2026 Camp 5:5 – Registration Form One Form Per Child Registrations are closed. If you have any questions or concerns please email summerprograms@eukaryaacademy.com. Step 1 of 5 20% FacebookThis field is for validation purposes and should be left unchanged.Camper Name(Required) First Last Grade for 2025-2026 School Year(Required)Rising kindergarteners & 1st graders - RookiesRising 2nd & 3rd graders- JuniorsRising 4th & 5th graders - SeniorsRising 6th graders - Middle School ManiaT-shirt Size(Required)Youth XSYouth SYouth MYouth LAdult XSAdult SAdult MAdult LWe 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: - Activities based around the weekly theme - Field trips, depending on age group (some of these outings may be a local park, pool, theater, caverns, 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: $50 Enrollment fee to be paid at time of registration. The weekly fee is $250. Weekly fee is due upon reserving camper’s spot, and will be paid prior to each week’s attendance. This includes a $25.00 field trip fee and T-Shirt. A non-refundable registration is due upon reserving the campers spots. Along with registration, the camp registration fee is due for all camps. If you would like to make payment arrangements then choose manual payment on checkout and reach out to accounting to finalize your registration. 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 $15 per day or $70 per week. Please reach out to Summerprograms@eukaryaacademy.com to reserve before or after care. 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 Summerprograms@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. Yes I am Interested in Before or Aftercare Before Care After Care Check these boxes if you are interested in receiving before or after care. CampsChoose Camps To Attend (Rookies)(Required) Jurassic Journeys (Jun 8th-12th) Mineral Mania (Jun 15th-19th) The Great Eukarya Cook-Off (Jun 22nd-28th) All-American Adventure (Jun 29th - Jul 3rd) Aloha Adventure (Jul 6th-10th) Mad Scientists (Jul 13th-17th) Lights, Camera, Camp! (Jul 20st-26th) Wilderness Explorers (Jul 27th - Aug 1st) Spy School (Aug 3rd - 8th) All Star Sports Camp (August 10 - 15) Choose Camps To Attend (Juniors)(Required) Jurassic Journeys (Jun 8th-12th) Mineral Mania (Jun 15th-19th) The Great Eukarya Cook-Off (Jun 22nd-28th) All-American Adventure (Jun 29th - Jul 3rd) Aloha Adventure (Jul 6th-10th) Mad Scientists (Jul 13th-17th) Lights, Camera, Camp! (Jul 20st-26th) Wilderness Explorers (Jul 27th - Aug 1st) Spy School (Aug 3rd - 8th) All Star Sports Camp (August 10 - 15) Choose Camps To Attend (Seniors)(Required) Jurassic Journeys (Jun 8th-12th) Mineral Mania (Jun 15th-19th) The Great Eukarya Cook-Off (Jun 22nd-28th) All-American Adventure (Jun 29th - Jul 3rd) Aloha Adventure (Jul 6th-10th) Mad Scientists (Jul 13th-17th) Lights, Camera, Camp! (Jul 20st-26th) Wilderness Explorers (Jul 27th - Aug 1st) Spy School (Aug 3rd - 8th) All Star Sports Camp (August 10 - 15) Choose Camps To Attend (Middle School)(Required) Jurassic Journeys (Jun 8th-12th) Mineral Mania (Jun 15th-19th) The Great Eukarya Cook-Off (Jun 22nd-28th) All-American Adventure (Jun 29th - Jul 3rd) Aloha Adventure (Jul 6th-10th) Mad Scientists (Jul 13th-17th) Lights, Camera, Camp! (Jul 20st-26th) Wilderness Explorers (Jul 27th - Aug 1st) Spy School (Aug 3rd - 8th) All Star Sports Camp (August 10 - 15) Jurassic Journeys: Jurassic Journeys Camp transports kids back in time for a thrilling exploration of dinosaurs and ancient discovery. Through hands-on activities, games, crafts, music, and team challenges, campers will step into an adventurous world where curiosity fuels imagination and every activity sparks new discoveries. The week concludes with an exciting field trip to Dinosaur Land, where kids can explore and connect with the prehistoric wonders they've been learning about all week.Mineral Mania: Mineral Mania Camp is a high-energy week packed with discovery and creativity as kids dig in, explore colorful minerals, and tackle interactive challenges that spark curiosity and teamwork. Through hands-on activities and fun problem-solving, campers uncover the fascinating world beneath their feet while making new friends and learning together. The week climaxes with an exciting field trip to Shenandoah Caverns, where kids witness the stunning underground geological formations they've been studying all week.The Great Eukarya Cook-Off: The Second Annual Great Eukarya Cook-Off is back and bigger than ever, bringing teams together to showcase their creativity, collaboration, and culinary skills through exciting themed challenges. Campers will compete in friendly competitions, design original dishes, and celebrate teamwork alongside plenty of laughter and hands-on learning. The week culminates with a behind-the-scenes field trip to Route 11 Potato Chips, where campers discover how their favorite snacks are