Registration & Payment Form | Wellness Gaines Fit

Camp Gaines 2025 Pre-Registration Form

Dates: June–August | Time: 9:00 AM – 2:00 PM

Location: Wellness Gaines Fitness, Renton, WA

Ages: 6-12

Welcome!

Thank you for your interest in Camp Gaines 2025 — where movement meets mindfulness and learning turns into fun! Our summer program is designed to keep kids active, engaged, and supported in a positive, structured environment.

Please fill out the form below to register and submit payment. Spots are limited and confirmed only once payment is received.

Pricing & Discounts

$275/week Early Bird Rate (through June 1)
$300/week Standard Rate (after June 1)
$220 for the 4-day week: June 30–July 3
Payments are non-refundable
All campers must bring their own nut-free lunch and water bottle daily

You will select your week(s) below and complete payment at the bottom of this form.

Parent/Guardian Information

First name

Parent/Guardian First Name

Last name

Parent/Guardian Last Name

Email

We’ll send all confirmation details and updates here.

Phone

Best number to reach you in case of questions or emergencies.

Address

Camper Information

Child’s Full Name

First and last name of the camper you’re registering.

Child’s Age

How old will your child be at the time of camp?

T-Shirt Size

Additional Child Information (Optional)

Add the name(s), age(s) and T-shirt size(s) of any additional siblings you'd like to register.

Week Selection & Payment

Select one or more weeks.

Camper Needs & Safety

Allergies, Medical Conditions, or Medications?

Please list any food allergies, medical needs, or anything our staff should know.

Any Special Needs, Accommodations, or Notes?

Any specific needs, preferences, or info you'd like to share?

Emergency Contact Name

Emergency Phone Number

Relationship to Camper

Authorized Pick-Up List (Full Name & Relationship)

List up to 3 names (must show photo ID at pickup)

Waiver + Terms Agreement

I understand that my payment is non-refundable and secures my child’s place for the selected week(s) of Camp Gaines.

I understand that camp hours are from 9:00 a.m. to 2:00 p.m. and agree to drop off my child no earlier than 8:50 a.m. and pick up promptly by 2:00 p.m.

I understand that late pickups will result in a fee of $1 per minute after 2:05 p.m., billed to the parent/guardian. After 2:20 p.m., if the child has not been picked up, emergency contacts will be called.

I understand that my child must bring their own nut-free lunch and a water bottle each day.

I understand that disruptive or unsafe behavior may result in my child being dismissed from the program, and that no refunds will be given in such cases.

I give permission for Wellness Gaines staff to apply basic first aid (e.g., Band-Aids, ice packs) if needed. In case of emergency, I authorize staff to contact 911 and administer necessary aid until I arrive.

I agree to receive communications from Wellness Gaines regarding this registration. I authorize Wellness Gaines to communicate with me via email or phone regarding camp updates.

I confirm that only the listed individuals are authorized to pick up my child, and that a valid photo ID is required at pick-up.

Select Your Camp Week(s):

June 23–27 $275

June 30–July 3 (4-day week)$220

July 7–11$275

July 21–25$275

July 28–August 1$275