2026 Friendship Camp Registration

Friendship Camp: LCA Early Learning Summer Camp

This application works best if filled out on a computer or tablet.
Camper's Legal Name

First NameMiddle NameLast NameSuffix
Camper's Birthday

MonthDayYear
Date
Which class are you registering for? *Note, we will cap these classes to keep classroom sizes manageable - you will receive an email after submitting this form confirming that we have room for your child.
Is your child enrolled at LCA for next school year?
What size T-shirt does your child wear?
Does your child have any learning, emotional, or physical disabilities? This likely will not disqualify your child from attending, rather we want to make sure we have adequate resources to meet all children's needs.
If yes, please explain:

Parental Information
Primary Parent/Guardian

First NameLast Name
Relation
Primary Parent Email
example@example.com
Primary Parent Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is there a secondary parent for this child?
Secondary Parent/Guardian

First NameLast Name
Address (if different than above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Secondary Parent Phone Number

Area CodePhone Number
Secondary Parent Email
example@example.com

Emergency Contact Information

(Non-Parent Contacts in case of emergency)
Emergency Contact #1 Name
Relation to Student
Emergency Contact #1 Phone Number

Area CodePhone Number
Emergency Contact #2 Name
Relation to Student
Emergency Contact #2 Phone Number

Area CodePhone Number
Please list, in order, who should be contacted during camp hours (include both parental contacts and emergency contacts).

Photography & Media Release Form
As a parent/guardian of this student, I hereby consent to the use of photographs/videotape taken during the course of this summer camp for publicity, promotional and/or educational purposes (including publications, presentations or broadcast via newspaper, internet, or other media sources). I do this with full knowledge and consent and waive all claims for compensation for use or damages.
Please select one:
E-Signature of Parent/Guardian:
Date

MonthDayYear
Date

Release of Claims
Do we have your permission to transport and/or contact emergency personnel if your child needs to be taken to the nearest hospital for emergency care if guardians or emergency contacts cannot be reached, as deemed necessary by Lakeland Christian Academy?
If you chose yes above, do you consent to any necessary examination, anesthetic, medical diagnosis, surgery or treatment, and/or hospital care to be rendered to your child under the general or special supervision and on the advice on any physician or surgeon licensed to practice medicine in the State of Indiana? ***This would only be done when a parent could not be reached and your child is in need of emergency medical care. This gives paramedics and/or hospital the permission to treat your child in an emergency situation until you can be contacted.
Lakeland Christian Academy (LCA) is committed to conducting its programs, activities, or trips in the safest possible manner and holds the safety of its students in the highest possible regard; however, it must be recognized there are inherent risks of injury associated with school programs, activities, or trips for students enrolled at LCA. Parents and/or guardians of students participating in any programs, activities, or trips at LCA will be waiving and releasing all claims for injuries sustained arising out of the programs, activities, or trips.

In consideration of Lakeland Christian Academy field trips for the school year we hereby release and forever discharge Lakeland Christian Academy, employees of Lakeland Christian Academy, Board of Directors of Lakeland Christian Academy, from any actions, causes of actions, claims and demands that result from any damage, loss, or injury, which hereafter may be sustained by our child in consequence of participation in said trips and all activities engaged in during said trips.

This extends and applies to, and also covers and includes, all unknown, unforeseen, unanticipated and unsuspected injuries, damages, loss and liability, and consequences thereof. The provisions of any state, federal, local or territorial law or statute providing in substance that release shall not extend to claims, demands, injuries or damages which are unknown or unsuspected to exist at the time, to the person executing such release, are hereby expressly waved.
E-Signature of Parent/Guardian
Date

MonthDayYear
Date

Bathroom Agreement
It is our policy that all students are independent in the restroom. This requires the ability to communicate, have muscle awareness, hand-eye coordination, and gross motor skills. All are readiness skills necessary for learning within the classroom.
A child who is independent in the restroom is able to:
- TELL the adult BEFORE they need to go. They must be able to say the words, “I need to go to the bathroom (potty).”
- Pull down their clothing and get them back on with little assistance.
- Get on and off the toilet (stools are available).
- Wipe themselves after using the toilet (flushable wipes are acceptable).
- Wash and dry hands.
- Wait if the restroom is occupied or the class is not near the restroom.
Teachers and staff continually remind children to use the restroom throughout the day and offer frequent restroom breaks including prior to naptime and if they wake up during naptime. With experience comes confidence and consistency. Accidents may occur with our early learners as a child may be more easily distracted at school by activities and friends. Because of this, parents are to provide a change of clothes and shoes in a labeled zip lock bag for their child. These will be stored in the classroom.

In the case of an accident, the restroom door shall remain ajar as a staff member coaches the child in cleaning and changing their clothing. The staff member will offer wet wipes if necessary. Soiled garments will be placed in a sealed bag to go home the same day. If a student needs additional assistance, a witness shall be present and gloves worn as the staff member aids in the process. In some cases parents may be called for assistance. Parents will be notified either by email, daily report, or a phone call based on the situation. As a reminder, if a child has repeated accidents, they are not considered to be independent in the restroom. With respect to the staff’s role and in consideration of other students, the student may be subject to withdrawal form the program.
E-Signature of Parent/Guardian
Date

MonthDayYear
Date

Summer Camp Agreement
Please check the following boxes to agree with the terms of LCA's summer camp.
E-Signature of Parent/Guardian
Should be Empty:

Friendship Camp: LCA Early Learning Summer Camp

Parental Information

Emergency Contact Information

Health Information

Photography & Media Release Form

Release of Claims

Bathroom Agreement

Summer Camp Agreement