2022 Summer Camp 2022 Summer Camp Application Please fill a complete application per childMinimum age is 4 years old (01/01/2018)Fees are $300 for first child, $275 for second child, and $250 for third child.Fees to be paid with a check to the servant or the priest Please enable JavaScript in your browser to complete this form.123Name of Participiant *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCell Phone *Home PhoneT-shit Size *Who do you authorize to pick up your child from camp? *Name /Relation to Child /Phone NumberIf I would like to authorize someone else to pick up my child not on this list, I agree to send with my child a signed authorization with the name and phone number of the person who will pick up my child on that day, or verbal communication with the servants of the camp. I give my permission for my child to take part in the church summer camp. I hereby give the leaders to act on my behalf according to their best judgment in an emergency requiring medical attention, and I agree to take responsibility for the expense of such a procedure. I understand that while the leaders will try to act in their best ability, I will not hold them nor the church responsible for any accident or injury, and hereby release the church and the leaders from any and all such liability. By signing below, you are indicating that you have READ and AGREED with all of the above. I also attest that I have read all of the summer camp rules mentioned in the attached cover sheet. 2022 Summer Camp RulesI agree and have read all the 2022 summer camp rules and the application guidelines *I CONSENT St. Mary Coptic Orthodox Church Delray Beach, Florida 2022 SUMMER CAMP Letter to Parents We are very excited to announce the 2022 summer camp coming soon! The camp this year will take place from June 6-July 1, 2022. Kids four years old and older (up to eighth grade) are eligible to sign up and join. Below are the rules for this year’s camp. Please read it carefully as you will need to sign an attestation on the permission slip stating your understanding and agreement to these rules. 1. As a security measure, there is only one entrance where you will be able to pick up and drop off your children and that is in the back of the hall, by the playground. 2. As an added security measure, you will be required to sign-in/out your children on a master roster. Please do not pick-up or drop off your children without coming inside. During this time, we will directly share with you any specific reminders or notes about your children. a. If you are sending someone to pick up your children, you must have listed them as an approved guardian on the application. That guardian must present photo ID when picking up. 3. Due to many complaints, absolutely no electronics, cell phones or any device with Internet access is allowed on premises. The Head Servants will confiscate any such devices they see our children using. If there is a medical or serious need that requires an exception to this rule, please contact Abouna Mikhail directly. 4. This year, we have compounded the cost of the camp to include the cost of the weekly Thursday trips for your convenience. We have also attached a separate permission slip for all of these trips, which must be submitted with the main summer camp permission slip if you wish to have your children attend. We have a very strict “No slip no trip” policy which will be enforced. a. Under no circumstance is a child who is not registered for the camp allowed to attend the summer camp field trips. 5. Please have your child eat breakfast prior to coming to camp, as no breakfast will be served. Please provide lunches daily for your child. We will be providing daily snacks. 6. Lastly, out of respect and courtesy to the servants, we ask that you drop off and pick up your children in a punctual manner. We look forward to another successful Summer Camp this year! If you have any questions, please feel free to contact any of the summer camp servants. 7. Camp fees are $300 for first child, $275 for second child, and $250 for third child. May God Bless You All, St. Mary's Summer 2022 Camp CommitteeNextParent's Name *Parent's Signature *Date *Emergency Contact *Name /Relation to Child /Phone NumberPhysician *Name /Phone NumberInsurance Company *Name /Policy NumberAny Other Special Circumstances Regarding the ParticipantNext Trip #1: Place of Event: Adrenaline Lake Worth Address of Event: 7645 Lake Worth Rd, Lake Worth, FL33467 Date of event: Thursday , June 9, 2022 Time of event : 12:00 am - 3:00 pmI give my permission for my child to take part in the church summer camp trip (adrenaline). I hereby give the leaders to act on my behalf according to their best judgment in an emergency requiring medical attention, and I agree to take responsibility for the expense of such a procedure. I understand that while the leaders will try to act in their best ability, I will not hold them nor the church responsible for any accident or injury, and hereby release the church and the leaders from any and all such liability. By signing below, you are indicating that you have READ and AGREED with all of the above.Parent's SignatureDate______________________________________________ Trip #2: Place of Event: Museum of Discovery &Science/IMAX Address of Event: 401 SW 2nd St, Ft Lauderdale, FL 33312 Date of event: Thursday, June 16, 2022 Time of event : 9:15 am - 4:00 pmI give my permission for my child to take part in the church summer camp trip (Museum). I hereby give the leaders to act on my behalf according to their best judgment in an emergency requiring medical attention, and I agree to take responsibility for the expense of such a procedure. I understand that while the leaders will try to act in their best ability, I will not hold them nor the church responsible for any accident or injury, and hereby release the church and the leaders from any and all such liability. By signing below, you are indicating that you have READ and AGREED with all of the above.Parent's Signature Date ______________________________________________ Trip #3: Place of Event: St Mary’s Coptic Church Address of Event:15450 Lyons Rd, Delray Beach, FL 33484 Date of event: Wednesday, June 22, 2022 Time of event : 12:30 pm - 2:30 pmI give my permission for my child to take part in the church summer camp trip (GABIE bus). I hereby give the leaders to act on my behalf according to their best judgment in an emergency requiring medical attention, and I agree to take responsibility for the expense of such a procedure. I understand that while the leaders will try to act in their best ability, I will not hold them nor the church responsible for any accident or injury, and hereby release the church and the leaders from any and all such liability. By signing below, you are indicating that you have READ and AGREED with all of the above.Parent's Signature Date ______________________________________________ Trip #4: Place of Event: SFL Science Center and Aquarium Address of Event: 4801 Dreher Trail N, WPB, FL 33405 Date of event: Thursday, June 30, 2022 Time of event : 9:30 am - 4:00 pmI give my permission for my child to take part in the church summer camp trip (Museum). I hereby give the leaders to act on my behalf according to their best judgment in an emergency requiring medical attention, and I agree to take responsibility for the expense of such a procedure. I understand that while the leaders will try to act in their best ability, I will not hold them nor the church responsible for any accident or injury, and hereby release the church and the leaders from any and all such liability. By signing below, you are indicating that you have READ and AGREED with all of the above.Parent's Signature Date PreviousSubmit
