Golden Rams Adventure Day Camps Registration Packet

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Kelly Newman
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1 Golden Rams Adventure Day Camps Registration Packet Welcome to Golden Rams Adventure Day Camps! We are so excited that you are joining us for this wonderful opportunity this summer! Located on West Chester University s Campus, Golden Rams Adventure Day Camps utilizes West Chester University s many resources to bring exciting opportunities to your campers. Make this summer your best summer! Camp Rules and Regulations 1) Show respect to all camp staff, campers, facilities, and materials used during camp. 2) Campers must stay with their group the entire camp day. 3) Campers must use appropriate language at all times. 4) Bullying of any kind is not permitted! 5) Sneakers must be worn at all times. 6) Campers are not permitted bring electronics or toys from home. 7) Campers are responsible for cleaning up after themselves. Cell Phone Policy Campers are not permitted to use cell phones, ipads, tablets, etc. during camp instructional time. If a camper is observed using a cell phone, ipad, tablet, etc. the item will be collected by the camp counselor and locked in a safe and remain in the safe for the duration of the day. Phones will be returned at the end of the camp day. Gold Rams Adventure Day Camps may designate specific times for phone usage. What to Bring (With the exception of sneakers, please clearly label all materials your camper brings with their first and last name.) Lunch Morning Snack Afternoon Snack Water Bottle Sneakers (No Flip Flops) Sun Screen University Student Housing, LLC is not responsible for lost, stolen, or damaged items.

2 Typical Camp Schedule 7:30 AM 8:45 AM Before Care (See our Before and After Care policy for costs) 8:45 AM 9:00 AM Camper Arrival 9:00 AM 9:20 AM Morning Announcements 9:30 AM 10:15 AM Session 10:15 AM 10:30 AM Morning Snack Break 10:30 AM 11:45 AM Session (or Activity) 12:00 PM 1:00 PM Lunch and Outdoor/Free Activity 1:15 PM 2:00 PM Session (or Activity) 2:00 PM 2:15 PM Afternoon Snack Break 2:15 PM 3:00 PM Session (or Activity) 3:15 PM 3:30 PM Afternoon Announcements 3:30 PM 4:00 PM Camper Departure 4:00 PM 5:30 PM After Care (See our Before and After Care policy for costs) Sign-In Policy Parent/Guardian will drop off their camper every day at a specific location which will be included in your confirmation correspondence. Parent/Guardian will sign camper in with Golden Rams Adventure Day Camps staff. Camper will be escorted to morning activity following morning announcements. Sign-Out Policy Parent/Guardian will drop off their camper every day at a specific location which will be included in your confirmation correspondence. Only a camper s parent/guardian or an adult on the approved pick up list will be allowed to pick up the camper. A photo ID must be presented to Golden Rams Adventure Day Camps staff at time of pick up. Staff Each camp will be staffed with a professional instructor and trained camp counselor staff. All camp counselors are certified in First Aid and CPR.

3 Payment Each full day camp is $295 per week/per camp/per child. Campers may sign up for Extended Care at $35 per week/$10 per day/per child. The full camp payment is due two weeks prior to your scheduled camp. Cancellation Policy Permanent withdrawal from a week of camp will result in Cancellation fee of $50 per/week/per camp/per child. No refunds are available after the start of camp. If a camp needs to be cancelled for any reason, USH will make that decision by June 1 st and notify all campers registered for camp. Extended Care Extended Care will be available for campers. Campers will sign-in or sign-out at the normal daily location. During this time, campers will engage in free choice activities, such as arts & crafts with a Golden Rams Adventure Day Camps Staff while they await the start of camp or to be picked up. Hours will be: Before care 7:30AM 8:45AM / After care 4:00PM 5:30PM $35per week / $10 per day/per camp/per child Payment for Before and After Care is due with final camp payment For more information, please contact Chris Hutelmyer, Day Camp Manager, at (610) or at chutelmyer@ushcommunities.org In order to complete your child s application please complete and return prior to the start of camp the Emergency Contact Form and Medical Information Form as well as the remaining camp payment. Completed forms and payments should be mailed to: Chris Hutelmyer 180 University Avenue West Chester PA, 19383

4 Emergency Contact Form Camper Information: Child s Name: M or F: Date of Birth: Camp: Week: Primary Guardian s Information: Primary Guardian s Name: Cell Phone: Address: Address: Home Phone: Employer: Employer s Phone: Relation to Camper: Primary Guardian s Information: Primary Guardian s Name: Cell Phone: Address: Address: Home Phone: Employer: Employer s Phone: Relation to Camper: List persons who can either pick up and/or assume responsibility for your child in the event of an emergency if parents cannot be reached. Any adult who may pick up the child, aside from the primary and secondary guardian, should be listed here. Anyone picking up a child must show their driver s license during pick up time: Photo Release: By signing this agreement, I hereby give University Student Housing, LLC permission to take photographic images of my camper for the use of USH marketing material including, but not limited to print and online media. Signature: Date / / Please return form to: Chris Hutelmyer 180 University Avenue, West Chester, PA 19383

Medical Form Insurance Information: Policy Number Name of Health Insurance Provider Primary Physician Address Phone Does your child have any health concerns (chronic conditions, behavioral, emotional

Does your child require any medication to remain on site during the camp day? If yes, please include an index card with specific instructions for the medication.

5 Medical Form Insurance Information: Policy Number Name of Health Insurance Provider Primary Physician Address Phone Does your child have any health concerns (chronic conditions, behavioral, emotional or challenges?) Is your child presently being treated for an injury or sickness, or taking any form of medication for any reason? Does your child require any medication to remain on site during the camp day? If yes, please include an index card with specific instructions for the medication. All medication must be in original containers and placed in a sealed bag with the index card included. The bag must be clearly labeled with camper s first and last name. Each individual medication should have an index card. Is your child allergic to any type of food or medication? _ I hereby give my permission to University Student Housing, LLC and West Chester University (collectively, the Releasees) to submit my child and/or dependent minor to a qualified physician, staff, and/or hospital emergency room to administer medical care in the case of an accident and/or emergency if the Releasees should determine in their sole discretion that such care is necessary or appropriate. I am aware that accidents, fatalities, serious bodily injury and/or property damage can occur during the summer camp activities as a result of negligence or otherwise and hereby hold Releasees harmless for any and all injuries or damages that occur as a result of my child s or dependent minor s participation in camp activities and I do, for myself, my heirs, executors and administrators, remise, release, waive and forever discharge Releasees and all of their officers, agents and employees, acting officially or otherwise, from all claims demands, actions, or causes of action, on account of any injury, death or property damage which may occur at any time or for any cause during their participation in a camp or event. It is agreed that this waiver of liability is submitted to University Student Housing, LLC, as an inducement to include my child and/or dependent minor in this event and that this agreement is signed as the undersigned s free and voluntary act with full knowledge of the contents of the agreement. Further, I represent and warrant that I am authorized to sign this signature as the parent or legal guardian of the child or dependent/minor. Parent Signature Date / / Please return form to: Chris Hutelmyer 180 University Avenue, West Chester, PA 19383

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