Deadline: Monday, May 18, 2015, 5:00pm OR until camp is full (Whichever comes first)
Name of Participant ________________________________________________ Male______ Female _________Grade_______
**Grade for 15-16 school year**
Parent(s) Names_______________________________________________________________________
Address_______________________________________________________Date of Birth _______________Age________
City ____________________ Zip Code ___________ Home Ph __________________ Bus Ph ___________________
E-Mail_____________________________________________Cell Phone____________________________________
Church Affiliation (Circle One):
MBUMC Member
Non-Member
Non-member/Church Home_______________________
Check Camp(s) You Wish To Attend:
_____ Soccer Camp: May 26 - 29 (Tuesday - Friday) 9:00am - 12:30pm
MBUMC Member $115.00
Non-Member: $140.00
Ages 5 - 12
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_____ Baseball Camp: May 26 – 29 (Tuesday-Friday) 1:30pm - 5:00pm Boys Rising Kindergarten – 5 grades
MBUMC Member: $115.00
Non-Member: $140.00
Please sign up for only ONE session of Sports Camp - ONLINE REGISTRAION ONLY
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_____ Sports Camp Session I: June 15 - 19 (Monday - Friday) 9:00am - 4:30pm Rising 2 - 5 grades
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_____ Sports Camp Session II: June 22 - 26 (Monday - Friday) 9:00am - 4:30pm Rising 2 - 5 grades
MBUMC Member: $265.00
Non-Member: $290.00
MUST SUBMIT COPY OF INSURANCE CARD
(1) Friend Request______________________
(2nd/3rd graders grouped together, 4th/5th grades grouped together)
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_____ Hoops Camp Session I: June 1 - 4, 9:00am-12:00pm (Monday-Thursday) Co-ed Rising 1 – 2 grades
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_____ Hoops Camp Session II: June 1 - 4, 1:30pm-4:30pm (Monday –Thursday) Boys Rising 3 & 4 grades
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_____ Hoops Camp Session III: July 6 - 9, 9:00am-12:00pm (Monday – Thursday) Boys Rising 5 – 8 grades
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_____ Hoops Camp Session IV: July 6 - 9, 1:30pm-4:30pm (Monday – Thursday) Girls Rising 3 – 8 grades
MBUMC Member: $95.00
Non-Member: $115.00
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_____ Cheerleading Camp: July 27 - 29, 9:00am-12:30pm, (Monday-Wednesday) Girls Rising K – 5 grades
MBUMC Member: $60.00
Non-Member: $75.00
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_____ Volleyball Camp I: Girls Rising 4 – 5 grades, July 20 - 23 (Monday – Thursday) 9:00am-12:00pm
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_____ Volleyball Camp II: Girls Rising 6 – 8 grades, July 2 0 - 23 (Monday – Thursday) 1:30pm – 4:30pm
MBUMC Member: $95.00
Non-Member: $115.00
T-Shirt Size (Circle one)
YS (6-8)
YM (10-12)
YL (14-16)
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Refunds: 75% refund will be given for withdrawal up to 2 weeks before camp begins, 50% from 2 weeks before until camp start date. No refund after camp begins.
WE WILL NEED A COPY OF YOUR INSURANCE CARD (FRONT & BACK) FOR SPORTS CAMPS I & II. INCLUDE DESCRIPTION OF ANY FOOD OR DRUG ALLERGY
YOUR CHILD HAS AND LIST ANY MEDICATION YOUR CHILD WILL TAKE WHILE AT CAMP WITH DOSAGE INFORMATION (FOR ALL CAMPS).
On behalf of my child, the above registered participant in the Recreational Ministry of the Mt. Bethel United Methodist Church, Inc., Marietta, Ga., I (undersigned) hereby
acknowledge that I understand the risks associated with each sport. Based upon this understanding, I do hereby forever relea se and discharge Mt. Bethel United Methodist
Church, Inc., it=s representatives, officers, employees, directors, assigns, successors, and heirs from and against any and all liability of w hatever nature of kind resulting from an
injury associated with the use or in the participation of any sporting or other event held on the premises of Mt. Bethel United Methodist Church, unless such injury results from an
action and/or inaction of the church or its employees which constitutes gross negligence.
