REGISTRATION
Detach and Return with check or money order in
the amount of $115.00 per week registered to:
Samuel L Gravely,Jr
4670 Waverly Farm Drive
Haymarket, VA. 20136
Camper Name:___________________
Age____ Grade entering______
Address
________________________________
Home Phone
Parent Name
Parent Work/Cell Phone___________
Our daily sports will be selected based
on the weather forecast for the day, to
ensure we have an activity every day of
camp. Below is a general listing of
sports and some details of activities we
will include.
Basketball
 Conditioning and drills
 Scrimmages and game play
 Shooting contest
Gravely Multi-Sport
Summer Camp 2015
Soccer
 Conditioning and drills
 Scrimmages and game play
Boys and Girls
Entering Grades 1-6
Flag Football
 Conditioning and drills
 Scrimmages and game play
 Punt, pass and kick contests
3 Sessions Available
Session A - June 22-26
Session B – June 29-July 3
Session C – July 6-10
School attend ________________
Parent email address, please print
clearly!
________________________________
T-Shirt Size:
Youth: YM
YL
Adult:
M
S
L
XL
Please Check Session(s) you are registering
for:
Session A June 22-26
Session B June 29-July 3
Session C July 6-10
__________
___________
___________
Volleyball
 Skills and drills
 Game play
 Large oversized ball use/ fun game
match
Floor Hockey
 Skills and drills
 Game play
Gravely Elementary School
9am-12pm
This multi-sport camp will provide a wide
range of sports, conditioning and skill
training specific to the sports we focus
on each day.
The emphasis is on FUN and
instruction.
The camp is designed for children
entering grades 1- 6th. Our daily sports
will be flexible based on the weather,
each day of camp may include:
basketball, soccer, flag football,
volleyball, and floor hockey.
SCHEDULE
WHAT: This multi-sport camp will provide a
wide range of sports and skills training
specific to the sports we focus on each day.
Session A - Mon-Fri June 22-26
Session B - Mon-Fri June 29-July 3
Session C - Mon -Fri July 6-10
PERMISSION
I give permission for my child(ren),
______, to
WHO: Students entering grades 1-6
WHY: Providing a multi-sport camp will
allow us the flexibility to offer our camp no
matter what the weather brings each day.
WHERE: Samuel L Gravely Elementary
4670 Waverly Farm Drive
Haymarket VA. 20169
participate in the Gravely Multi-Sport
Daily Schedule:
Camp. I have notified the staff of any
9:00-9:15am
Arrival
9:15-9:45am
Skill Development
REGISTRATION
Max. 50 campers accepted for all
sessions weekly.
Sessions fill up quickly, don’t delay.
COST: $115.00 per week covers
facilities, use of equipment,
15hrs/per week of instruction,
t-shirt and snack.
NOTE
You will only be contacted if a session
that you have registered for is full.
In this case we will ask if you would like
another session or refund your check.
Camp Director: Anthony Klisiewicz, (Mr.K)
For more information call
703.400.6891 or email
[email protected]
I understand that sports participation is
a strenuous activity and will not hold
9:45-10:15am
Scrimmage/Game
10:15-10:30am
Break/Snack
10:30-11:00am
Skill Development
11:00-11:30am
Scrimmage/Game
11:30-12:00pm
Review/Pick up
WHEN: 3 Sessions available:
**IMPORTANT PLEASE READ**
medical conditions and concerns.
Prince William County Schools, Samuel
L Gravely School, or any staff members
responsible for injuries that may occur
through normal participation. My child
has been instructed to dress
appropriately, wear supportive shoes,
and rest and drink water as needed. I
Please Bring:
 Cool, Comfortable clothes.
 Athletic shoes
 Water Bottle (water and cups
are always available)
will pick my child up on time, 12:00pm.
Parent Name
.
Parent Signature
.
All equipment provided.
** Please make camp director aware of any
special medical concerns or medication
needs.
Please call with any questions.