Spring Break Camp
(Mon 4/2 thru Fri 4/6)
7:00am - 6:30pm
for Boys and Girls
ages 5 - 16 years old.
(Lite Breakfast and Lunch Provided)
Kids are encouraged to bring snacks
* Home Phone
Special Health Conditions/Allergies
Austin Rd (Henry Co)
Fair View (Henry Co)
Narvie J. Harris
Martin Luther King
authorize Camp of Champions and it's contracted transportation
company to transport,
to and from any Camp of Champions activities during his/her contracted
stay at the day camp.
I hereby give my approval for his/her participation
in any activities of the Camp of Champions, Inc. Basketball Camp
and After School Program, held at Camp Site:
and authorize staff persons of the Camp of Champions, Inc. to
provide guardianship for him/her while participating in Camp of
I assume all risks and hazards incidental to such participation,
including transportation to and from the activities, and do hereby
waive, release, absolve, indemnify and agree to hold harmless
the Camp of Champions, Inc., the organizers, sponsors, supervisors,
participants, staff persons, and person transporting my child
to or from activities, for any claim arising out of injury to
I agree to pay the Camp of Champions, Inc a late fee in cash
upon pick-up if pick-up is made after 6:30pm ET.
At 6:31pm ET a fee of $5.00 is required and $1.00 for each additional
minute beyond 6:30pm ET.
Parent __________________________ Date __________
All fees are due no later than the first pick-up for the week.
Payments received after the first pick-up will be assessed
a late payment charge of $10.00
(A weeks consists of 3 or more days between
Monday and Friday)
Make all check (s) & Money Orders Payable to:
Camp of Champions, Inc.
All return checks will be charged a $25.00 service fee.
Please complete the form, print, sign, date and mail to the
following address with your check.
Camp of Champions
P.O. Box 361531
Decatur, GA 30036-1531
or Bring the forms in person to the Camp Site
Print 2 copies
of the form prior to Submitting
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