I (undersigned) have consulted with reliable medical authorities about any conditions, limitations, medications, and prior injuries for the above registered participant in the
Recreational Ministry of the Mt. Bethel United Methodist Church, Inc., Marietta, Ga., and assert that these do not constitute a barrier to my child=s participation in this program. I
request and grant permission to coaches and other officials of this program to provide reasonable care to my child in the eve nt of injury or illness during any activity if I am not
present. I agree to accept the financial liabilities resulting from such care. I hereby give my permission for photographs of my child to be used for church purposes.
Signature of Participant=s Parent/Guardian_________________________________________Date______________________
Name of Emergency Contact (other than self)__________________________________Relationship_____________ Phone______________
Office Use Only: App Date _____________ Check # ___________ Amt.________________ Arena_______ Ins.____
2015 SUMMER CAMP INFORMATION
Mt. Bethel Recreational Ministries
Soccer Camp
May 26 - 29 9:00 - 12:30 (Tuesday B Friday), Co-ed Boys and Girls, Ages 5 B 12
Mt. Bethel UMC along with Challenger Sports will present our summer soccer camp. This camp
focuses on teaching the correct execution of skills to prepare players for the next level. The fun
competitions and individual attention will improve any player’s skills.
Baseball Camp
May 2 6 - 29 1:30 – 5:00 (Tuesday B Friday) Boys Rising Kindergarten B 5th Grades
Mt. Bethel UMC will present our summer baseball camp. This camp will focus on players=
mechanical and fundamental skills.
Sports Camps
Session 1: June 15 - 19, 9:00 B 4:30, (Monday B Friday) Rising 2nd B 5th Grades
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Session 2: June 22 - 26, 9:00 B 4:30, (Monday B Friday) Rising 2 B 5 Grades
MUST SUBMIT COPY OF INSURANCE CARD
Some of the fun activities campers will be participating in are: soccer, basketball, baseball, kickball,
dodgeball, indoor rock climbing, etc. Some off-site activities include bowling, skating, swimming,
lunch at the Varsity, Stone Mountain and a cook out with s’mores. Campers will participate in a
mission project and devotionals.
Hoops Camp (Monday B Thursday)
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I
June 1 - 4 9:00 - 12:00
Co-ed rising 1 /2 Grades
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II
June 1 - 4 1:30 - 4:30
Boys rising 3 /4 Grades
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III
July 6 - 9 9:00 B 12:00
Boys rising 5 B 8 Grades
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IV
July 6 - 9 1:30 B 4:30
Girls rising 3 B 8 Grades
Four-day camp focusing on fundamentals of the game B shooting, passing, dribbling and defense
lead by our own Roger Kaiser (2-time All American for Ga. Tech, won three national championships
as coach).
Volleyball Camp
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I
July 20 - 23 9:00 B 12:00 (Monday B Thursday) Girls rising 4 B 5
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II
July 20 - 23 1:30 B 4:30 (Monday B Thursday) Girls rising 6 – 8
This 4 day camp lead by Mt. Bethel Christian Academy volleyball coaches Melissa Sneed and Brian
Bergius will focus on the rules and fundamentals of volleyball while incorporating
game play situations.
Cheerleading Camp
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July 27 - 29 9:00 – 12:30 (Monday – Wednesday) Girls rising K – 5
Mt. Bethel, along with local varsity cheerleaders, will teach your daughter all of the cheering essentials. The
girls will learn cheers, routines, tumbling and stunts.
Mt. Bethel UMC, Recreational Ministries, 4385 Lower Roswell Road, Marietta, GA 30068, 770-971-5280
www.mtbethel.org/rec
www.mtbethel.org/camps
In Jesus’ Name We Play