SUMMER CAMP PROGR AMS

Transcription

1 SUMMER CAMP PROGR AMS Online Registration Available at Registration Begins March 2, 2016 Camp locations are subject to change. Register for any camp on this page/shown below by April 20, and receive $5 off per week/per session! Summer Camp Campnastics! Arts and crafts, fun sport competitions, organized games, and special events with guest presenters. Kids enjoy a trip to the local pool for recreational swimming and a special event or field trip for each of the six weekly sessions. Bring bag lunch and drink daily (if in extended care, please bring a daily snack). Before care begins at 6:30 a.m., after care ends at 6 p.m. Closed Monday, July 4. Weekly fee includes field trips, guest presenters, and swimming fees. A specialized camp offering gymnastics instruction for vault, ropes, trampoline, bars, dance, balance beam, and the outrageous pit. Nine weekly sessions with a weekly trip to the pool and a weekly field trip or special event! Daily activities include creative arts, special events, and organized games. Bring a bag lunch, drink, and snack each day. Before Care starts at 6:30 a.m.; After Care ends at 6 p.m. Closed Mon, July 4. Campers must be minimum age listed by first day of camp; and no older than the maximum age listed by the first day of camp. Mon-Fri Jun 20-Jul 29 8 a.m.-4 p.m. Resident Fee: /week; Non-Resident: $130 $40 Before OR After Care; $50 Before AND After Care Locations & Age Requirements All Camps Waldorf: Wade, Hanson Age: 6-14 Indian Head: Henson La Plata: Somers Campers must be minimum age listed by first day of camp; an no older than the maximum age listed by the first day of camp. Elite Gymnastics & Recreation Ctr. (Waldorf) Age: 6-14 Mon-Fri Jun 20-Aug 19 8 a.m.-4 p.m. Weekly Resident Fee: $145; Non-Resident: $150 $40 Before OR After Care, $50 Before AND After Care Junior Campnastics Extreme Recess Sports Camp Spend an action packed week this summer at our Extreme Recess Sports Camp. Campers will be introduced to wide range of sports, games, and exciting competitions in a traditional day camp environment. Our goal is to promote FUN while instilling teamwork, lifelong physical fitness, and personal health. Includes sports-themed field trips and weekly swimming. Bring a bag lunch and drink daily. Before and after care not available for this camp. Age: 8-14 Resident Fee: $145/wk; Non-Resident: $150 Our popular gymnastics camp is now offered as a half-day experience for younger children and gymnasts. Camp includes basic gymnastic instruction and activities, games, and arts and crafts. Children must be toilet trained. Camp T-shirt is provided, campers should bring a morning snack. Elite Gymnastics & Recreation Ctr. (Waldorf) Age: 4-6 Session A Jun 27-Jul 1 Session B Jul Session C Jul Session D Aug 8-12 Resident Fee: $90; Non-Resident: $95 Stoddert (Waldorf) Session 1: Mon-Fri Jul Session 2: Mon-Fri Jul Session 3: Mon-Fri Jul a.m.-4 p.m. 8 a.m.-4 p.m. 8 a.m.-4 p.m. Camps listed on this page include a T-shirt in the fee. Shirts are issued one time per child; not weekly per camp. Additional shirts or lost shirts can be replaced at a cost of $7.

