First Kids SUMMER DAY CAMP Enrollment
GOD CREATED EVERYTHING
Register early, spots fill fast!
DATES: Wednesdays June 12 & 26 * July 10 & 24 * August 7
TIMES: 9 am - 2 pm
AGES: 2 to 10 years  
COST: $25 per day or $100 for all five days (no refunds will be given). Pay online to reserve a spot!
BRING: A sack lunch and blanket for watching a movie. Wear play clothes and bring a good attitude. We'll provide the fun!

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Child's Name *
Child's Date of Birth *
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Address *
Home Number 
 *
E-Mail Address(s) *
Mother's Name *
Mother's Cell Number *
Mother's Work Place *
Mother's Work Number *
Father's Name *
Father's Cell Number *
Father's Work Place *
Father's Work Number *
Emergency Contact if parent/guardian cannot be reached
(Name, Relationship to child, Phone Numbers)
 *
Authorized Person for Pickup
I hereby authorize FUMC Sealy to allow my child to leave the preschool facility ONLY with the following persons. If I cannot contact you or the emergency person, then I will contact an authorized person.
Authorized Person #1
(Name, Relationship to child, Phone Numbers)
 *
I hereby authorize FUMC Sealy to allow my child to leave the preschool facility ONLY with the following persons. If I cannot contact you or the emergency person, then I will contact an authorized person.
Authorized Person #2
(Name, Relationship to child, Phone Numbers)
 *
***IMPORTANT*** Please list or indicate NKA or type of allergies or illnesses.
List any special problems that your child may have, such as allergies, existing illness, previous illness, injuries in the past 12 months, and medications prescribed for a long-term continuous use, and nay other information that staff should be aware of such as special needs.
 *
My child's immunizations are current. *
My child is toilet trained? *
Check the boxes of the days you would like to attend:
$25 per day or pay $100 for all FIVE camps! (NO REFUNDS)
 *
Required
Water Activities: (Wading pools and other bodies of water provided by the facility)
I hereby give my consent for my child to participate in water activities:
 *
May we have permission to photograph your child? *
May we have permission to use your child's photograph for the purpose of promotion? *
IMPORTANT:

Upon receipt of your registration form, and FEE, your child will be secured a place in the program. This will be done on a first come, first-served basis. If we receive your registration and the session is already full, we will place your child on a waiting list. 


Questions? Contact Joanna Kruzel @ 979-885-2223
I understand after I reserve my child's spot with this registration form, payment will be required by going to the FUMC payment site before my registration is complete. Complete your registration by paying online now or by cash/check to the church office at First United Methodist Church, 200 Atchison, Sealy, TX 77474.  *
Today's Date *
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