CAMP SUNRISE LAKE CIT Registration

Transcription

1 2019 CIT Registration Morris County Park Commission Recreation Department Mailing Address: Morris County Park Commission, P.O. Box 1295, Morristown, NJ Telephone: Fax: Camp Address: 270 Mendham Road, Morris Township CIT Camp Hours: 8:30-4:00 ~PLEASE PRINT ALL INFORMATION CLEARLY IN BLUE OR BLACK INK~ CIT Information Last Name: First Name: Nickname: Gender: Male Female Age (as of 7/1/19): Birthdate: / / Grade (completed): Years attending Camp SRL (including this year): Sessions (Check all that apply): Week 1 (July 8-12) Child s Current Swimming Level: T-Shirt Size: Youth Small New to the Water Youth Medium Week 2 (July 15-19) Beginner Youth Large Week 3 (July 22-26) Intermediate Adult Small Experienced Adult Medium Adult Large Photo: Please attach a 2x3 photo of the CIT to this application. CIT Address Camper lives with: Both parents Mother Father Guardian(s) Home Address (Street): City, State, Zip Code: Home Telephone: ( )_ Contact Information Parent/Guardian 1 Name: Address: Home Phone: Cell Phone: Work Phone: Address (if different from camper): Parent/Guardian 2 Name: Address: Home Phone: Cell Phone: Work Phone: Primary Contact: Please print clearly, we will be primarily contacting you via Primary Phone Contact: Camp Sunrise Lake 2019 CIT Registration 1

2 Medical Information Name of Child s Physician: Phone:( ) Address: Name of Dentist/Orthodontist: Phone:( ) Address: Hospital of Preference: The closest hospital to Camp Sunrise Lake is Morristown Medical Center Insurance Information: Is the child covered by family medical/hospital insurance? Yes No A photocopy of the child s insurance card must be attached to this application. Name of Provider: Policy Number: List any known allergies: _ Describe the reaction and how it is managed: Is your child presently being treated for an injury or sickness or taking any form of medication? Yes No (Please note that Camp does not administer non-emergency medication to campers) If yes, please explain: Immunizations: Please indicate the correct statement. My child is up to date on all required medical vaccines as per the NJ School requirement for their appropriate age/grade. My child does not receive vaccines due to medical reasons or religious affiliations. Has/Does the participant: Wear glasses or corrective lenses? Yes No Have frequent ear infections? Yes No Have an attention or learning disorder? Yes No Have convulsions/epilepsy? Yes No Have diabetes? Yes No Have heart defects? Yes No Have a bleeding/clotting disorder? Yes No Have asthma? Yes No If yes to any of the above, please explain: Describe any other physical, mental, social, or psychological conditions requiring medication, treatment, restrictions, or considerations while at camp: Camp Sunrise Lake 2019 CIT Registration 2

3 Pick-Up Authorization The following people are authorized to pick up the camper (please INCLUDE parents and guardians in this list): 1) Name: Phone Number: ( ) Relationship: 2) Name: Phone Number: ( ) Relationship: 3) Name: Phone Number: ( ) Relationship: 4) Name: Phone Number: ( ) Relationship: 5) Name: Phone Number: ( ) Relationship: The following people are NOT authorized to pick up camper (please attach a copy of any Court Orders): 1) Name: Relationship: Situation: 2) Name: Relationship: Situation: Provide a Password: Please provide us with a password so that we may verify that we are speaking with or allowing your child to leave camp with someone you trust. Please only give this password to someone you would allow to pick up your child. PASSWORD: (you may use numbers and letters) Note: If any person other than those listed above is going to pick up your camper, a written note MUST be sent in that morning and given to the Counselor or ed as an attachment to recreation@morrisparks.net or the Camp Director. You must provide that person with your child s password. There are NO exceptions. Terms of Agreement Please initial next to all statements. A. Waiver: I hereby waive and release all rights and claims for damages against the Morris County Park Commission, County of Morris, and their employees for all injuries which may be sustained by the herein named minor while participating in the program. I understand the content of the program and the risks of personal injury therein. B. Medical Release: In the event of injury or serious illness if I/we as parents/guardians cannot be reached (and/or if there is a medical emergency requiring immediate action), I/we give permission for Camp Sunrise Lake to seek medical attention for my/our child. C. Photo Release: I authorize and acknowledge that my camper may be photographed and/or videotaped for educational and publicity purposes (slideshow, website, etc.). Photos and videos will not include names or personal information about any individual unless permission is granted. D. Refunds: I understand and acknowledge that Camp Sunrise Lake has a strict NO REFUND policy. Camp Sunrise Lake 2019 CIT Registration 3

4 Permissions Please Initial Each Box That Applies Sunscreen Permission: I give permission for a staff member or CIT to apply Sunscreen to my camper if necessary. YES Sunrise Lake Beach Club Permission: I give permission for my child to go swimming and use the Zoom Floom slides (inflated slides on the beach into the shallow water) and boats (lifejackets are always worn during this activity) at Sunrise Lake Beach Club. Note: Lifeguards will always be on duty when Camp is at the facility. YES Wibit Use: I give my permission for my child to use the WIBIT (an inflatable obstacle course in the lake) at Sunrise Lake Beach Club. I know my child must be 7 or older and pass the facilities swim test and will wear a lifejacket in order to use the WIBIT. Transportation: I give my permission for my child to be transported via bus or van to and from a trip/activity Payment Price: $200 per week, per CIT YES YES NO NO NO NO Payment Method: Check (enclosed) Check (mailed) Credit Card (call with payment) Camp Sunrise Lake 2019 CIT Registration 4

