2024 RCCG HOF Summer Enrichment Program Application
Please complete this form in order to enroll your child in the summer program. Please note the program is Monday - Friday 8 am to 4:30 pm June 3 -July 26. Registration is $200 per child until April 28,2024 and $250 per child for late registration until May 30th.  
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Email *
Parent's name *
Parent's cell number *
Parent's Home Address *
Child #1 (first and last name) *
Child #1 date of birth (month, day, year) *
Grade Level (grade that your child will complete in May 2024 *
Name of School District *
Child #2 first and last name
Child #2 date of birth
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Grade Level
Child #3 first and last name
Child #3 date of birth
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Grade Level
Child #4 first and last name
Child #4 date of birth
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YYYY
Child #5 first and last name
Child #5 date of birth
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Attendance: The summer program is Monday- Friday 8 am to 5 pm.  Please mark days that your child will attend.  (check all that apply) *
Required
Meal policy (children will be provided breakfast, lunch and snack. Parents will be allowed to bring an additional snack for children.) *
Field Trips- we will have weekly field trips to various locations in Arlington. Children will be transported by program staff on church vehicles to/from field trips. *
Water activities- we will have various water activities such as splash park, sprinkler play and water table play. Will your child be able to participate?   *
COVID Health and Safety Policy: Social distancing will be practiced. Students and staff will be required to wear masks. Daily temperature checks and screeners will be conducted. Students that have fever will need to be fever free for 24 hours prior to returning back to camp. All classrooms, chapel, lunchroom, and common areas will be cleaned in addition to materials on a daily basis. *
Emergency Contact first and last name  (please note all emergency contacts must show ID when picking up children. *
Emergency contact phone number *
Emergency Contact #2 (first and last name)
Emergency Contact #2 phone number
Transportation consent (for emergencies) *
Required
Name of Physician *
Physician's Address
Physician's Phone Number *
Medical information (List any special problems your child may have such as allergies, current/previous illness, injuries or hospitalizations during the past 12 months, and any medication prescribed for long term use, and any other information we should be aware of. Please note that we will not be able to administer any medication.) *
Photo Release  (I grant to HOF its representatives and employees the right to take photographs of my child in connection with the above-identified subject. I authorize HOF, its assigns and transfers to copyright, use and publish the same in print and/or electronically. I agree that HOF may use such photographs of my child with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. I have read and understand the above.) *
Acknowledgement of Liability Limitations and Assumption of Risk (Texas law provides that educational entities, and their agents or employees, are not ordinarily liable for property damage, personal injury or accidental death, except in instances of gross negligence. Accordingly, parents assume risks any time students are permitted to travel and/or participate in summer program-related events. RCCG Household of Faith acknowledges that you are not waiving your child’s or your personal rights, as defined under the liability limitations (outlined in the state’s tort claims law) by signing this permission authorization. However, the above-signed parent/guardian acknowledges disclosure that RCCG Household of Faith reserves all rights, immunity, and qualified defenses available to it under the law in connection with the permitted activities subject of this authorization.) *
Please list any additional information regarding your children that we need to know. *
A copy of your responses will be emailed to the address you provided.
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