registration form

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REGISTRATION FORM SUMMER 2018 Register online 24/7 at dbc.org/campunite!

Child’s Full Name: Gender: M F

T-Shirt Size: XS YS YM YL AS AM AL AXL

Address: City: Zip: Home Phone Number: Main E-mail Address: Date of Birth: Age as of 5/31/18:

Grade Just Completed: (2017/18 school year)

Swim Level (applies to ages 6 & up): q Does Not Swim q Beginner q Intermediate q Advanced Mother’s Full Name: Email Address: Cell Phone Number: Work Phone Number: Father’s Full Name: Email Address: Cell Phone Number: Work Phone Number: Emergency Contact (If parents cannot be reached) Full Name: Relationship to child: Telephone Number(s): Please list all individuals who have permission to pick-up your child from camp. No one else will be permitted to pick-up your child without your written permission. 1) 2) 3) Please list any allergies your child has (food, insects, medications, etc.) *We are a peanut free camp! Symptoms: Medical Attention Required: Please indicate any other conditions we should know that would help us in working with your child: Do you have a church home that you feel connected to and that supports you and your family? q Yes q No If yes, what is that church? Would you like more information about Dunwoody Baptist Church? q Yes q No Page 1

Camp Fees ‰‰ Full-day

$230/week (Week 5: $184)

for Rising 2nd Graders - Age 12 only

‰‰ Half-day

$190/week (Week 5: $152)

for Ages 2 - Rising 1st Graders only

Week 2—Camp Unite during VBS week is only available to Rising 2nd Graders - Age 12 ‰‰ $100 for Monday - Thursday *You must first register for DBC’s free VBS online at dbc.org/vbs to attend camp this week. Cancellation Policy: If you withdraw for any reason for a week that you are registered for, you may transfer to another week of camp for no additional charge. However, if you withdraw prior to April 1, the full fee less 20%, will be refunded. After April 1, the full fee less 40% will be refunded. No refunds will be given after Wednesday prior to the week of camp you originally registered for. All refunds are given at the discretion of the Camp Director.

Extended camp hours are available each day from 7:45-8:45 am and 4:00-5:30 pm. Early Drop-Off, Late Pick-Up and Camp Plus are only available for Full-Day Campers. This includes VBS Week. Please select the extended camp hours option that applies to you. ‰‰ Early Drop-Off (As early as 7:45 am): $35

‰‰ Late Pick-Up (As late as 5:30 pm): $40

‰‰ Camp Plus (Early Drop-Off + Late Pick-Up): $50

‰‰ Do not need extended hours

For Ages 2 - Rising 1st Graders Only: Which week(s) of camp will your child be attending? (Descriptions on page 6)

‰‰ June 4-8: Summer in the Circus

‰‰ July 2, 3, 5, 6: Bach to Rock

‰‰ June 11-14: VBS Week (register at dbc.org/vbs)

‰‰ July 9-13: Princess Ballerina & Tiny Tots Sports

‰‰ June 18-22: Dinosaur Week

‰‰ July 16-20: Dr. Seuss on the Loose

‰‰ June 25-29: Pirates & Mermaids

‰‰ July 23-27: Tropical Paradise

For Rising 2nd Graders - Age 12 Only: Which week(s) of camp will your child be attending? ‰‰ Week 1: June 4-8

‰‰ Week 2: June 11-14

‰‰ Week 3: June 18-22

‰‰ Week 4: June 25-29

‰‰ Week 5: July 2, 3, 5, 6

‰‰ Week 6: July 9-13

‰‰ Week 7: July 16-20

‰‰ Week 8: July 23-27

Specialties for Rising 2nd Graders - Age 12 (Descriptions on page 4 and 5) • Pick a specialty for your camper to participate in for one morning block per day each week. • If your choice ends up not being offered, you will be contacted and allowed to select another option at that time. Specialty Options By Week: Check One per Week Week 1: June 4-8

‰‰Soccer

Week 2: June 11-14

‰‰VBS Week (You must first register for DBC’s free VBS at dbc.org/vbs to attend camp this week.)