5 CIT Supplemental Information Camp Experience Please answer the following questions: 1. Have you been a camper at Camp Sunrise Lake in the past? Yes No 2. If yes, how many years? 3. If yes, what is your favorite memory from camp? 4. Have you attended other summer camps? About You Please answer the following questions: 1. Why do you want to be a CIT? What do you hope to gain from the experience? 2. What are your strengths? What are your weakness/challenges as a leader? Camp Sunrise Lake 2019 CIT Registration 5

6 3. Please provide a list of your extracurricular activities and experience with children. 4. Describe something you ve done that you are proud of. 5. Indicate what age group(s) you are most comfortable working with. 5-6 year olds 7-8 year olds 9-11 year olds 6. Indicate what activities you are comfortable leading. Arts and Crafts Sports Games Nature Science Boating Fishing Outdoor Skills Camp Sunrise Lake 2019 CIT Registration 6

7 CIT Agreement Terms of Agreement Please initial next to all statements. Training: I understand that if selected for the CIT Program, I must participate in mandatory CIT Training. If there is a conflict, a private training can be arranged, but the Camp Director must be alerted by July 1, Attendance: I understand that if selected for the CIT Program, I am expected to attend all 5 days of camp and arrive at the CIT start time of 8:30 AM. If there is a conflict, I will alert the CIT Counselor and Camp Director at least 30 minutes before start time. Behavior: I will abide by the Camper Discipline Policy, the CIT Policy and behavior expectations. I will serve as an assistant to the program and counselors while being a role model for campers. CIT Discipline Policy Camp Sunrise Lake CITs are held to a higher standard than the average camper. They will work one on one with campers, facilitate activities and games, and are awarded extra privileges and freedoms. CITs must: Be helpful and willing to perform camp tasks as delegated by the Camp Director and counselors Be friendly, outgoing, and cheerful Display maturity Display leadership with younger campers Facilitate group activities appropriately and enthusiastically CITs must NOT: Break any rules in the Camper Discipline Policy Be disrespectful to a camper, counselor, or Director Abuse privileges or authority Stray away from group or assigned area I,, have read, understand, and will comply with the Camp Sunrise Lake CIT Discipline Policy. Parent Signature: Date: CIT s Signature: Date: Camp Sunrise Lake 2019 CIT Registration 7

8 2019 Camper Discipline Policy At Camp Sunrise Lake, we seek to provide a safe and fun environment where all children are respected and have an equal opportunity for fun. You child s experience at camp will be an enjoyable and memorable learning experience. Our hope is to address behavioral problems that might impede this experience through our Discipline Policy. In the event that discipline becomes necessary, the following actions are standard and may be used in any combination during camp activities: Verbal Warning Time Out Exclusion from Activity Written Warning Incident Report Early Pick-Up Suspension and/or Removal from Camp (without refund) Please review the following guidelines with your child: Be safe: Always obey Camp and Lake rules and guidelines and the directions of staff. Show respect: Be respectful of the Camp and Lake Staff as well as other campers. Talk pleasantly: Foul language, sass, bullying, and putdowns will not be tolerated. Take care: Treat all equipment, supplies, and venues with proper care. No littering in the parks. Positivity: Have a positive attitude and have fun! Automatic suspension of one or more days, at the discretion of the Camp Director, will be given as a result of any of the following incidences, but is not limited to: Repeated bullying Threatening another camper or staff member Repeated use of foul/offensive language Stealing Possession of drugs/alcohol/cigarettes/lighters/stink bombs/firecrackers etc. Damaging park commission or private property (Parents and guardians will be responsible for repairs/replacement) In the event that drugs/weapons are found, the incident will be reported to the Morris County Park Police. The Camp Directors, at their sole discretion, may remove any camper whose behavior violates Camp Sunrise Lake s Discipline Policy or infringes/interferes with the safety or rights of others. If, at any time, a parent refuses to pick up their child from Camp, it may be considered abandonment and referred to the Morris County Park Police. I,, have read, understand, and will comply with the Camp Sunrise Lake Discipline Policy. Parent Signature: Date: Camper s Signature: Date: BOTH SIGNATURES ARE MANDATORY REGARDLESS OF CAMPER S AGE Camp Sunrise Lake 2019 CIT Registration 8

9 Policies Office Policies: Camp Sunrise Lake has a strict NO REFUND policy. Spots are given on a first-come, first-serve basis. No one will be entered into our database and spots will not be reserved without completed paperwork and payment. Campers are aged CITs must be years old. If all CIT spots fill up, year olds are welcome to register as campers. If you have any concerns or problems, please speak directly with the Camp Director. The Camp Director will then address the situation and correct the problem if possible. If further action needs to be taken, the MCPC Recreation Staff (Recreation Supervisor and Recreation Program Specialist) will become involved. Camp Policies: Due to the complexity of food allergies, we ask that all food brought to camp be NUT-FREE. Drop-off is at 9:00 AM and pick-up is promptly at 4:00 PM. There are no aftercare services available. Those who may need to drop-off their child earlier that 9:00 AM may enroll in the Morning Explorers Program that begins at 8:15 AM. CIT drop-off is at 8:30 AM sharp. Lunch should be packed separately from snack. No glass is allowed in lunch boxes. Pack a refillable water bottle, water will always be available. Cell phones and all other forms of technology are NOT allowed at camp. We ask for parent cooperation with this, as technology hinders campers from a full camp experience. Camp Sunrise Lake is not responsible for lost, stolen, or broken items. Counselors and groups leave the parking lot promptly at 9:15. If the is an instance in which you will be arriving after this time, please call the Camp Director so that check-in arrangements can be made. More information, rules, guidelines, and suggestion will be sent out in camper packet in late June/early July. Camp Sunrise Lake 2019 CIT Registration 9