Camp PEAK Summer 2026 Registration Form

Camp PEAK 2026 Summer Registration Form
CHILD INFORMATION:
My child will attend camp at
Child Name

First NameLast Name
Birth Date

MonthDayYear
Date
Birth Date

MonthDayYear
Gender
Race/ethnicity

Other
Shirt Size
Grade (Fall 2026)
Name of School Student Will Attend Fall 2026
2nd Child Name

First NameLast Name
Birth Date

MonthDayYear
Gender
Race/ethnicity

Other
Shirt Size
Grade (Fall 2026)
Name of School Student Will Attend Fall 2026
Date

MonthDayYear
Date
3rd Child Name

First NameLast Name
Birth Date

MonthDayYear
Gender
Race/ethnicity

Other
Shirt Size
Grade (Fall 2026)
Name of School Student Will Attend Fall 2026
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name

PrefixFirst NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Emergency Phone Number (if different)

Area CodePhone Number
E-mail
example@example.com
MEDICAL INFORMATION
I blanks* (parent/guardian), give the following medical information for blank* (full name of student) as related to the The SMARTPLAY (formerly known as the American Baseball Foundation) program. I hereby authorize The SMARTPLAY to act for me according to their best judgment in any emergency requiring medical attention during the 2026 program. I also hereby waive and release the SMARTPLAY from any and all liability for any injuries or illnesses incurred while participating in the program. I have no knowledge of any physical impairment that would be adversely affected by participation of the student in the The SMARTPLAY program.

Parent or Guardian signature: Signature*     Date*
Medications currently being taken
Is your child allergic to any medications? If so, please list
Please list any serious medical illnesses that your child has had in the past
Any medical/health concerns our instructors should be aware of
Please list any additional information our staff should know about: (food allergies/diet needs, physical limitations, learning disabilities, family information, etc)
In case of emergency, please notify:

First NameLast Name
Relationship
Phone Number

Area CodePhone Number
Medical/Accident Insurance Carrier
Policy Number
Permission Section
I blanks* (parent/guardian), give permission for my child/ren blank* to attend The SMAARTPLAY's summer 2026 program at PEAK Central PEAK South PEAK East* from June 1st through June 26th, 8:00am to 2:30pm. I will assume all financial responsibility for my child in the event of an injury, as well as damage inflicted to any persons or property. The SMARTPLAY, John Carroll High School, The Worship Center Christian Church and Indian Springs First Baptist Church are released of any liability in the event of any injury, which could result from normal activity during the camp. They are also allowed to take reasonable measures in an emergency situation involving my child.
Media Release

My child/ren has/have permission to be photographed, or videotaped for publicity for The SMARTPLAY projects. I understand that any proceeds from projects will be used to benefit the TSP and no participant will be rewarded financially for participating in these projects. Also, from time to time the news media reports on TSP community projects. This form serves as a legal release from those situations.

Logistics for both programs:
- Every week day June 1st through June 26th
- 8:00am - 2:30pm
- Rising 1st - Rising 8th graders
- Families provide transportation
- Student brings their lunch
- Cost is $50 per family
My child will attend the entire program.
I fully understand and agree to the terms stated above
Date

MonthDayYear
Date
How would you like to pay? (Please submit payment within 7 days of registration)
Should be Empty:

Camp PEAK 2026 Summer Registration Form

CHILD INFORMATION:

PARENT/GUARDIAN INFORMATION:

MEDICAL INFORMATION

Permission Section