2023 Camp 5:5 – Registration Form One Form Per Child Step 1 of 4 25% Camper Name(Required) First Last Grade for 2023-2024 School Year(Required)Rising kindergarteners & 1st graders - RookiesRising 2nd & 3rd graders- JuniorsRising 4th & 5th graders - SeniorsRising 6th - 8th graders - Middle School ManiaWe are so excited that you will be joining us at Camp 5:5 this summer! The name Camp 5:5 comes from Revelation 5:5, “Then one of the elders said to me, “Do not weep! See, the Lion of the tribe of Judah, the Root of David, has triumphed”. We are looking forward to ten great weeks of camps this summer! Please complete this form to reserve your camper’s spot as space is limited! Spaces will be first come, first serve. Each week has a specific theme that will be explored in various ways each day. Structure of the Day: Each camper’s day will include: - Start of day worship and Bible lesson - Activities based around the weekly theme - Field trips, depending on age group (some of these outings may be a local park, pool, zoo, laser tag, etc.) Campers who are not currently registered at ECA or EKC will need to submit all enrollment forms, including a birth certificate and immunization record BEFORE their first day of camp. For campers currently registered at ECA or EKC, we will be in touch if additional forms or information are required. We will be enrolling kids for the following class groupings, based on need: Rising kindergarteners & 1st graders - Rookies Rising 2nd & 3rd graders- Juniors Rising 4th & 5th graders - Seniors Rising 6th - 8th graders - Middle School Mania Pricing: $25 Enrollment fee to be paid at time of registration. The weekly fee is $170 when you register by May 1. If you register after May 1, the weekly fee becomes $185. Weekly fee is due upon reserving camper’s spot, and will be paid prior to each week’s attendance. Phrasing needs to change to reflect reservation process. Local field trips (pool, parks, library) are included in each week’s fee. Additional field trips (laser tag, zoo, etc.) will be included in that week’s invoice. Before/After Care: Before and After Care is an option for families that need it.After Care is $12 per day or $50 per week. Before care is given based on reservation. $2.50 per day or $10 per week. Schedule: I understand that I am reserving the following days for my camper. If a change must occur, a notice of two weeks must be given by email to Owen Donnelly (odonnelly@eukaryaacademy.com). If a two week’s notice is not received, I understand that I will be responsible for payment of days registered for. For last-minute schedule changes, I understand that I must receive confirmation that a spot is available before dropping off. Enrollment Fee / Registration Fee(Required) Price: Aloha! June 12-16 Aloha!: Immerse yourself in the beauty and warmth of Hawaii as we learn hula dancing, make colorful leis, and create tropical crafts. Learn about Hawaiian traditions and food while making new friends and creating unforgettable memories.Aloha! (4-5) Price: 3 spots remainingJune 12-16Aloha! (6-8) Price: 6 spots remainingJune 12-16Aloha! (2-3) Price: 4 spots remainingJune 12-16Aloha! (K-1) Price: 18 spots remainingJune 12-16Before Care (7:30am-8am)None1 Day ($2.50)2 Days ($5.00)3 Days ($7.50)4 Days ($10.00)Whole Week ($10.00)After Care (3:45pm-6pm)None1 Day ($12.00)2 Days ($24.00)3 Days ($36.00)4 Days ($48.00)Whole Week ($50.00)The Great Outdoors June 19-23 The Great Outdoors: Rediscover nature's beauty as we pitch tents, learn campfire cooking, and master wilderness survival skills. Our adventure will take us on a hike to discover the wonders of the forest, and we will observe local wildlife in their natural habitat.The Great Outdoors (K-1) Price: 18 spots remainingJune 12-16The Great Outdoors (2-3) Price: 5 spots remainingJune 12-16The Great Outdoors (4-5) Price: 3 spots remainingJune 12-16The Great Outdoors (6-8) Price: 9 spots remainingJune 12-16Before Care (7:30am-8am)None1 Day ($2.50)2 Days ($5.00)3 Days ($7.50)4 Days ($10.00)Whole Week ($10.00)After Care (3:45pm-6pm)None1 Day ($12.00)2 Days ($24.00)3 Days ($36.00)4 Days ($48.00)Whole Week ($50.00)Mission Impossible June 26-30 Mission Impossible: Become a master spy by decoding messages, completing obstacle courses, and undertaking a top-secret scavenger hunt. For our Middle Schoolers, this adventure includes a thrilling visit to a local escape room where we'll use our problem-solving skills to accomplish our mission.Mission Impossible (K-1) Price: 19 spots remainingJune 26-30Mission Impossible (2-3) Price: 5 spots remainingJune 26-30Mission Impossible (4-5) Price: 2 spots remainingJune 26-30Mission Impossible (6-8) Price: 8 spots remainingJune 26-30Before Care (7:30am-8am)None1 Day ($2.50)2 Days ($5.00)3 Days ($7.50)4 Days ($10.00)Whole Week ($10.00)After Care (3:45pm-6pm)None1 Day ($12.00)2 Days ($24.00)3 Days ($36.00)4 Days ($48.00)Whole Week ($50.00)Superhero Smash July 5-7* Superhero Smash: Get ready to save the world with a week-long celebration of superhero culture. Create your own superhero costume, design a secret lair, and train your superpowers with fun activities such as obstacle courses and superhero-themed crafts. Use your imagination and creativity to become the hero the world needs!The ECA campus will be CLOSED on Monday, July 3 and Tuesday, July 4, 2023.Superhero Smash (2-3) Price: 9 spots remainingJuly 5-7Superhero Smash (4-5) Price: 8 spots remainingJuly 5-7Superhero Smash (6-8) Price: 11 spots remainingJuly 5-7Superhero Smash (K-1) Price: 22 spots remainingJuly 5-7Before Care (7:30am-8am)None1 Day ($2.50)2 Days ($5.00)3 Days ($7.50)4 Days ($10.00)Whole Week ($10.00)After Care (3:45pm-6pm)None1 Day ($12.00)2 Days ($24.00)3 Days ($36.00)4 Days ($48.00)Whole Week ($50.00)To Infinity & Beyond July 10-14 To Infinity & Beyond: Let your imagination soar as we explore the vast and exciting world of space through rocket building, creating alien creatures, and delving into the mysteries of the universe. Learn about the planets and stars, watch a space-themed movie, and participate in astronaut simulation activities.To Infinity & Beyond (2-3) Price: 6 spots remainingJuly 10-14To Infinity & Beyond (4-5) Price: 2 spots remainingJuly 10-14To Infinity & Beyond (6-8) Price: 7 spots remainingJuly 10-14To Infinity & Beyond (K-1) Price: 17 spots remainingJuly 10-14Before Care (7:30am-8am)None1 Day ($2.50)2 Days ($5.00)3 Days ($7.50)4 Days ($10.00)Whole Week ($10.00)After Care (3:45pm-6pm)None1 Day ($12.00)2 Days ($24.00)3 Days ($36.00)4 Days ($48.00)Whole Week ($50.00)Once Upon a Time July 17-21 Once Upon a Time: Step into a world of wonder and fairy tales as we craft puppets, dress up, and bring our favorite stories to life. Read classic stories and myths, learn about the history of fairy tales, and participate in role-playing games.Once Upon a Time (2-3) Price: 5 spots remainingJuly 17-21Once Upon a Time (4-5) Price: 3 spots remainingJuly 17-21Once Upon a Time (6-8) Price: 6 spots remainingJuly 17-21Once Upon a Time (K-1) Price: 20 spots remainingJuly 17-21Before Care (7:30am-8am)None1 Day ($2.50)2 Days ($5.00)3 Days ($7.50)4 Days ($10.00)Whole Week ($10.00)After Care (3:45pm-6pm)None1 Day ($12.00)2 Days ($24.00)3 Days ($36.00)4 Days ($48.00)Whole Week ($50.00)Problem Solvers July 24-28 Problem Solvers: Sharpen your critical thinking skills with a week of challenging brain-teasers, puzzles, and thought-provoking activities. Build structures, solve mysteries and participate in team-building activities to improve your analytical and creative thinking skills.Problem Solvers (2-3) Price: 5 spots remainingJuly 24-28Problem Solvers (4-5) Price: 4 spots remainingJuly 24-28Problem Solvers (6-8) Price: 10 spots remainingJuly 24-28Problem Solvers (K-1) Price: 19 spots remainingJuly 24-28Before Care (7:30am-8am)None1 Day ($2.50)2 Days ($5.00)3 Days ($7.50)4 Days ($10.00)Whole Week ($10.00)After