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True Life Youth Ministries

ELEMENTARY CLUB STEM CAMP

Greetings! Our staff is so happy that you are interested in signing your child/children up for our Elementary Day Camp. This is a 3- day camp in our Lebanon location where we will provide food, fun and an unforgettable experience for your child this summer. This camp is only for kids k-5 (just graduation kindergarten) to 5th grade (just graduated 5th grade). Please read the details below and provide us with your child’s information so that we can reserve their spot!

MEETING PLACE: 1300 W MAPLE ST, LEBANON, PA 17046

DATES: TUESDAY, JUNE 11TH - THURSDAY, JUNE 13TH

ASSEMBLY TIME: 9:30 AM (FOR BREAKFAST) OR 10 AM (REGULAR START TIME)

PICK UP TIME: 2PM

Permission

Waivers

Date

If you have any questions, don't hesitate to contact our Student Life Director Asia Kunarasa at 917-324-4466.

Camper Info

Birthday

Emergency Contact #1

Emergency Contact #2

Medical Insurance Info

The Camper Has Medical Insurance (Y/N)
Yes
No

Medical Waiver

IN THE EVENT THAT MY CHILD IS INJURED AND NEEDS MEDICAL CARE, TRUE LIFE HAS MY PERMISSION TO SEE THAT SHE/HE RECEIVES MEDICAL TREATMENT AND I WILL BE DIRECTLY RESPONSIBLE FOR THE PAYMENT OF THAT TREATMENT.

Date

Additional Medical Info

Does the camper have any medical conditions that we should be aware of?
Yes
No
Are there any special instructions for this child? (dietary restrictions, forbidden activities, etc...)
Yes
No
Any allergies?
Yes
No
Any prescription medications that the child will need to take while at camp?
Yes
No
My child needs transportation to/from True Life Day Camp.
Yes
No
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