Elementary School Camp Registration Elementary School Camp Registration Choose your camp location* Freedom - 19802 (2401 Thatcher St, UP Headquarters) Hope - 19801/South Bridge (455 Townsend St, Mt Joy UMC) Victory - 19801/East Side (800 N Walnut St, Ezion Mt Carmel UMC) Promise - 19805/West Side (1411 W 4th St, Be Ready Jesus is Coming) Harmony *7th & 8th Grade* (3301 N Market St., Resurrection Center) UP Camps are intended for children who live in the immediate community surrounding each camp. Please select the camp that is located within the geographic area of your home address.Child's Name* First Last Age*Grade Entering* Birthday* MM slash DD slash YYYY School* Home Address* Street Address Address Line 2 City ZIP / Postal Code Home Phone*Medical Considerations:* Allergies (food and/or medication):* Disabilities and/or IEP* Court/Legal Matters:* Gender:* Male Female Race* American Indian or Alaskan Native White Black or African American Native Hawaiian or other Pacific Islander Asian Other Race Non Disclosed Ethnicity* Hispanic or Latino Not Hispanic or Latino Non Disclosed Discipleship & Mentoring:* Discipleship Mentoring My child will not attend on Fridays Discipleship: 60 minutes of small group (1-4 other campers) learning about Jesus & practical ways to serve others. Mentoring: 60 minutes of 1-on-1 time with a StreetLeader focusing on building their relationship & learning a life skill. Program Season:* Summer Camp Afterschool Program Both Contact InformationParent/Guardian* First Last Relationship* Parent's Email Cell Phone*Work PhoneEmergency Contact (if parent isn't reachable):* First Last Relationship to Child(ren)* Home/Cell Phone*Additional Children(living at the same address who will be attending camp)Child's Name First Last AgeBirthday MM slash DD slash YYYY Grade Entering Medical Considerations: Allergies (food and/or medication): Disabilities and/or IEP Court/Legal Matters: Race American Indian or Alaskan Native White Black or African American Native Hawaiian or other Pacific Islander Asian Other Race Non Disclosed Ethnicity Hispanic or Latino Not Hispanic or Latino Non Disclosed Discipleship & Mentoring:* Discipleship Mentoring My child will not attend on Fridays Discipleship: 60 minutes of small group (1-4 other campers) learning about Jesus & practical ways to serve others. Mentoring: 60 minutes of 1-on-1 time with a StreetLeader focusing on building their relationship & learning a life skill. Program Season: Summer Camp Afterschool Program Both Additional Children(living at the same address who will be attending camp)Child's Name First Last AgeBirthday MM slash DD slash YYYY Program Season: Summer Camp Afterschool Program Both Grade Entering Medical Considerations: Allergies (food and/or medication): Disabilities and/or IEP Court/Legal Matters: Race American Indian or Alaskan Native White Black or African American Native Hawaiian or other Pacific Islander Asian Other Race Non Disclosed Ethnicity Hispanic or Latino Not Hispanic or Latino Non Disclosed Discipleship & Mentoring: Discipleship Mentoring My child will not attend on Fridays Discipleship: 60 minutes of small group (1-4 other campers) learning about Jesus & practical ways to serve others. Mentoring: 60 minutes of 1-on-1 time with a StreetLeader focusing on building their relationship & learning a life skill. Program Season: Summer Camp Afterschool Program Both Take HomesMy child(ren) will:* walk home alone from camp be picked up by someone they will be picked up by... Please carefully read the following and then sign the agreement on the registration form:* I understand that my child will need to attend a minimum of 3 days a week to stay registered in the program. If they need to be absent for a particular reason, I will communicate that reason to the Director in person or in writing. * I give permission for my child to participate in the activities sponsored by UrbanPromise and other cooperating organizations in the neighborhood. * In case of medical emergency, I understand that an effort will be made to reach me. However, I do give permission for the staff of this program to authorize emergency medical care for my child. * I understand the risk involved in this program and that the staff will exercise all reasonable care for my child. I will not hold UrbanPromise Ministries, Inc. or other cooperating organizations, their staff or representatives, responsible for injuries which occur to my child. * I understand that Christian education is part of the UrbanPromise camp program. * I understand that UrbanPromise and the cooperating organizations are not responsible for my child until and unless they arrive at the program site and/or after they have left the site. * I give permission for my child’s name and photograph to be used in publications produced by UrbanPromise Ministries, Inc. * I agree to support my child and the staff of this program through accepting and enforcing the discipline structure that is used. Covid Safety Practices* I understand that my child will be tested regularly on Mondays & Thursdays during the camp times at the program site to prevent any spread of Covid 19. * I understand that my child will be required to wear a mask during programming sessions. * If my child has any covid related symptoms, my child will stay home. Δ