Week 3: June 18-22

‰‰Cheerleading

‰‰Flag Football

‰‰It’s Showtime

‰‰Art (FULL) ‰‰Camp Live

Week 4: June 25-29

‰‰Gymnastics (FULL)

‰‰Basketball

‰‰Drama

‰‰Art

Week 5: July 2, 3, 5, 6

‰‰Basketball

‰‰Outdoor Adventure

‰‰Cooking

Week 6: July 9-13

‰‰Soccer

‰‰Gymnastics

‰‰Dance Through the Ages ‰‰Cooking

Week 7: July 16-20

‰‰Outdoor Adventure

‰‰Sports Up

‰‰Music Theater Dance

‰‰Drums

Week 8: July 23-27

‰‰Basketball

‰‰Cooking

‰‰Lacrosse & Hockey

‰‰Hip Hop

‰‰Volleyball

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‰‰Unite’s Got Talent

‰‰Art (FULL)

Multiple Week Discount

$10 off starting with 5th session.

Payment Plan Option

$50 per session is due at initial registration. Remaining payments will be drafted February 28, March 30, April 30 and May 30. All fees must be paid by May 30. Registrations after May 30 will require full payment.

How did you hear about Camp Unite? ‰‰ Returning Camper

‰‰ Friend/Neighbor

‰‰ The Aha! Connection

‰‰ Online Search

‰‰ The Crier ‰‰ Reporter Newspaper ‰‰ Other: Office Use Only: Date Registered

Camp Fees

Extended Camp Fees

Total Due

Amount Paid

Check #

Cash / Credit



Camp Unite: Release and Waiver of Liability Photograph Permission Form In consideration for allowing my child to participate in camp, recreational and other activities at or sponsored by Dunwoody Baptist Church, Inc. (the “Church”) and further in consideration of the Church allowing me and my child to enter and use the facilities owned, leased or otherwise provided by the Church (the “Facilities”), the undersigned, for myself and for my child and his/her parents, heirs, assigns, personal and legal representatives and estate, fully and completely releases, discharges and holds harmless the Church, and its directors, trustees, officers, employees, agents, insurers, instructors, coaches, and volunteers (collectively “its agents and employees”) from any and all claims, actions, causes of action, and damages of any kind whatsoever, including but not limited to claims for personal injury or property damage, arising out of or related to my child’s participation in any activity sponsored by the Church or held at the Facilities. The undersigned (i) consents to the Church’s agents and employees transporting my child to and from any Churchsponsored activity in which my child is participating that is conducted away from the Facilities, (ii) acknowledges and recognizes there are inherent risks involved in activities sponsored by the Church or held at the Facilities and the undersigned and my child assumes the risk of any injury sustained while participating in activities sponsored by the Church or held at the Facilities, and (iii) agrees to indemnify, defend and hold harmless the Church and its agents and employees from any and all claims arising out of my child’s participation in any activity sponsored by the Church or held at the Facilities, even if such claim arises as a result of a negligent act or omission of the Church or its agents and employees. In the event of accident or illness, I authorize Church personnel to examine, treat, or administer medications deemed necessary for any illness or injury to my child. In the event of an emergency or if I cannot be reached by telephone, I authorize Church personnel to obtain any medical care deemed necessary as determined by the sole discretion of said Church personnel, including hospitalization, injection, anesthesia, and surgery, from a licensed, certified, or authorized health care provider for my child. I accept sole responsibility for the payment of any medical care. I understand that as a participant my child may be photographed or videotaped during normal event activities and these photos/videos may be used in the Church’s promotional materials and give my permission for my child’s likeness to be used in such materials. Child’s Name: Signature (Parent/Guardian):

Date:

