Solid Foundation Christian Academy

Please fill out the form below to apply for Solid Foundation’s Summer STEAM & Reading Summer Camp.

Program Details

Program runs June 1st, 2020 - July 24, 2020
Monday - Friday from 7:30 a.m. - 4:00 p.m.
Cost starts at $90/week (lunch included)
$50 nonrefundable registration fee

2020 Summer STEAM & Reading Camp Application

Student's Full Name

First Name

Last Name

Date of Birth

YYYY

Gender

Last Grade Completed

Social Security Number

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone #

(###)

###

####

Current School

Does student have an IEP or ever received Speech or 504 accommodations?

If yes, what type of program?

Has student ever been expelled?

If yes, please explain

Are there any custody issues of which the school should be made aware?

If so, please explain

Others in your household attending/enrolling in Solid Foundation's Summer Camp:

Enter Name, Age, Present School

Dad's Full Name

First Name

Last Name

Dad’s Address & Phone

(If different from child’s)

Dad's Work Phone #

(###)

###

####

Dad's Email Address

Mom's Full Name

First Name

Last Name

Mom's Address & Phone #

(If different from child’s)

Mom's Work Phone #

(###)

###

####

Mom's Email Address

The child may be released to the person(s) signing this agreement or to the following:

Provide Name, Address, Phone #, Relationship to parent/child

Persons to contact in the case of emergency when parent or guardian cannot be reached:

Provide Name and Phone #

Child's Doctor/Clinic Name & Phone #

My child has the following special needs:

The following special accommodation(s) may be required to most effectively meet my child’s needs while at camp:

My child is currently on medication(s) prescribed for long-term continuous use and/or has the following pre-existing illness, allergies, or health concerns:

EMERGENCY MEDICAL AUTHORIZATION Should my child suffer an injury or illness while in the care of SFCA and the school is unable to contact me (us) immediately, it shall be authorized to secure such medical attention and care for the child as may be necessary. I (We) shall assume responsibility for payment for services. My child will be taken to the nearest emergency room. I authorize to have my child transported.

Enter Parent Name