2025 Wonderful World of Wizardry Club 45

Where Faith and Science Coexist

June 23 – 27, 2025
9:30 – 12:30

CLUB 45 (4^TH & 5^TH Grades)

Our annual, weeklong Summer Camp is a fun morning with science experiments, games and activities, crafts, music and stories.

Our Club 45 camp is for kids in 4^th and 5^th grades. They will have special adventures throughout the week and fun competitions. They will walk off the campus at different times for scavenger hunts downtown and field games at Toby Atwell Park (Old Waterford Road behind the Senior the Center).

Kids will get an introduced to a story from the Bible each day and learn how Jesus calls us to follow him by loving our neighbors and treating others how we want to be treated.

Our trained and experienced groups of paid and volunteer staff will ensure your child has a blast as they explore the Wonderful World of Wizardry!

This form is for kids in 4^th & 5^th grades only.
Use this form for younger kids and this form to volunteer.

$40 per child through April 20
$50 per child April 21 - Memorial Day
$60 per child May 27 - June 15

Leesburg United Methodist Church
107 W. Market Street
Leesburg, Virginia

Parent Guardian Name

This address will receive a confirmation email

Phone

Address

Church Affiliation, if any (optonal)

Emergency Contact Name

Mobile

Other Adults who will pick up child(ren) (optional)

Registration

Child 1

Child 1 Name

Gender

Current Grade (2024-25)

Please share Medical or Allergy concerns

Child 2

Gender

Current Grade (2024-25)

Please share Medical or Allergy concerns

Child 3

Child 3 Name

Gender

Current Grade (2024-25)

Please share Medical or Allergy concerns

Child 4

Child 4 Name

Gender

Current Grade (2045-25)

Please share any medical or allergy concerns

Special Request

Please indicate any friends that your child would like to be placed with. We do our best to meet all requests

Cancellation and Refund Policy

In registering my child today, I fully expect that they will participate in June. If our plans change, we will notify the camp as soon as possible (email: angela@leesburgumc.org) Cancellations made prior to April 30 may receive a full refund Cancellations made between April 30 and May 31 may receive a 50% refund Cancellations made after May 31 cannot be refunded

I understand the Cancellation policy

Would you or a family member like to volunteer? (optional)

Youth volunteers must have completed 6th grade. All volunteers are asked to participate in training at 11 am on Sunday, June 8 to include Child Protection Policy requirements. Everyone over 18 must complete a background check application (no charge to you); this will be part of the training. Online training will be made available - in person is always preferred.

Yes (please complete form linked in the Confirmation email) Not this year

Waivers

I acknowledge that Club 45 groups may leave the premises of Leesburg United Methodist Church, by foot and in groups, during Vacation Bible School with counselor supervision, and hereby grant my child permission to go and participate with the group. I understand that my child is responsible for being self-controlled, following all safety instructions and staying with the group at all times. I understand that failure to comply may result in removal from the program.

Leesburg UMC has my permission to use my or my child’s photograph publicly to promote VBS. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

Yes No

I affirm that I will not send my child if any of the following apply: 1) A fever of 100.4 degrees F or higher in the past 24 hours. 2) Any Nausea, Vomiting or Diarrhea.

I understand and will abide by the sick policy

Under the terms of this Agreement and sufficiency of which is hereby acknowledged, do hereby release and forever discharge Leesburg United Methodist Church including their agents, employees, successors and assigns, and their respective heirs, personal representatives, affiliates, successors and assigns, and any and all persons, firms or corporations liable or who might be claimed to be liable, whether or not herein named, none of whom admit any liability to the undersigned, but all expressly denying liability, from any and all claims, demands, damages, actions, causes of action or suits of any kind or nature whatsoever, which I now have or may hereafter have, arising out of or in any way relating to any and all injuries and damages of any and every kind, to both person and property, and also any and all injuries and damages that may develop in the future, as a result of or in any way relating to participating in church sponsored or promoted events and activities. It is understood and agreed that this Agreement is made and received in full and complete settlement and satisfaction the causes of action, claims and demands mentioned herein; that this Release contains the entire Agreement between the parties; and that the terms of this Agreement are contractual and not merely a recital. Furthermore, this Release shall be binding upon the undersigned, and his respective heirs, executors, administrators, personal representatives, successors and assigns. This Release shall be subject to and governed by the laws of the State of Virginia. This Release has been read and fully understood by the undersigned and has been explained to me and remains in effect until June 30, 2026.

As parent/guardian, I consent

Parent/Guardian Name as Signature

Payment

We strive to keep our VBS camps accessible to all with low registration fees while seeking to provide high quality programs to help you and your children grow in faith. You can make a tax deductible contribution here, in addition to your fees, to help us serve our community.

Tax Deductible Donation

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

2025 Wonderful World of Wizardry Club 45

Description

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