Summer Day Camp Registration

Complete this registration form to reserve your spot at Parkway Summer Day Camp!

Gender *
T-shirt Size *

Field Trip Permission
I hereby give my permission for my child to go on all field trips scheduled for the 2021 Parkway Summer Day Camp program. I hereby agree to hold PARKWAY CHRISTIAN ACADEMY (Parkway Summer Day Camp) blameless of any liability resulting from injury sustained or loss of personal property of my child while on these field trips. In the event of an emergency and a parent/guardian cannot be reached, I hereby give my permission for a Parkway representative to obtain emergency medical treatment. Listed below is medical information for my child: *

Medical Consent
I, the undersigned, am the parent or legal guardian of the above named child, and hereby authorize a representative of Parkway Summer Day Camp to take my child to the nearest hospital for treatment in the case that I cannot be reached in an emergency. I further authorize the hospital or a licensed doctor of medicine to administer treatment in case of an emergency. It is understood that I will be contacted by telephone, if at all possible, prior to treatment. *

Electronic Signature

The electronic signatures below and their related fields are treated by Parkway Christian Academy like a physical handwritten signature on a paper form.

Reservation and Financial Agreement

Parent/Legal Guardian #1 (responsible for weekly payments):

Parent/Legal Guardian #2 (responsible for weekly payments):

Please select the week(s) your child will attend:
** I understand that Parkway Summer Day Camp has the right to refuse enrollment to or ask for withdrawal of any camper who is a continual discipline problem, who refuses to obey camp personnel and/or who, in the opinion of the camp director, is considered a harmful influence to other campers. *
**I understand that chapel time is a part of scheduled activities. *
**I understand that any parent or legal guardian has the right to remove my child from the premises of Parkway Summer Day Camp without notifying other family members. If there is a custody issue, legal documentation is required to restrain such action. *
**I understand that advance reservations are required for each week the camper is to attend camp. I understand that the week my child attends camp must be paid in full by the Friday before. I understand that for each minute I am late past 5:00 pm to pick my child up that I will be charged $1 per minute per child. *
My signature below affirms that all of the information contained in this application is correct, complete, and honestly presented. I understand that the electronic signatures below and their related fields are treated by Parkway Christian Academy like a physical handwritten signature on a paper form. *
Thank you for your submission, you will be contacted by the school office shortly. Please contact our offices at 863-646-5031 or info@pcalakeland.org with any questions.
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