Week 1 (June 15 - 19, 2020) - a.m. Golf + p.m. Pottery Painting (Age 8

Student's Date of Birth *

Student Full Name (First Last) *

Lunch Select all that apply 5 Days (+ $25.00) We don't need this service.

Allergy or other medical information (Please notice that you may store your Child's medication at Champion office and take it back when checking out Champion Camp.)

Extended Care Select all that apply Morning care + Mandarin Afternoon care for registering 2 and more weeks of camp (Free). Morning Care (8:00am - 9:00am) - 5 Days (+ $25.00) Mandarin Afternoon Care (4:00pm - 6:00pm)- 5 Days (+ $50.00) Mandarin/Math/English Literacy Afternoon Care (4:00pm - 6:00 pm) - 5 Days (+ $50.00) Morning care + Mandarin Afternoon care for After School Students (Free) We don't need this service.

*Must arrive at Champion before 8:30 am each morning. Once the Champion bus leaves for the destination, you are responsible to send your child to the sports center. Call 919-388-1739 for emergency Select all that apply OK!

Please dress in old clothes: Art camp allows kids to be creative and messy. Select all that apply OK!

Accident Release, First Aid, Media and Financial Responsibility Wavier Select all that apply I authorize and grant permission for a representative of Champion Camp to treat minor injuries including scrapes, small cuts, splinters, and insect bites. I authorize and grant permission for a representative of Champion Camp to obtain emergency medical care from any licensed physician or hospital and/or medical clinic should my child become ill or injured. I therefore freely and voluntarily execute this release with such knowledge, assume the risk of personal injury and/or property loss arising from or in any way connected with participation in any programs offered by said child care center. I hereby release and discharge said child care center and any and all agents from any liability, claim, cause of action, demand or damages from injury or damages of any kind to my child or my property as a result of participation in the programs of Champion Camp. I grant permission and understand that photos and other images taken during this event could be used in print advertisement and other forms of media. I understand that should my child become a disruptive force during the educational program that the instructor may choose to release him/her from the program with no refund.

Week 1 (June 15 - 19, 2020) - a.m. Golf + p.m. Pottery Painting (Age 8 - 13)

All Camps for Age 8 - 13