Participant Information

Camper First Name *

Camper Last Name *

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Date of Birth *

Age *

Camper Email Address *

Grade *

School Name *

Parent/Guardian Contact Information

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Last Name *

Street Address *

Address Line 2

City *

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Employer

Emergency Contact Information

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Relationship *

Medical/Allergy Information

Medical Conditions *

Allergies or Dietary Restrictions *

Pediatrician Name *

Pediatrician Phone Number *

Authorized Pickup

Enter the name(s) of those authorized to pick up your child *

How Did You Hear About Us

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How the CORE4 Camps work:

• Each week of camp will have a focus on one of the CORE4 skills, yet campers will rotate through all of the CORE4 throughout the week, each day learning new skills, participating in team activities, games and challenges. Campers will learn leadership skills, build new friendships, work on financial literacy, as well as develop healthy eating and fitness habits. They will have fun and learn so much!

• Campers can sign up for multiple weeks and experience different aspects of Core 4. Each week, the campers will go on a field trip related to the weekly theme. Speakers and experts will work with campers to develop Core 4 skills. They get individual attention and mentorship!

• If campers miss a week and would like to come back, the themes are offered a few times throughout the summer. If campers liked a certain week, they can come back and experience new skills and activities around that theme. Every experience is different! Each week is a new adventure.

• Campers will collaborate and work together on the weekly community service projects. They learn to give back to the community and understand the importance of service.

Location:  1633 N. Cleveland, Chicago (Old Town) St. Michael's Church Recreation Center
Hours:   Monday - Friday: 9:00am - 3:00pm
Pricing:   Lunch Included!
Single Week = $395 (This EARLY BIRD RATE is extended through May!)
Select 4 or more weeks = Save $100 off total price! (enter code: 4weeks)
Select all 8 Weeks = Save $300 off total price! (enter code: 8weeks)

Sibling Discount 10% (enter code: sibling)

Select Week(s)

6/12 - 6/16 - Week 1: Ninja Sports & Fitness - (FITNESS) Work with professional trainers at fitness club & get CPR certifciation

6/19 - 6/23 - Week 2: Director's Chair - (FRIENDSHIPS) Create & Direct the CORE4 YouTube Channel

6/26 - 6/30 - Week 3: Food Truck - (FOOD) - Building a CORE4 Food Truck

7/10 - 7/14 - Week 4: Live Your Own Life - (FINANCES) - Be an entrepreneur, learn how to launch a business in the Shark Tank Challenge

7/17 - 7/21 - Week 5: DJ Sports & Dance - (FITNESS) - Use sports & music to learn about fitness

7/24 - 7/28 - Week 6: GameCraft - (FRIENDSHIPS) - Create a live-action video game using visual arts like building, painting, drawing and more!

7/31 - 8/4 - Week 7: Chef Week - (FOOD) - Day of cooking with chefs, create personalized cook book

8/7 - 8/11 - Week 8: Life on Mars - (FINANCES) - You colonize mars

Current Total:

$0.00

Enter Quantity Discount Code:
(if registering for 4 weeks or more enter code 4weeks; if registering for 8 weeks enter code: 8weeks)

Enter Discount Code

Enter Sibling Discount Code:
Enter code sibling if child is family member of another registrant(s)

Total:

$0.00

Do you need Early Drop Off / Late Pick Up ($10 per hour & Invoiced at time of camp)

Early Drop Off - 8:00am - 9:00am

Late Pick Up - 3:00pm - 4:00pm

Camp Waiver and Release Form

Please read the standard CORE4 written policies and waiver below and check the box to acknowledge full understanding and acceptance of policies (required):

Waiver for Participation:

I understand that CORE4 Skills, Inc. (CORE4) activities may have certain inherent risks and I hereby assume all risks and hazards that may occur as a result of my child’s participation in all CORE4 programs and facilities, including transportation to and from said activities. I further release, absolve, indemnify and agree to hold harmless, CORE4, the organizers, supervisors, directors, staff, teachers, trainers, volunteers, participants, as well as persons or parents transporting participants to or from such activities from any claims or injury sustained in use of CORE4 facilities or participation in any CORE4 activity, whether located on CORE4 property or not. I further agree, by participating in any CORE4 activity with, CORE4 shall not be liable for any direct, indirect, special, incidental, consequential, or exemplary damages, for any injury or harm to me or my child, incurred in, on, or around the property where CORE4 activity(s) occurs.

CORE4 Skills Inc. (CORE4) Policy:
Parents have the obligation to disclose to CORE4, any significant, medical, physical or behavioral issues of the child at the time of the child’s enrollment and on an ongoing basis for any significant changes thereto. Due to the large group format of our program, we are unable to provide one-on-one care for any child except on an intermittent basis, such as injuries, immediate disciplinary issues and certain personal care needs customarily provided to other children.

Waiver for Medical Treatment:
In the event that my child requires emergency medical treatment and I cannot be reached, I hereby authorize CORE4 staff to make arrangements to transport my child to the nearest hospital / emergency medical facility or clinic. I give my written consent for any and all necessary medical care treatment for my child during this time.

Waiver for Photo / Video / Audio Release:

I give my consent for any photos, video and/or audio taken of my child involved in C4S programs to be used solely for C4S promotions, trainings and/or displays. I understand that C4S will own the photographs and videotape and all right to use or reproduce such photographs and video, in any media, as well as the right to edit or prepare derivative works thereof, only as necessary for editing purposes, and solely for C4S business purposes.

By Checking this box I agree and accept all terms of CORE4 Camp Waiver AND confirm that I am the participant's parent or legal guardian. *

I agree

PRINT Camper name(s) *