Hollis Crossings 2023

Start Date

Monday, June 26, 2023 CST

End Date

Thursday, June 29, 2023 CST

RSVP Date

Monday, June 12, 2023 CST

Location

Hollis Renewal Center 11414 Kansas Avenue Kansas City, KS 66111

Hollis Crossings Summer Day Camp is a fun, active and faith-filled week during the summer for children grades K-5.
During the week, kids run, play, jump, explore the outdoors and make new friends…while experiencing God love for all.
Hollis receives both staff and program from Camp Tomah Shinga , an accredited camp with Lutheran Outdoor Ministries.

We are so excited you have chosen to share your camper with us this summer.
We can't wait to welcome them to Hollis!

To register your camper(s) for Hollis Crossings Summer Day Camp, please choose the number of campers you are registering,
enter each camper's information (age, grade, shirt size, health info) and remit payment.

Cost to attend camp is $85/camper
**Registration closes Monday, June 12th - or when we are sold out.**

Eligible Campers are kids who have completed grades Kindergarten-5th grade.
When asked for grade, please indicate the grade camper will have just completed during 2022-2023 school year.

Contact us with questions.
(913) 441-0451 | holliscrossings@holliscenter.org | www.holliscenter.org

Day Camp Registration

Registration	Cost Per Camper	Quantity	Total
Day Camp Sponsorship - DINNER	$50.00	Filled !	$0.00
Each evening we provide dinner for our camp counselors. Help off set the costs by becoming a dinner sponsor.
Day Camp Sponsorship - PICNIC LUNCH	$100.00		$0.00
Each year we host a group picnic campfire lunch for our campers and counselors. Kids roast hot dogs, smores and enjoy fresh fruit and chips. Help provide that meal for campers.
Day Camp Sponsorship - Activities & Supplies	$250.00		$0.00
Each year we bring in organizations such as Operation Wildlife or Drum Safari to do a presentation for the kids. Help subsidize that cost by donating today.
			Total: $0.00

Camper #1 Information

Please fill this out for your camper. If you are registering more than 1 camper, please select the "Click here to add additional campers" button to provide information on any additional campers.

Is Guardian above responsible for transport? * The field Is Guardian above responsible for transport? is required.

Secondary Transportation Contact * The field Secondary Transportation Contact is required.

Secondary Transportation Contact Phone # * The phone field Secondary Transportation Contact Phone # is required.

Emergency Contact * The field Emergency Contact is required.

Emergency Contact Phone * The phone field Emergency Contact Phone is required.

Emergency Contact Email * The email field Emergency Contact Email is required.

Medical Insurance Company & Policy Number The maximum length for the field Medical Insurance Company & Policy Number is 500 characters.

Name & Contact Number of Family Doctor The maximum length for the field Name & Contact Number of Family Doctor is 500 characters.

Preferred Hospital The maximum length for the field Preferred Hospital is 500 characters.

Camper First Name * The field Camper First Name is required.

Camper Last Name * The field Camper Last Name is required.

Camper Birthday * The date field Camper Birthday is required.

Grade * The field Grade is required.

Gender * The field Gender is required.

T-Shirt Size * The field T-Shirt Size is required.

Known allergies and/or dietary restictions The maximum length for the field Known allergies and/or dietary restictions is 5000 characters.

Medications being taken OTC or prescribed The maximum length for the field Medications being taken OTC or prescribed is 5000 characters.

Medical History

Medical History Explanations The maximum length for the field Medical History Explanations is 5000 characters.

Physical restrictions of camper The maximum length for the field Physical restrictions of camper is 5000 characters.

Any additional information about camper The maximum length for the field Any additional information about camper is 5000 characters.

PERMISSION TO ADMINISTER MEDICATION * The field PERMISSION TO ADMINISTER MEDICATION is required.

AUTHORIZATION FOR MEDICAL TREATMENT * The field AUTHORIZATION FOR MEDICAL TREATMENT is required.

AUTHORIZATION TO PARTICIPATE * The field AUTHORIZATION TO PARTICIPATE is required.

PHOTO/VIDEO RELEASE * The field PHOTO/VIDEO RELEASE is required.

DIGITAL SIGNATURE * The field DIGITAL SIGNATURE is required.

How did you hear about Hollis Crossings * The field How did you hear about Hollis Crossings is required.

List of the Additional Camper Info added to the registration.

#	First Name	Last Name	Edit

Click here to add Additional Camper Info

Total Amount Due: $0.00

Parent/Guardian

First Name *

Last Name *

Business Name

Email *

Phone *

Address Line 1 *

Address Line 2

City *

State *

Zip *

Country / Region

Additional Comments

Day Camper Information

Hollis Crossings 2023

Day Camp Registration

Camper #1 Information

Parent/Guardian

Your Payment Method

Your Billing Information

Your Payment Information