2 Sports Camps Tightline Basketball Camp Former CSM Head Coach, Todd Fong, helps improve basic skills through individual instruction with special attention to specifics and techniques. Everyone receives a T-shirt. Register early, space is limited. Session 1 Age: 5-8 Half Day Camp Z1 Mon-Fri Jun Z2 Mon-Fri Jun p.m. Resident Fee: $90/session; Non-Resident: $95 Full Day Camp Z3 Mon-Fri Jun a.m.-4 p.m. Resident Fee: $170/session; Non-Resident: $175 Session 2 Age: ZZ Mon-Fri Jul a.m.-4 p.m. Resident Fee: $170/session; Non-Resident: $175 Sensible Soccer Camp Sensible Soccer is a leading international soccer education & development organization based in the UK. They create and implement innovative, progressive programs at the forefront of today s game, which educate and inspire individuals to achieve their full potential in soccer. Their camps provide innovative and creative teaching methods that introduce skill development within a positive learning environment that provides players with a fun, exciting and challenging week tailored to their age and abilities. An action packed week of soccer activities including quality coaching, fun soccer games, mini soccer tournaments, speed, agility & fitness exercises. Age: D1 Tues-Fri Jul a.m.-4 p.m. Resident Fee: $145; Non-Resident: $ D2 Mon-Fri Jul a.m.-4 p.m. Resident Fee: $180; Non-Resident: $185 Foundational Skills Wrestling Camp This foundational wrestling camp will introduce folkstyle wrestling to those new to the sport and will improve upon skills and techniques learned by beginning wrestlers. Participants should wear tennis shoes, a pocketless t-shirt and shorts to camp each day. Bring a bagged lunch, snacks, water bottle, towel, bathing suit and sunscreen. Camp ran by Thomas Stone Wrestling Club. Thomas Stone High School (Wrestling Room) Age: TS Mon-Fri Jul 11-Jul p.m. Resident Fee: $170; Non-Resident: $175 Camp Splash Camp Splash is a fun and safe way to enjoy the wide world of aquatic sports, games, and activities. We focus on water safety, swimming skills, diving skills, and other aquatic games. Campers will also participate in other traditional camp activities ranging from popular sports, games, and crafts. Weekly fee includes a field trip and T-shirt. Campers are required to bring a bathing suit, two towels, and change of clothes, tennis shoes, and bag lunch with drink. Participants must be able to swim one length of the pool (25 yds) and tread water for 30 seconds. No before or after care. Age: 8-13 Resident Fee: $180; Non-Resident: $185 Donald M. Wade Aquatic Ctr. (Waldorf) SC Mon-Fri, Jul a.m.-4 p.m. North Point Pool (Waldorf) NP Mon-Fri, Jul a.m.-4 p.m. Lackey Pool (Indian Head) LK Mon-Fri, Aug a.m.-4 p.m. Swim/Aquatics Camps Junior Lifeguard Camp Camp is for teens who want to learn about the responsibilities and duties of a lifeguard. This is NOT a lifeguard training class. The camp is designed to teach basic rescue skills, first aid, CPR, and water safety. Upon completion students will have a certification in first aid and American Red Cross Junior Lifeguard Completion certificate. Campers receive a camp T-shirt and are required to bring bathing suit, two towels, change of clothes, tennis shoes, and a bag lunch and drink. Participants must be able to swim one length of the pool (25 yds), tread water for 1 minute, and swim underwater for 10 yards. No before or after care. Age: Resident Fee: $180; Non-Resident: $185 North Point Pool (Waldorf) NP Mon-Fri Jul a.m.-4 p.m. Charles County Dept. of Community Services: 8190 Port Tobacco Rd, Port Tobacco, MD MD Relay: 711 Relay TDD: Equal Opportunity County

3 Specialty Camps Spanish Camp for Kids This is an introductory course for absolute beginners to establish a strong foundation and promote future success in Spanish learning for years of study. The detailed practice and accompanying drills will strongly develop the four essential skills of learning Spanish: understanding, speaking, reading, and writing. Age: D1 Tue-Fri Jul 5-Jul D2 Mon-Thu Jul Resident Fee: $90; Non-Resident: $95 Flight Camp Gadget s and kids have always gone hand and hand, and things that fly are no exception. Campers are introduced to rockets, remote controlled helicopters, and other things that fly under the careful eye of our staff. Along the way they