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Summer Camp 2016
Participant Information
BUILDER #1
First Name:
*
Last Name:
*
Sex:
*
Male
Female
Birthdate:
*
+
Grade:
*
K
1st
2nd
3rd
4th
5th
School:
*
BUILDER #2
First Name:
Last Name:
Sex:
Male
Female
Birthdate:
+
Grade:
K
1st
2nd
3rd
4th
5th
School:
SUMMER 2016 CAMP BRICK
UNITY CHURCH 5125 Frankline Pike, Nashville, TN 37220
*If your child is staying "ALL DAY" they will be supervised from 9am-4pm. Please bring a lunch and drink as well as a snack.
June 6th-10th On Your Mark..Get Set..BUILD 9am-12:30pm (ages 4-14 years)
June 6th-10th Minecraft Stop Motion Movie Camp 1pm-4pm (ages 7-14 years)
June 13th-17th On Your Mark..Get Set..BUILD 9am-12:30pm (ages 4-14 years)
June 13th-17th MINDSTORMS Robotics 1pm-4pm (ages 9-14 years)
June 20th-24th On Your Mark..Get Set..BUILD 9am-12:30pm (ages 4-14 years)
June 20th-24th On Your Mark..Get Set..BUILD 1pm-4pm (ages 4-14 years)
June 27th-July 1st On Your Mark..Get Set..BUILD 9am-12:30pm (ages 4-14 years)
- FULL
July 5th-8th On Your Mark..Get Set..BUILD 9am-12:30pm (ages 4-14 years)
(4 day week - no camp July 4th) (Cost $180.00)
July 5th- July 8th Adventures in Minecraft 1pm-4pm (ages 6-14 years)
(cost $180.00)
July 11th-15th On Your Mark..Get Set..BUILD 9am-12:30pm (ages 4-14 years)
July 11th-15th Adventures In Minecraft 1pm-4pm (ages 6-14 years)
July 18th-22nd On Your Mark..Get Set..BUILD 9am-12:30pm (ages 4-14 years)
July 18th-22nd On Your Mark..Get Set..BUILD 1pm-4pm (ages 4-14 years)
- FULL
- FULL
MT. JULIET COMMUNITY CENTER 1075 Charlie Daniels Parkway
*Bring a lunch and a snack if your child plans to stay all day and participate in
Mr. Bond Science Camps
from 1pm-4pm
June 20-24th On Your Mark..Get Set..BUILD 9am-12:30pm (ages 4-14 years)
July 11th-15th On Your Mark..Get Set..BUILD 9am-12:30pm (ages 4-14 years)
HOUSEHOLD/ADULT PRIMARY CONTACT
Relationship:
*
Mother
Father
Other
Other
First Name:
*
Last Name:
*
Street Address
*
City
*
State
*
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Zip Code
*
Phone Number
*
Alternate Phone:
*
Email Address
*
Emergency Contact Name:
*
Emergency Contact Phone:
*
Receive Email Updates?
*
Yes
No
This is permission for camp updates and information. We will not spam you or give your address out
I give my permission for Camp Brick to use my child's picture for marketing purposes?
*
Yes
No
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