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Group Classes
CLASS SCHEDULE
STRENGTH & CARDIO
YOGA
PILATES
BARRE
CYCLING
SENIOR FITNESS
AQUA FITNESS
FAST FEED TENNIS
Personal Training
One On One
Small Group Training
Pilates Reformer
Dynamic Stretch
Sports
Swimming
Tennis
Pickleball
Racquetball
Basketball
Junior Sports
Kids & Family
Camps
Fun FACtory
Preschool
After School
Events
Birthday Parties
Pool Parties
Massage
Dynamic Stretch
About Us
Location
Juice Bar
Employment
Membership
Access Pass
Leadership
Policy & Rules
Contact Us
Member Login
Membership
Access Pass
Group Classes
CLASS SCHEDULE
STRENGTH & CARDIO
YOGA
PILATES
Barre
CYCLING
SENIOR FITNESS
AQUA FITNESS
FAST FEED TENNIS
Personal Training
One on One Training
Small Group Training
Pilates Reformer
Dynamic Stretch
Sports
Swimming
Tennis
Pickleball
Racquetball
Basketball
Junior Sports
Kids & Family
Fun FACtory
Preschool
After School
Camps
Events
Birthday Parties
Pool Parties
Massage
Dynamic Stretch
FAC News
Courtside Café
About Us
Location
Juice Bar
Employment
Membership
Access Pass
Leadership
Policies & Rules
Contact Us
Menu
Member Login
Membership
Access Pass
Group Classes
CLASS SCHEDULE
STRENGTH & CARDIO
YOGA
PILATES
Barre
CYCLING
SENIOR FITNESS
AQUA FITNESS
FAST FEED TENNIS
Personal Training
One on One Training
Small Group Training
Pilates Reformer
Dynamic Stretch
Sports
Swimming
Tennis
Pickleball
Racquetball
Basketball
Junior Sports
Kids & Family
Fun FACtory
Preschool
After School
Camps
Events
Birthday Parties
Pool Parties
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Summer Camp 2024 Registration
2024 Hog Star Summer Camp - Camper Information (ages 5-12 years)
Child's Name
(Required)
First
Last
Birth Date
(Required)
Month
Day
Year
Age as of June 1, 2024
(Required)
5 years old
6 years old
7 years old
8 years old
9 years old
10 years old
11 years old
12 years old
Grade entering Fall 2024
(Required)
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Primary Parent/ Caregiver Name
(Required)
First
Last
Relationship to child:
(Required)
1st Parent/ Guardian Cell Phone
(Required)
Home Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Primary Parent/ Caregiver's Place of Employment
(Required)
Work Phone
(Required)
1st Parent/ Caregiver Email
(Required)
Secondary Caregiver Name
First
Last
Secondary Caregiver Cell Phone
Email
Secondary Caregiver Address
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Secondary Parent/ Cargiver's Employer
Secondary Parent/ Caregiver Work Phone
EMERGENCY CONTACT /NAME OF PERSON TO CALL IF PARENTS CAN NOT BE REACHED
(Required)
Emergency Contact Cell Phone
(Required)
Emergency Contact Email
(Required)
Emergency Contact Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Is the emergency contact authorized to take the child from FAC?
(Required)
YES
NO
List all other adults who are authorized to take the child from the center:
Name
First
Last
Relationship
Cell Phone
Name
First
Last
Relationship
Cell Phone
Name
First
Last
Relationship
Cell Phone
Select weeks camper will be attending
(Required)
Please visit our Summer Camp 2024 Guide (linked above) to review our 2024 Summer Camp Field Trips!