learn how to build and launch rockets, navigate rc helicopters, and learn some history about things that fly. Participants get to take home their creations. Campers are encouraged to bring a morning snack. Henson Community Ctr. (Indian Head) Age: H1 Mon-Thu Jul H2 Mon-Thu Jul Resident Fee: $90/week; Non-Resident: $95 Special Populations Camp Co-Op Designed for Charles County students with significant cognitive delay who are receiving special education services. Activities include arts and crafts, swimming, games, sports, life skills, and special field trips. Camp operates for six, one week sessions. Enrollment: 40 participants per session. The first three weeks of camp (June 20-July 15) we will enroll 10 inclusion kids into camp. Sessions are a first come, first served basis. Transportation available at designated areas (based on need). Registration required. No camp July 4. Inclusion Age: 6-14 La Plata High School Age: 5-21 Mon-Fri, Jun 20-Jul 29 9 a.m.-2:30 p.m. Fee: $185/wk THEATER CAMP FOR KIDS Lights, Camera, Action! Learn basic acting techniques, fundamentals of public speaking, improvisational skill, how to prepare for an audition, cold readings, and other skills to ignite the acting bug. Camp sessions end with a final presentation for family and friends. Bring a lunch, drinks, and snacks each day. Davis Community Ctr. (Waldorf) Resident Fee: $140/ea; Non-Resident: $145 $40 Before or After Care: 6:30-8 a.m. / 4-6 p.m. $50 Before AND After Care Age: Mon-Fri, Jun 27-Jul 1 8 a.m.-4 p.m. Age: Mon-Fri, Jul a.m.-4 p.m. Jr. Chefs Camp Once your chef straightens their hat, arranges their apron and gets familiar with their work station, the fun begins. In addition to guest presenters, staff will discuss kitchen safety, terminology, food groups and nutrition. Our student chefs will prepare and enjoy fun and easy to make recipes. Chefs will make and take home decorated cupcakes, healthy wraps, dipped chocolates, s mores, fun food creations and more. On our final day each chef will be presented with a photo certificate and a graduation spoon. Somers Community Ctr. (La Plata) Age: S1 Mon-Thu, Jul Age: S2 Mon-Thu, Jul p.m. Resident Fee: $90/week Non-Resident: $95

4 Volleyball Camp Share the excitement of a week at Southern Maryland Volleyball Camp and join camp director, Nila Toribio-Straka, technical director for Southern Maryland Volleyball Club and volleyball recruiter for the College of Southern Maryland and her staff. You will learn from the finest as you receive instruction in all aspects of the game and be immersed in the basic skills of serving, passing, setting, and hitting. Camp is designed for the beginner to intermediate player and will incorporate essential life-lessons such as teamwork and sportsmanship. On the court, you will participate in drills and game related situations. You will observe demonstrations and learn from competitive films. Our volleyball camp will be offering two sessions: VB1 for ages 7-10 and VB2 for ages Monday-Friday, July Age: 7-10 VB D1 Age: VB D2 1-4 p.m. Resident Fee: $100 Non-Resident: $105 Art Camp Your budding artist will be exposed to many mediums of expression. Water colors, pencil drawing, Robert Sabuda inspired pop-up cards, silhouettes, bisque flower vases, clay and more. This class gives each artist an opportunity to find their artistic passion and talent. Your artist will receive a photo certificate on our last day of class. Somers Community Ctr. (La Plata) Age: S1 Mon-Thu, Jul p.m. Age: S2 Mon-Thu, Jul Noon Resident Fee: $90; Non-Resident: $95 HALF DAY CAMP Force Inspiration Star Wars Themed Day Camp Use the FORCE of creativity during this Star Wars themed camp which includes a variety of creative activities to capture your child s imagination. Children will develop their force in a range of Star Wars related activities. The curriculum has been designed to enable kids to learn how to draw their favorite Star Wars characters, act out famous scenes in fun drama sessions, play sports related Star Wars games, develop skills to spin lightsabers and much more to further develop their interest and knowledge of Star Wars. Resident Fee: $90/session; Non-Resident: $95/session Session 1 Age: DA Mon-Fri, Jul Session 2 Age: 5-12 Port Tobacco Recreation Ctr. (Port Tobacco) PT Mon-Fri, Aug 8-12

