Will your camper need early care? (The earliest we accept campers for drop off is 8 AM)
*
Please Select
Yes
No
Will your camper need late care? (The latest we allow for camper pick-up is 5 PM)
*
Please Select
Yes
No
What time will you be dropping off your camper?
Hour Minutes
AM
AM/PM Option
What time will you be picking up your camper?
Hour Minutes
PM
AM/PM Option
Payment Method
Early Bird Registration Discount (Before May 23rd): $125 per week Standard Rate After May 23rd: $150 per-week
Payment Method
*
Please Select
Online
Cash
Bank Transfer
Release of Liability
I hereby agree to release the Adventure Learning Centre, its staff, and any related corporate entities associated with sponsoring this organization of any injury or illness that may occur during my child’s stay at Adventure Day Camp, including medical and hospitalization costs. The parents or guardians of the camper, should there be need of medical treatment of any kind, does hereby consent to any and all medical and surgical treatment including anesthesia and surgery which may be deemed advisable by a medical professional such as a physician or surgeon. The intention hereof is to grant authority to administer and to perform all and singularly any examinations, treatment, anesthetics, surgery, and diagnostic procedures which may now or during the course of the patient’s care be deemed advisable and necessary. Adventure Learning Centre is not responsible for cost of medical expenses and in the event that such expenses are incurred, the undersigned is responsible for all such medical expenses.In witness of my consent and agreement to the matter stated in the preceding sentences, I have inscribed my signature below.
Signature
*
Date
*
-
Month
-
Day
Year
Date
How did you hear about our camp?
*
Social Media
Flyer
School
Friend/Family
Other
Submit
Submit
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