Parent/Guardian Printed Name: Relationship to Child: Page 3

Specialty Options for Rising 2nd Graders - Age 12 Week 1: June 4-8 Soccer: Learn skills and tactics of the game of soccer in a fun and competitive way. Campers will develop individual skills through drills and fun competitions and scrimmages. Volleyball: Campers will be introduced to passing, setting, spiking, blocking, serving, receiving serve and have lots of fun scrimmaging! Art: Learn the dynamic art technique of fused glass. Campers will take a variety of visual inspirations and create a work of art suitable for framing. (Instructor: Ann Hewatt) Unite’s Got Talent: Not just for singers! Calling Magicians, dancers, and instrumentalists too! Learn stage presence, confidence and independence from instructor Jane Hendrix. Showcase your special, unique talent for judges and parents at a special presentation at the end of the week.

Week 2: June 11-14 Vacation Bible School Week: Campers will attend VBS each morning and then participate in a variety of electives in the afternoon. You must first register for DBC’s free VBS at dbc.org/vbs in order to attend camp this week. Once you’ve registered for VBS, use the link in your confirmation email to register for Week 2 of Camp Unite.

Week 3: June 18-22 Flag Football: Learn techniques of speed and agility and the fundamentals of blocking, tackling, passing, running and catching. We will put it all together with Unite Bowl V on Friday. Cheerleading: Cheerleading is a dynamic blend of tumbling, dance and performance! Back 2 Basics Cheer includes instruction in tumbling, jumps and stunting. Campers will demonstrate all they have learned at Unite Bowl V on Friday. Art: Learn the dynamic art technique of fused glass. Campers will take a variety of visual inspirations and create a work of art suitable for framing. (Instructor: Ann Hewatt) It’s Showtime: Performance camp including acting, singing and dancing. Campers work to put together a show in just one week. Learning songs, dances, working on projection and stage presence in preparation to star in their very own show. Every imagination gets to shine! (Instructors: Leslie Kelley & Jane Hendrix) Camp Live: Have you ever wanted to be on a TV talk show? Learn about putting together the story, interviewing, shooting and editing video. Put it all together for a broadcast at the end of the week.

Week 4: June 25-29 Basketball: Learn the fundamentals or fine tune your skills and basic game strategies of basketball while having fun. We will include scrimmages each day. Gymnastics: A great combination of gymnastics and fitness activities including cartwheels, tumbling, balance beam, trampoline and more led by Back 2 Basics Gymnastics Academy. Art: Have fun exploring the principles of sketching using pencil, charcoal and other mediums. Learn to draw lines, shapes, light/ shadows, perspective, black and white and color. Campers will create artwork of their favorite subjects, nature or illustrations. Drama: Experience the process of creating a 5-minute sketch, as a director and/or actor, which will be performed on the last day. Includes writing an original script, auditioning for/casting roles and developing other theater skills including blocking, projection and improvisation. (Instructor: Niña Deshpande)

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Week 5: July 2, 3, 5, 6 Basketball: Learn the fundamentals or fine tune your skills and basic game strategies of basketball while having fun. We will include scrimmages each day. Cooking: Enhance your creativity, literacy, math, science and small motor skills through hands-on cooking activities! In this fun, fiveday camp, young chefs will practice essential kitchen skills and master the fundamentals of cooking. Outdoor Adventure: Learn to find, prepare and set up a campsite for an overnight adventure. We’ll also talk about fire and pocket knife safety, different types of campfires to build, how to pitch a tent and more!

