Middle School Summer Serve
Summer Serve is a half day of service plus a half day of summer fun!

For Who:
For students who will enter grades 6-9 in the 2019/2020 school year.

When:
Wednesday July 10th, 17th, 24th and 31st.
From 9am-4pm.

What Are We Doing:
July 10: Feed My Starving Children followed by Mini Golf and Games at Veteran’s Park in Richfield.
July 17: Park Clean Up followed by the 12:10pm Twins Game (for this event only we can only take 20 students.)
July 24: Special projects at church followed by walking to Bush Lake Beach (less than a mile away).
July 31: Camp Eddie prep projects followed by a giant Slip ‘N Slide party and other games.

Cost:
$10 per day. This will cover all fees and transportation. Students should bring their own lunch.

Contact:
Nicole Smalley, Director of Faith Formation Birth to Grade 8
952-835-7101 x210
nsmalley@stedwardschurch.org
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Email *
Is your family registered at the Church of St. Edward? *
Mother's First and Last Name
Father's First and Last Name
Street Address *
City, State & Zip *
Mother's Cell Phone
Father's Cell Phone
Parent's Preferred Email Address *
Student #1 First and Last Name
Please select the days Camper #1 will attend
Student #1 Gender
Student #1 Grade for 2019/2020 school year
Student #1 anything we need to know such as allergies, physical limitations, special needs, etc.
The more we know the more we'll be able to make camp a great week for your camper!
Student #2 First and Last Name
Please select the days Student #2 will attend
Student #2 Gender
Student#2 Grade for 2019/2020 school year
Student #2 anything we need to know such as allergies, physical limitations, special needs, etc.
The more we know the more we'll be able to make camp a great week for your camper!
Student #3 First and Last Name
Please select the days Student #3 will attend
Student #3 Gender
Student #3 Grade for 2019/2020 school year
Student #3 anything we need to know such as allergies, physical limitations, special needs, etc.
The more we know the more we'll be able to make camp a great week for your camper!
Emergency Contact Name *
Please list someone we can contact in case of emergency, if you are unavailable.
Emergency Contact Phone Number *
Authorized Pick Up List *
Please list anyone who is authorized to pick up your student(s). The people listed will need to show ID. Anyone not on this list will not be able to take students home. If this list needs to be updated, please contact Nicole Smalley directly.
Image Release *
Emergency Care *
Family Insurance Provider, Policy Number and group number *
We require this information in the case that emergency care is needed and a parent is unavailable.
Parental Authorization
I/we give permission for my child to take part in the associated activities. In consideration of the opportunity for my child to participate and fully recognizing that such an undertaking involves an element of risk, we assume all risks and hazards incidental to such participation and do hereby release, absolve, indemnify, and agree to hold harmless the Archdiocese of St. Paul and Minneapolis, Church of St. Edward, nor any of said persons shall be held financially responsible for any injury, illness, or death incurred as a direct or indirect result of this activity, except for gross negligent acts.

I acknowledge that my initials represent an electronic signature that is intended to represent my legal signature. I accept all of the terms in this agreement and my initials (electronic signature) confirms my acceptance.

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