United Learning Summer Camp Application

Thank you for your interest in the 2021 United Learning Summer Camp. We are pleased to offer a number of fun and interactive camps for children in grades K-8. Please submit an application for each child you wish to enroll in the 2021 United Learning Summer Camp.

Important Information about the United Learning Camp program:

  • Camp runs 9:00am – 4:00pm daily at UCHM (150 South State Street, Louisville, KY 40206)
  • Drop off is between 8:45am – 9:00am, Pick-up is between 3:45-4:05pm
  • The cost of the camp is a suggested donation of $100. This is not a mandatory payment and if you are unable to contribute we still welcome you to join us.
  • We provide an afternoon snack. Please bring a snack lunch.
  • Due to COVID-19, we follow all CDC guidelines to ensure that campers, staff and volunteers are safe, including required masks, social distancing, temperature checks, and screening.
We collect this information for grant reporting purposes.
A donation is not required to attend our camp. We provide a suggested donation amount only if you are interested in financially contributing to our program and supporting our efforts monetarily.

Emergency Contact Information

Additional Persons Authorized to Pick-up My Child

Medical Information

These forms can list supports children use in schools to help them learn and strategies to help teachers understand behaviors.
Include nasal/respiratory, food, skin, any other our child has and please indicate the severity.

Camper Information

Please enter the grade that the child will be entering in the 2019-2020 school year. Children must have completed Kindergarten to be eligible for K-3 camps.
We collect this information for grant reporting purposes. Selection is optional if you wish not to identify.

Consent/Release

By checking each box you are providing your consent/release for each item.
The United Learning Summer Camp includes 2-3 field trips per week. If you wish that your child not attend field trips, we cannot guarantee that we will have a staff member to remain on site during field trips.

Payment

$ 0.00