Week 0 - May 28-31, 2024 (closed Monday/Memorial Day)
Week 1 - June 3-7 - (Field Trips including Altitude, Siloam Springs Aquatic Center, Gulley Park, & Veterans Park)
Week 2 - June 10-14 - (Field Trips including Lake Fort Smith & Springdale Aquatic Center)
Week 3 - June 17-21 - (Field Trips including Lokomotion, Tyson Park, Wilson Park & Wilson Pool)
Week 4 - June 24-28 - (Field Trips including Ozark Lanes, Willie George Park, Melvin Ford Pool, & Orchards Park)
Week 5 - July 1,2,3,5 - (Field Trips including Malco, Gator Golf, Bentonville Community Center, & 28th St Park)
Week 6 - July 8-12 - (Field Trips including Devils Den, Crystal Bridges, & Osage Park)
Week 7 - July 15-19 - (Field Trips including Parrot Island, Carol Ann Cross Park, Prairie Grove Aquatics Center, & Battlefield Park)
Week 8 - July 22-26 - (Field Trips including Fast Lanes, Rogers Aquatic Center, & Railyard Park)
Week 9 - July 29-Aug 2 - (Field Trips including Amazeum, Ozark Nature Center or Beaver Lake & Roller City)
Week 10 - Aug 5 - 9 - (Field Trips including SkyZone, Jones Center, & Shogun)
Select All
Consent
(Required)
I understand that my child will be attending the field trips listed above and will be transported by the FAC buses and/or vans. I grant the Fayetteville Athletic Club team permission to transport my child to/from these locations. I also understand that I may NOT pick up my child from the field trip location(s). Please sign below.
Signature
(Required)
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Camper Medical Information
Allergies? (n/a if none)
(Required)
Physical or Emotional Concerns Your Child May Have:
Special Food Needs?
Prescribed Diet:
Other Conditions or Comments?
Please Select All of The Following Conditions/Illnesses That Your Child Has Had:
Measels
Chicken Pox
Defective Heart
Frequent Ear Infection
Diabetes
Mumps
Whooping Cough
Sun Sensitivity
Frequent Throat Infection
ADD/ADHD
German Measels
Positive TB Test
Fainting Spells
Frequent Colds
Temper Tantrums
Hospital Emergency Room of Choice:
(Required)
Phone
(Required)
Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
I, (mother/father/guardian), do hereby give my consent to the Director of the Child Care facility, or his/her representative, for said child to receive medical or surgical aid as may be deemed necessary and expedient by a duly licensed or recognized physician or surgeon in case of emergency when parent/guardian can not be reached. Consent is also given for the Director or his/her duly appointed representative to transport said child for emergency medical treatment, if the parents cannot be reached. Please sign below.
(Required)
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I give, or do not give the Director of the Kid's FACtory or his/her appointed representative, permission to give my child Acetaminophen. I understand that I will be notified if that medication has been administered
(Required)
YES
NO
Signature
(Required)
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I give, or do not give the Director of the Kid's FACtory or his/her appointed representative, permission to use sunscreen/ suntan lotion on my child, when weather permits. I understand that school age children may apply sunscreen to themselves with supervision.This consent is in accordance with Minimum Licensing Requirements: DCCECE/ Child Care Licensing Unit: 1100.1101.17
(Required)
YES
NO
Signature
(Required)
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ACKNOWLEDGMENTS
This is a statement of verification that I have been informed that child care licensing/ child maltreatment investigators and/or law enforcement may possibly interview my child for the purpose of determining licensing compliance or for investigative purposes. This is accordance with Minimum Licensing Requirements: DCCEDE/ Child Care Licensing Unit: 200.201.4
Signature
(Required)
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Consent
(Required)
This is to acknowledge that I have received and will comply with the rules as stated in the Kids Fun FACtory Parent Handbook.
Consent
(Required)
I have been informed of the behavior guidance policy practiced.
Consent
(Required)
I understand that I may ask for a conference with the caregiver(s) as needed.
