Level Up Camp Registration - Lighthouse Baptist Academy

Student Information

Below is the registration form for the LBA "Level Up Camps". Our camp offers a unique opportunity for rising 7th-12th graders to embark on a week-long journey filled with engaging activities and immersive learning experiences. Each scheduled week features a thrilling theme, from Digital Media and Sports to ACT Prep and Tech & STEM. Led by our dedicated staff, students will dive into hands-on activities, exciting excursions, and collaborative projects that promise growth and exploration. To ensure a high-quality learning environment, classes will be capped, allowing for personalized attention and meaningful interactions. Don't miss out on this incredible opportunity to join us for a summer of fun, learning, and unforgettable memories!

Name(Required)

First Middle Last

Date of Birth(Required)

Gender(Required)

Male

Female

Grade Level (Going Into...)(Required)

Contact Information

Parent/Guardian Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Emergency Contact

Name(Required)

First Last

Relationship to Student(Required)

Phone(Required)

Medical Information

Does the camper have any allergies that we should know?(Required)

Yes

Please list them:

Does the camper take any medications on a regular basis?(Required)

Yes

Please list any medications:

Does the camper have any medical conditions or special needs?(Required)

Yes

Please list them:

Camp Preferences

Each week of camp has a tuition cost of $200. This covers all materials, costs for excursions, etc. Payment will be due on the the Friday before the camp week.

Which weeks will the camper attend?(Required)

ACT/College Prep Week (July 8 - July 12)

Digital Media Week (July 15-19)

Sports Week (July 22 - 26)

Technology and STEM Week (July 29 - August 2)

Permission and Consent

I give permission for participants to be photographed and/or videotaped during Lighthouse Baptist Academy summer camp activities. I understand that these photos/videos may be used for promotional purposes by Lighthouse Baptist Academy. I waive any right to inspect or approve the finished product, including written copy that may be created in connection therewith. I release Lighthouse Baptist Academy and its representatives from any and all claims, demands, and liabilities whatsoever in connection with the use of these materials.

Agreement:(Required)

Yes, I agree.

No, I do not agree.

I understand that participation in Lighthouse Baptist Academy summer camp activities involves certain risks. In consideration of being allowed to participate in these activities, I hereby assume all risks and hazards incidental to such participation, including transportation to and from the activities. I hereby waive, release, absolve, indemnify, and agree to hold harmless Lighthouse Baptist Academy and its officers, agents, volunteers, and employees from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury that may be sustained by the participant during the course of involvement in the activities.

Agreement:(Required)

Yes, I agree.

No, I do not agree.

In the event of an emergency where it is impractical to obtain consent from a parent/guardian, Lighthouse Baptist Academy is authorized to obtain emergency medical treatment for participants. This authorization includes, but is not limited to, administration of medication, performance of medical procedures, and/or transportation to a medical facility as deemed necessary by medical personnel.

Agreement:(Required)

Yes, I agree.

No, I do not agree.

Signature

Additional Information

How did you hear about the camp? (optional)

Comments/Questions (optional):

Registration Payment

The registration to participate is $30 before May 6. After May 6, the cost to hold the spot increases to $50. With each registration, the student will receive a T-Shirt with the camp logo.

Registration + CC Fee

Price:

Credit Card(Required)

Card Details

Cardholder Name