Project 61 2025 Registration

Camp Information

Si necesita ayuda para completar este formulario, envie un mensaje al (918-417-2624).
Project 61 Camp Schedule
Tuesday - Friday
10:30 AM - 2:30 PM. Students will be fed lunch

Campers must be at least 6 years old and entering the 1st grade.

*All camper family members are invited to the Project 61 Showcase on Friday evening to celebrate their campers' accomplishments.*

Student Information

Name

Gender

Male Female Prefer not to say

Birthdate

Which races or ethnicities best describe your student?

White/Caucasian Black/African American Hispanic/Latino Native American Asian/ Pacific Islander Other Prefer not to say

Please list any of the following: current medications, medication allergies, food allergies, or chronic health conditions.

Is your student enrolled in SoonerCare or Medicaid?

Yes No Other Uninsured Prefer not to say

Other

Education

Please indicate the grade your student will be this Fall

Grade

Other

What are your student's strengths? What do they especially enjoy doing?

Does your student have any behavioral challenges, learning disabilities, etc?

Does the student have an IEP or 504 plan? Yes No

If yes, please explain what the IEP is for and what accommodations are included in the IEP or 504 plan.

Students must be toilet trained to participate.

Yes, the student is toilet trained. No, the student is not toilet trained.

The following information will help us better serve your student and provide us with helpful data for grant funding. Your answer to this question will not affect your student's eligibility for this program.

Has your student previously attended Project 61?

Yes No I Don't Know

Has your student participated in extracurricular sports or arts programs at school?

Yes No Tried out but did not make it

Was your student suspended from school at any point during the last school year?

Yes No Prefer not to say

Has your student ever been involved in the juvenile or criminal justice system (e.g., been arrested, charged, or placed on probation)?

Yes No Prefer not to say

Contact Information

Student's Address

Student lives with (choose all that apply)

Mother Father Grandma Grandpa Other relative(s) Other non-related adult(s) Foster parent(s)

Does student have siblings in the same household who will also be attending the program?

Yes No

Names of siblings attending the program:

Parent/ Guardian Information

Parent/ Guardian Name

Are you the parent or legal guardian of this student?

Yes No

Parent/ Guardian Primary Phone

Do you give permission for One Hope to text information about the program to this number?

Yes Use Parent/Guardian #2 phone number instead

Parent/ Guardian Primary Email

This address will receive a confirmation email

Parent/ Guardian Address (if different from student's)

Parent/ Guardian 2 Name

Parent/ Guardian 2 Primary Phone

Parent/ Guardian 2 Email

This address will receive a confirmation email

Parent/ Guardian 2 Address (if different from student's)

Emergency Contact

Emergency Contact Name

Emergency Contact Number

Emergency Contact Relationship to Student

Emergency Contact 2 Name

Emergency Contact 2 Phone

Emergency Contact 2 Relationship to Student

Transportation Request

We are able to offer limited transportation to and from camp for those within a 2-3 mile radius of the Rose Bowl.

If you would like to request transportation, please indicate so below.

Pick-up/ Drop-off will be at 1:10 and 4:45.

My student's transportation plan:

My student has transportation My student will walk My student needs One Hope Transportation

Where does your student need transportation from?

Please list the names of anyone you authorize to pick up student. Parents/guardians and emergency contacts listed on this form may always pick-up students. Anyone picking up a student may be asked to show photo ID.

Please list the names of anyone who is NOT authorized by you to pick-up student.

Does your student have permission to walk home from the Rose Bowl? Note: if a student wishes to walk home early, director must make contact with student's parent.

Yes No

Releases and Late Policy

RELEASE OF LIABILITY: I, parent/guardian of the above-mentioned student, give my permission for him/her to participate in One Hope Summer Programs and I release the One Hope staff and volunteers from liability in the case of any kind of injury or harm that could occur during or due to my child's participation. I authorize the One Hope staff and volunteers to give my child emergency medical care and to transport him/her to and from places where such care can be provided and to authorize such care as they deem necessary. I also give permission for my child to be transported to and from One Hope's programs including Resilient Kids and to and from events, activities, and field trips associated with One Hope, formal or informal. Further, I agree to abide by the policies of One Hope in relationship to Resilient Kids and other One Hope events and activities.

Do you consent to the above statement?

Yes, I understand and give my consent.

MEDIA RELEASE: I also give my consent for One Hope staff or persons given permission by One Hope staff to use photos, videos, stories, and/or audiotape that feature or include my child and to use work done by my child as well as my child"s first name for the purpose of publicizing and promoting One Hope Ministry. I understand that these images, text, or recordings maybe be published in newspapers, magazines, or on the internet, may be broadcast on television or radio, may be utilized in One Hope fund raising efforts and/or may be presented in One Hope information or promotional materials or presentations or used however One Hope sees fit.

Do you consent to the above media release?

Yes, I give my full consent to the above media release. I give consent for my student's photos and videos to be used ONLY INTERNALLY, such as printing photos to be hung in the classroom. I do not consent to their photo being shared on social media.

Late Pick-Up Policy

Camp ends at 2:30 and campers must be picked up by 2:45PM.

Do you agree to the late policy?

Yes No

Note: One Hope Tulsa reserves the right to determine camper enrollment status.

Project 61 2025 Registration

Description

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