Care (3:45pm-6pm)None1 Day ($12.00)2 Days ($24.00)3 Days ($36.00)4 Days ($48.00)Whole Week ($50.00)Pirate Adventure July 31-Aug 4 Pirate Adventure: Hoist the Jolly Roger and set sail on a pirate-themed adventure, complete with treasure hunts, ship-building, and swashbuckling pirate crafts. Our adventure includes learning about the fascinating history of pirates and their adventurous exploits on the high seas.Pirate Adventure (2-3) Price: 4 spots remainingJuly 31-Aug 4Pirate Adventure (4-5) Price: 5 spots remainingJuly 31-Aug 4Pirate Adventure (6-8) Price: 7 spots remainingJuly 31-Aug 4Pirate Adventure (K-1) Price: 18 spots remainingJuly 31-Aug 4Before Care (7:30am-8am)None1 Day ($2.50)2 Days ($5.00)3 Days ($7.50)4 Days ($10.00)Whole Week ($10.00)After Care (3:45pm-6pm)None1 Day ($12.00)2 Days ($24.00)3 Days ($36.00)4 Days ($48.00)Whole Week ($50.00)Eukarya’s Got Talent Aug 7-11 Camp's Got Talent: Showcase your unique abilities and hidden talents in a week-long celebration of creativity, self-expression, and personal growth. Our adventure includes practicing and performing a variety of skills, culminating in a talent show where we'll applaud each other's achievements.Eukarya’s Got Talent (2-3) Price: 8 spots remainingAug 7-11Eukarya’s Got Talent (4-5) Price: 3 spots remainingAug 7-11Eukarya’s Got Talent (6-8) Price: 7 spots remainingAug 7-11Eukarya’s Got Talent (K-1) Price: 19 spots remainingAug 7-11Before Care (7:30am-8am)None1 Day ($2.50)2 Days ($5.00)3 Days ($7.50)4 Days ($10.00)Whole Week ($10.00)After Care (3:45pm-6pm)None1 Day ($12.00)2 Days ($24.00)3 Days ($36.00)4 Days ($48.00)Whole Week ($50.00)Safari in the Serengeti Aug 14-18 Safari in the Serengeti: Journey to Africa and experience the thrill of a safari, observing wild animals and learning about their habitats and behaviors. Learn about the Serengeti ecosystem, go on nature walks, and participate in animal-themed crafts and activities.Safari in the Serengeti (2-3) Price: 6 spots remainingAug 14-18Safari in the Serengeti (4-5) Price: 6 spots remainingAug 14-18Safari in the Serengeti (6-8) Price: 7 spots remainingAug 14-18Safari in the Serengeti (K-1) Price: 20 spots remainingAug 14-18Before Care (7:30am-8am)None1 Day ($2.50)2 Days ($5.00)3 Days ($7.50)4 Days ($10.00)Whole Week ($10.00)After Care (3:45pm-6pm)None1 Day ($12.00)2 Days ($24.00)3 Days ($36.00)4 Days ($48.00)Whole Week ($50.00)Pre-Camp Care: Due to the lack of demand for pre-camp care over the last two years, and building space conflicts during the two weeks before camp begins, we will begin Camp 5:5 on June 12.Form Completed by(Required) First Last Billing Email(Required) Email to send receipt and future billing correspondence related to this transaction. Phone(Required) PERMISSION and MEDICAL RELEASECamper’s Name First Last Date(Required) MM slash DD slash YYYY Permission(Required) As the parent or legal guardian of listed students, I give my permission for him/her to attend the field trips and activities, both on and off campus, of Camp 5:5 until September 1, 2023.Field Trip Cancellation Policy(Required) I understand that the staff or Board of Eukarya Christian Academy reserves the right to cancel any trip for safety or other reasons. In the event of such a cancellation, the policies of those providing services in connection with the trip will determine the amount of the refund to which I am entitled, if any.Conduct(Required) I understand that in addition to the rules and requirements established by each field trip venue, all school rules apply to each person attending each field trip.Transportation(Required) I understand that a staff member, a faculty member, an administrator, may be used to transport students to and from an activity. The owner of the vehicle is required to carry bodily injury insurance and have proof of a current vehicle state inspection.Acknowledgement of Personal Liability and Waiver(Required) I understand that field trips and activities