5 Brick Inspiration Lego Camp Our camp explores, science, technology, architecture, engineering and art concepts using LEGO bricks. The children will design, build and light up an entire city comprising of tall buildings, bridges, roads, parks and railways and use batteries, bulbs, wires and switches to bring their creations alive. The possibilities are limited only by their imagination. Our camp will fire up your child s imagination and spark creativity in the form of inspired play following one of our many themed Lego builds coupled with our magical delivery. Our curriculum will provide your child with an opportunity to design and build LEGO creations working either individually or in groups and participate in challenges, group competitions as well as free build time towards the end of the camp. Session 1 Age: 5-12 Half Day Camp D1 Tue-Fri, Jul D2 Tue-Fri, Jul p.m. Resident Fee: $72/session; Non-Resident: $77 Full Day Camp D3 Tue-Fri, Jul a.m.-4 p.m. Resident Fee: $145/session; Non-Resident: $150 Session 2 Age: 5-12 Port Tobacco Recreation Ctr. (Port Tobacco) Half Day Camp P1 Mon-Fri, Aug P2 Mon-Fri, Aug p.m. Resident Fee: $90/session; Non-Resident: $95 Full Day Camp P3 Mon-Fri, Aug a.m.-4 p.m. Resident Fee: $180/session; Non-Resident: $185 Counselor-In-Training The Counselor-in-Training Summer Camp Program (CIT) is a two week training program designed to offer young adults an opportunity to train and prepare for positions as camp counselors, managers, or recreation leaders. Participants will receive special training in what it takes to be a camp counselor by learning teaching techniques, going on field trips, working with special needs campers, and becoming CPR and First Aid certified. Participants must possess a genuine interest in working with youth, display high energy and enthusiasm, and display a positive attitude. CIT participants will need to provide their own lunch, snacks, and drinks daily, and dress appropriately for the day's activities. No program July 4. Open to Students in Grades 9-12 Davis Community Ctr. (Waldorf) Training Mon-Fri, Jun 27-Jul p.m. Job Shadowing Tues-Fri, Jul p.m. Resident Fee: $300 Non-Resident: $325 Registration Code: D1 Counselors-In-Training 2 Upon successful completion of the Counselors-In-Training (CIT) program, you may take the CIT 2 program. CIT 2 s will receive training that is designed to prepare them for employment as a future camp counselor. Training is also geared towards enhancing their interpersonal and communication skills, leadership training, team building, community service, and personal growth. Successful participants will come away from this program with valuable leadership skills that will serve them at home, in school, and in their own communities. Upon completion of CIT 2 participants will be eligible to volunteer in Recreation programs throughout the year. Open to Students in Grades Davis Community Ctr. (Waldorf) Training Mon-Fri, Jul 11-Jul p.m. Job Shadowing Mon-Fri, Jul p.m. Resident Fee: $300 Non-Resident: $325 Registration Code: D2

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7 CHARLES COUNTY CAMP REGISTRATION FORM Camper Data Sheet ONE FORM PER PARTICIPANT PLEASE PRINT No child permitted to these camps without a completed camper data sheet. PARENT/GUARDIAN INFORMATION Please Print Parent/Guardian Address Mailing Address City State Zip County Phone #'s Home Work Cell Parent/Guardian Address Phone #'s Home Work Cell Camper Information First Name Last Name Nickname Age Date of Birth Sex (circle) M F Emergency Contacts (other than parent/guardian) Name: Phone: Name: Phone: MEDICAL RELEASE TRANSPORTATION RELEASE In addition to parent/guardian, my child will be picked up by the following authorized individual(s). For the safety of all campers, parents and authorized individuals must show identification every day when signing out a camper. Physician s Name: Does your child require medication: No Yes If yes, medical consent form is required. Please explain medications: Name Name Name Relationship Relationship Relationship Special health conditions (please include physical, psychiatric, or behavioral conditions): Does your child have allergies: No Yes Please list: Does your child have asthma: No Yes Please list any activities your child may not