Week 6: July 9-13 Soccer: Learn skills and tactics of the game of soccer in a fun and competitive way. Campers will develop individual skills through drills and fun competitions and scrimmages. Gymnastics: Get ENERGIZED with a great combination of gymnastics and fitness activities including cartwheels, tumbling, balance beam, trampoline and more led by Back 2 Basics Gymnastics Academy. Cooking: Enhance your creativity, literacy, math, science and small motor skills through hands-on cooking activities! In this fun, fiveday camp, young chefs will practice essential kitchen skills and master the fundamentals of cooking. Dance Through The Ages: Campers will experience the magic as we dance through the decades! We’ll learn some of the most popular dances of all time and put it all together for one great performance on Friday. (Instructor: Leslie Kelley)

Week 7: July 16-20 Sports Up: Shoot, run, jump and hit your way into a variety of sports for the week! Campers will learn the basic fundamental or improve on what they already know in a different sport each day including basketball, track and field, golf, tennis and baseball. Outdoor Adventure: Learn to find, prepare and set up a campsite for an overnight adventure. We’ll also talk about fire and pocket knife safety, different types of campfires to build, how to pitch a tent and more! Music Theater Dance: Become a triple threat! If you love performing and the dramatic arts, this is the camp for you. Learn to combine singing, acting and dancing for one incredible performance. (Instructor: Lauren Overton) Drums: Hear the history and have fun as you get “The Beat” and find the rhythm in learning to play music using various percussion instruments. You’ll be amazed at what you hear! Campers will showcase their new skills on Friday. (Instructor: Jerry Fields)

Week 8: July 23-27 Basketball: Learn the fundamentals or fine tune your skills and basic game strategies of basketball while having fun. We will include scrimmages each day. Cooking: Enhance your creativity, literacy, math, science and small motor skills through hands-on cooking activities! In this fun, fiveday camp, young chefs will practice essential kitchen skills and master the fundamentals of cooking. Lacrosse & Hockey: Learn the rules of lacrosse and hockey to improve skills including cradling, passing, shooting, stick handling, defense and basic passing drills. Equipment provided if necessary. Hip Hop: Learn how to keep time, count with rhythm, move across the floor, and follow choreography. Campers will incorporate their personality into each dance to encourage creativity and raise confidence. (Instructor: Lauren Overton)

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Specialty Options for Ages 2 - Rising 1st Graders Week 1: June 4-8 Summer in the Circus: Come one, come all to the greatest camp on Earth! We will create crafty clown art and play fun games. Lee Bryan, That Puppet Guy will be performing his puppet show The Suitcase Circus on Wednesday at 10 am.

Week 2: June 11-14 Vacation Bible School Week: Register for DBC’s free VBS at dbc.org/vbs!

Week 3: June 18-22 Dinosaur Week: Discover the prehistoric time period as we dig deep into the land of the dinosaurs. Lee Bryan, That Puppet Guy will be stopping by to perform Dr. Dinosaur on Wednesday at 10 am.

Week 4: June 25-29 Pirates and Mermaids: Ahoy there! Have a blast exploring the big sea and stumble on some gnarly pirates and beautiful mermaids. Jeffini the Great will stop by to perform a hysterical magic show.

Week 5: July 2,3, 5, 6 Bach to Rock: Campers will love this performance camp while learning how FUNtastic it is to be on stage! This camp will be taught by Leslie Kelley and Jane Hendrix.

Week 6: July 9-13 Princess Ballerina (Ages 3 - Rising 1st Graders): Experience the magical world of fairy tales with tea parties, dress-up and dancing in a real castle! Tiny Tots Sports (Ages 2 - Rising 1st Graders): Campers will learn the basic techniques in a variety of different sports through Back2Basic Gymnastics Academy. They will also be taught social skills such as waiting their turn and sharing with others.

Week 7: July 16-20 Dr. Seuss on the Loose: From the Cat in the Hat to The Lorax, have the best time with the outrageous stories from Dr. Seuss. We will read and make Green Eggs and Ham and have so much silly, willy, nilly, zilly fun. Cricket’s Mobile Petting Zoo will also stop by so we can visit with a few of their sweet farm friends.

Week 8: July 23-27 Tropical Paradise: Sail away with us as we create beautiful beach scenes and play some island games. Jeffini the Great will be back this week to ooh and aah us with his amazing magic show and make us actually believe we are in paradise.

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