Camp Gaines 2026 Registration Form

Name: Beginner Sneaker Tap Class – Fundraiser for Keep a Breast Foundation
Start: 2024-10-12T09:00:00-07:00
End: 2024-10-12T10:00:00-07:00
Location: Wellness Gaines Fitness

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.

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Welcome!

Thank you for your interest in Camp Gaines 2026 - 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

$200/week Standard Rate (After June 1)
$140 for the 4-day week: June 29 - 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.

Date of Birth

What grade will your child be in Fall of 2026?

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.

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.

Week Selection & Payment

Select Your Camp Week(s):

Week 1: June 22–26200 US$

Week 2: June 29–July 3140 US$

Week 3: July 20-24200 US$

Week 4: July 27-31200 US$

Week 5: August 3-7200 US$

Week 6: August 10-14200 US$

Signature

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Beginner Sneaker Tap Class – Fundraiser for Keep a Breast Foundation

sáb, 12 oct

|

Wellness Gaines Fitness

Tap your way to a great cause! Join us on October 12th at 9 AM for a fun, donation-based Beginner Sneaker Tap Class led by the amazing Pamela Yasutake. You can join us in person at Wellness Gaines Fitness or tune in virtually! All proceeds will benefit the Keep A Breast Foundation, supporting breast

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Beginner Sneaker Tap Class – Fundraiser for Keep a Breast Foundation

Horario y ubicación

12 oct 2024, 9:00 – 10:00 GMT-7

Wellness Gaines Fitness, 17110 116th Ave SE Unit A, Renton, WA 98058, USA

Acerca del evento

Join us on October 12th at 9 AM for an empowering and fun Beginner Sneaker Tap Class, part of our fundraising series for Breast Cancer Prevention Month! Led by the incredibly talented Pamela Yasutake—who has performed in Broadway’s Shuffle Along, with the Syncopated Ladies, and appeared in Unfrosted (Netflix) and Spirited (Apple TV+)—this class will get you moving for a great cause. Pamela will be working as a choreographer with the 5th Avenue Theatre for their upcoming season, so you’ll be learning from one of the best!

Whether you're a seasoned dancer or just starting out, Pamela will guide you through an exciting, energetic session that’s sure to inspire. Not only will you learn some new moves, but you'll also be supporting a vital cause. All proceeds from this event will go directly to the Keep A Breast Foundation, which is dedicated to reducing breast cancer risk and promoting prevention through education and action.

How to Participate:

In-Person: Join us live at Wellness Gaines Fitness for a high-energy, supportive environment! Don’t forget to wear PINK to show your support for Breast Cancer Awareness Month.
Virtual Viewing: Can’t attend in person? No problem! Join us virtually and tap along from the comfort of your home while still being part of this amazing cause.

Why Participate? This event is about more than just dance—it’s a chance to come together as a community to fight breast cancer. Whether you're here for the dance or the cause, every step helps make a difference. Your participation and donations will directly support the Keep A Breast Foundation’s mission of raising awareness and promoting prevention.

Event Details:📅 Date: October 12th, 2024🕘 Time: 9:00 AM – 10:00 AM

📍 Location: Wellness Gaines Fitness (In-Person) or Virtual Viewing🎗 Donation Link: Donation Link Here

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