Signature
(Required)
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Discipline Policy
(Required)
The discipline policy of the Fayetteville Athletic Club, Kids Fit Fun FACtory will be that any time a child's behavior jeopardizes the safety of him/herself, others or is acting in a disruptive manner, the child will be removed from the class or program. The Kids FACtory uses "timeout" to encourage good behavior. A child who has been given a "timeout" will be taken out of the group/class participation and must sit alone quietly under staff supervision for 1 minute for each year of age. After the 2nd offense, another timeout will be given. Following a 3rd offense, the child will be sent home for the remainder of the day. The parents and child will need to schedule a conference with the Director to discuss the issue. Continuous or more serious behavior issues may result in suspension/ pending termination from the Kid's Fit Fun FACtory program. I understand and agree to comply with the Discipline Policy.
Signature
(Required)
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CAMP PHOTOGRAPHY
We will be taking pictures throughout the year to capture the action and adventure of our Kids FACtory programs. I hereby grant permission to Fayetteville Athletic Club to use photographs and/or video of my child(ren) taken during FAC programs, in publications, news releases, online, and in other communications related to the Kid FACtory programs.
SELECT YES OR NO
(Required)
YES
NO
Signature
(Required)
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FAC WAIVER RELEASE STATEMENT
(Required)
I agree to the Fayetteville Athletic Club's Waiver release statement. By signing this form, I understand that I am releasing all claims for injury, I or my child may sustain through any of our programs. I agree to assume full risk and to waive, relinquish, and release all claims I and/or the participant may have against, indemnify, hold harmless and defend the Fayetteville Athletic Club. This release includes FAC officers, agents, servants, and employees from such claims resulting from injury, damages, or loss sustained while participating in the FAC program or event. I understand that I am responsible for all personal insurance and understand that I must cover any medical costs incurred for my family participating in this FAC program. I also understand that every precaution is taken to protect the safety of each participant.
Signature
(Required)
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SUMMER CAMP PAYMENT POLICY
The Registration fee, first full week of camp fees must be paid to register for your child(ren)'s first week of summer camp. Each subsequent week my be confirmed by placing a $25 non-refundable deposit on the week(s) that your camper will attend. The balance for each week that has a deposit will be billed for the balance, the Wednesday prior to the week of camp. This balance must be paid by a credit card or bank account on file with FAC. Payments must be received for your camper to attend camp. Non-payment by the required due dates will result in relinquishing the camper's space in the program. FAC Junior Membership are required for each camper to receive the Member discount for our summer camp program. Changes or cancellation requests must be received a minimum of 2 weeks prior to the start of camp and must be made in writing to the Director. FAC member discounts will be voided and additional charges will occur if the FAC Junior membership is canceled at any time during the program duration. A $25 returned payment fee will be applied to any returned payments. Fayetteville Athletic Club accepts, Visa, Master Card, Discover, American Express, bank drafts and checks. I agree to abide by the Billing policy that has been presented.
Name as it appears on your credit card
(Required)
Credit card type
(Required)
VISA
Mastercard
Discover
American Express
Credit card number
(Required)
Expiration date
(Required)
CVV
(Required)
Signature
(Required)
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CHOOSE YOUR WEEKS - Please remember that your registration fee, your first full week of camp and all deposits for additional weeks must be paid at the time of enrollment to reserve your spots.
(Required)
REGISTRATION FEE $30
WK 0-May 28-31 $159 Member/ $191 Guest (holiday wk)
WK 1-June 3-7 $199 Member/ $239 Guest
WK 2- June 10-14 $199 Member/ $239 Guest/ $25 deposit
WK 3- June 17-21 $199 Member/ $239 Guest/ $25 deposit
WK 4- June 24-28 $199 Member/ $239 Guest/ $25 deposit
WK 5- July 1,2,3& 5 $159 Member/ $191 Guest/ $25 deposit
WK 6- July 8-12 $199 Member/ $239 Guest/ $25 deposit
WK 7- July 15-19 $199 Member/ $239 Guest/ $25 deposit
WK 8- July 22-26 $199 Member/ $239 Guest/ $25 deposit
WK 9- July 29-Aug 2 $199 Member/ $239 Guest/ $25 deposit
WK 10- Aug 5-8 $199 Member/ $239 Guest/ $25 deposit
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