may expose my child to some risks and I assume any such risk that may arise there from. I accept full responsibility for all medical expenses for any injuries that might occur to my child by reason of his/her participation.By signing this form, I release Camp 5:5 d.b.a. Eukarya Christian Academy, its Board members, administrators, directors, faculty, staff, and volunteers (“released parties”) from and against all claims, demands, actions, complaints, suits or other forms of liability that any of them may sustain (a) arising out of my child’s failure to comply with local, state, and federal laws and Camp 5:5’s policies and procedures; (b) arising out of any damage or injury caused by my child; or, (c) arising out of a designated driver’s operation of a motor vehicle in relation to these trips/activities. I also agree to indemnify and hold harmless the released parties from any and all related costs, attorney fees, liabilities, settlements, and/or judgments. Medical Release(Required) I authorize a designated representative of Eukarya Christian Academy to administer general first aid treatment for any minor injuries or illnesses experienced by child(ren) listed above. If the injury or illness is life threatening or requires emergency treatment, I authorize the designated representative of Camp 5:5 to summon any and all professional emergency personnel to attend, transport, and treat listed child(ren) and to issue consent for any X-ray, anesthetic, blood transfusion, medication, or other medical diagnosis, treatment, or hospital care deemed advisable by, and to be rendered under the general supervision of, any licensed physician, surgeon, dentist, hospital, or other medical professional or institution duly licensed to practice in the state in which such treatment is to occur. I agree to assume financial responsibility for all expenses of such care. This shall be in effect on or off the Camp 5:5 campus.Parent/Guardian Signature(Required) Date(Required) MM slash DD slash YYYY Parent/Guardian Name(Required) First Last Parent/Guardian Signature Date MM slash DD slash YYYY Parent/Guardian Name First Last Your registration is not yet complete! In order to finish registering for camp you need to make a pre-payment and vault a card on file. You are going to be sent to our payment processor, Stripe, to make the payment. Click submit below to be sent to our processor. Your registration is not finished until payment has successfully completed. You will receive a receipt in your email with details of your transaction. If you don't see it right away then please check your spam email.Total Due Today Price: Pre-payment for one camp + registration fee is required at this time. The rest of the payment is auto-billed using the card on file Remaining Balance Due This is the remaining balance you will owe after today's payment. In order to keep payments simple, we have spread out the billing so that camps are charged 7 days prior to the camp. Your pre-payment today covers the first camp you register for, and then the remaining amount for each camp will be auto-billed from your card on file 7 days prior to the beginning of each camp.Consent(Required) I agree to the privacy policy.I, the parent/legal guardian of the enrolled child, hereby acknowledge and agree to pay all fees associated with the Eukarya Christian Academy Summer Camp on the Wednesday before each camp session begins. I understand that it is my responsibility to ensure that my payment information is up-to-date and that any outstanding balances are paid in a timely manner. I further understand that my card used today will be the default automatic payment method on file for summer camps. By checking this box, I confirm my understanding and acceptance of this automatic payment agreement.CorrectionThis is a simple backend correction in the system to the balance. You can ignore this and pay attention to the Total Due Today and the Remaining Balance due.