made—from farm to fryer.All-American Adventure: All-American Adventure Camp is a red, white, and blue celebration packed with patriotic fun for Fourth of July week. Campers will enjoy themed games, crafts, team challenges, and classic summer activities that celebrate creativity, teamwork, and all-American spirit while making unforgettable memories. The week culminates with a field trip to the Army Museum in Chantilly, where campers explore American military heritage with free admission for the entire group.Aloha Adventure: Aloha Adventure Camp brings the spirit of the islands to life! Kids will dive into tropical games, crafts, and challenges, go on fun-filled "island quests," and enjoy a week of sun, friendship, and unforgettable summer fun. The week's adventure concludes with a trip to Jay-Dees, where campers experience waterpark fun, mini golf, and go-kart racing.Mad Scientists: Mad Scientists Camp is an exciting, hands-on adventure where curious kids explore the world of science through wacky experiments, creative challenges, and mind-blowing discoveries. Campers will mix, build, and investigate while unleashing their inner genius. The week concludes with an exploration of the Shenandoah Valley Discovery Museum, where interactive exhibits bring hands-on discovery to life.Lights, Camera, Camp!: Lights, Camera, Camp! is a creative, high-energy adventure where kids step into the spotlight and become stars of their own show. Campers will dive into acting games, themed activities, crafts, and team challenges inspired by movies and theater—building confidence and creativity while having a blast. The week culminates with a special trip to the Winchester Little Theater to experience the magic of live theater at James and the Giant Peach.Wilderness Explorers: Wilderness Explorers Camp is an outdoor adventure where kids discover nature, wildlife, and survival skills through hands-on activities, games, and challenges. Campers will explore trails, learn new skills, and enjoy meaningful teamwork while making lasting memories in the great outdoors. The week includes a special field trip to Sky Meadows State Park for an unforgettable hiking experience.Spy School: Spy School Camp is a top-secret adventure where kids become junior agents! Campers will crack codes, solve mysteries, complete stealthy challenges, and test their problem-solving skills while having a blast in a world of espionage and intrigue. The week includes a field trip to an escape room where junior agents put their detective skills to the ultimate test.All Star Sports Camp: An action-packed week celebrating athletic excellence and teamwork! Campers rotate through skill-building stations including relay races, obstacle courses, soccer challenges, basketball shoot-outs, and team competitions. Every participant will build confidence, develop sportsmanship, and create lasting memories.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, 2024.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 AgreeIn the event that the parents cannot be contacted and 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).Parent/Guardian Signature(Required)Date(Required) MM slash DD slash YYYY Parent/Guardian Name(Required) First Last Parent HandbookPlease review the parent handbook. Photo Release(Required) I GIVE MY APPROVAL for using my child’s image for publications, etc. over which ECA has control I DO NOT GIVE APPROVAL for using my child’s image for publications, etc. over which ECA has control. Camp 5:5 may solicit various media outlets for coverage of school events and students, such as the ECA website, a newsletter, school videos, and other school publications and presentations.Signatory's Name(Required) First Last Signature(Required)I have read and understood all of the policies, rules, and procedures as set forth in the Camp 5:5 Handbook and agree to adhere to all policies to the best of my ability. Make Payment to Complete Registration In order to finish registering for camp you need to make a payment. If you cannot pay in full at this time, please choose manual payment and reach out to the accounting team to setup a payment plan. Please note that your space is not reserved until payment arrangements have been made. Your card will be processed by our payment processor, Square, to make the payment. You will receive a receipt in your email with details of your transaction. If you don't see it within a few minutes then please check your spam email.Promotional Code Enter a promotional code if you have it.Pay Weekly Pay Weekly Payment for each camp is due the week before the camp. Registration fee and the first camp fee is due now.Registration Fee Due Today(Required) Price: Total Due Today(Required) Price: $0.00 Total Due First Camp Fee(Required) Price: Early Bird Discount Price: 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.Credit Card(Required) Cardholder Name Card Details