2026-2027 School Break Camp Registration
Gathering Student Information
Student Full Name
*
First Name
Last Name
Grade
*
Please Select
Rising Kindergarten
Rising 1st
Rising 2nd
Rising 3rd
Rising 4th
Rising 5th
Rising 6th
Rising 7th
Student School
*
Age
*
Parent Name
First Name
Last Name
Parent Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Secondary Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Medical Information
Does the child have any allergies? If yes, please list them below
*
Does the child have any previous injuries? If yes, please explain them below
*
Does the child have any current medical conditions? If yes, please list them below
*
Does the child take any medication? If yes, please list them below and explain its purpose
*
How did you hear about us?
*
Internet Search
Friend or Family
FunClubs
Child's School
Marietta City Schools
Previously Attended Camp
Camply
Other
I, the parent/guardian of this camper gives authority to the staff of this camp to apply judgment in regards to medical assistance in the event of an accident, injury, or illness if the emergency contact person cannot be reached.
I authorized first aid, medical/surgical diagnosis, and treatment which may deem necessary.
I released the organizers, coaches, staff, or managers of this camp for any responsibility in case of accident, illness, or injury during my child's enrollment.
I confirm that all information given in this form is true, complete, and accurate.
Parent/Guardian Signature
*
Additional Notes (medical conditions, special requirements, etc.)
*
Permitted to Pick-Up (Please list all names including Parents/Guardians)
*
My Products
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Fall Break- September 21-25, 2026
$199.00
$
199.00
Febuary Break- February 15-19, 2027
$199.00
$
199.00
Spring Break- April 5-9, 2027
$199.00
$
199.00
Daily Drop In
One Day of Camp
$50.00
$
50.00
Quantity
1
2
3
4
5
Session
Fall Break
February Break
Spring Break
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
ACH Bank Transfer
Afterpay
After submitting the form, you will be redirected to Afterpay to complete the payment.
Register
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