Harmony Christian Academy Summer Camp Application

Harmony Christian Academy Summer Camp Application

Apply for the HCA Summer Camp. Please provide camper details, contact info, medical information, permissions, and select your payment plan.
Camper Information
Camper's Full Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Grade Entering (Fall 2026)
Parent/Guardian Contact Information
Parent/Guardian Full Name

First NameLast Name
Relationship to Camper
Parent/Guardian Email
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Medical Information
Allergies or Medical Conditions
Medications (if any)
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Permissions & Agreements
I give permission for my child to participate in all camp activities.
I authorize emergency medical treatment if necessary.
I consent to photos/videos of my child being used for camp promotion.
Payment & Plan Selection

Full Summer Session (July 6- August 7)

$700.00

Weekly Rate

Per week, flexible attendance.

$200.00 Quantity

Registration Fee

Extended care for early drop-off or late pick-up.

$100.00 Quantity

Total