participate in, or any problems which may require special attention: Last school attended: State If your child attends a school in Maryland, he/she has received all required immunizations unless exempt for medical or religious reasons. If out of state, please provide a copy of immunization record. Has your child been exempted from any immunizations? No Yes Please explain: I understand that transportation will be provided for all necessary camp field trips, and my signature below authorizes my child to be transported accordingly. If you wish for your child to arrive or depart by WALKING, RIDING A BIKE, or OTHER MEANS, written parental permission is required. You must provide an explanation, time to be dismissed, and identify the alternate form of transportation in your correspondence. Charles County Government is not responsible for program cancellations due to Charles County Public Schools programming. I agree to participate or to allow my child to participate in these programs knowing that safety precautions will be taken but realizing that the Charles County Government does not have accident insurance for participants. I do hereby release and hold harmless Charles County, Maryland, its officials, employees, instructors, and volunteers from any and all liabilities arising from any injuries that might occur during the supervised programs. I also authorize the Charles County Government to take photographs of me/my child for promotional and/or educational purposes. I hereby state and declare that this information is freely, willingly, and voluntarily made. SWIMMING RELEASE Please check which level best describes your child s swimming ability: All pools are 3 1/2 ft deep at the shallow end, and anywhere from 9-11 ft at the deep end. No wading pools are available at any pool location. My child is not allowed in the pool (ALL children will be transported to the pool. Children not allowed in the pool will be provided with alternate activities at the pool site.) Non swimmer/allowed in the pool: Must use U.S. Coast Guard approved flotation vest (no floaties or swimmies). Learning to Swim Swimmer Any changes to a camper s swimming permission must be made in writing. FORMS WITHOUT SIGNATURE WILL NOT BE ACCEPTED I acknowledge that I have read and understand the Summer Camp Packet, including the refund policy. I understand that if my child forgets his/her camp T-shirt on a field trip, I will purchase one that day for the fee of $7. By signing this form, I acknowledge the above and give permission to Charles County Government in the event of a MEDICAL EMER- GENCY, to transport this child to the nearest hospital emergency room to receive medical treatment. Signature Date Charles County Department of Community Services 2016 Summer Camp Programs

8 CHARLES COUNTY CAMP REGISTRATION FORM Non-Residents: Add $5 per camp/per session. Camper Name: REMINDER: SIGNATURE REQUIRED ON SIDE 1 OF FORM (CAMPER DATA SHEET) Campers must be minimum age listed by first day of camp; and no older than the maximum age listed by the first day of camp. * A COMPLETED Camper Data Sheet must accompany EACH child on the FIRST day of camp! No Exceptions. Week 1: June *Summer Camp Week 2: June 27-July 1 *Summer Camp Week 3: July 5-8 (closed July 4) *Summer Camp Week 4: July * Summer Camp * Campnastics $145 Tightline Basketball A.M. $90 *Junior Campnastics $90 Sensible Soccer $145 *Junior Campnastics $90 Tightline Basketball P.M. $90 *Counselors In Training $300 Spanish Camp $90 *Counselors In Training 2 $300 Tightline All Day $170 Theater Camp $140 Lego Camp A.M. $72 *Extreme Recess Sports $145 TOTAL DUE: Week 1 Week 5: July * Summer Camp *Extreme Recess Sports Camp $145 Theater Camp $140 Jr. Chef A.M. (July 18-21) $90 Art Camp P.M. (July 18-21) $90 Volleyball Camp A.M. $100 Volleyball Camp P.M. $100 Junior Lifeguard $180 TOTAL DUE: Week 5 Before & After care $50 TOTAL DUE: Week 2 Week 6: July * Summer Camp *Junior Campnastics $90 *Extreme Recess Sports $145 Flight Camp (July 25-28) $90 Jr. Chef P.M. (July 25-28) $90 Art Camp A.M. (July 25-28) $90 Sensible Soccer $180 Camp Splash $180 TOTAL DUE: Week 6 Lego Camp P.M. $72 Lego Camp All Day $145 TOTAL DUE: Week 3 Week 7: August 1-5 TOTAL DUE: Week 7 Week 8: August 8-12 *Junior Campnastics $90 Camp Splash $180 Star Wars Camp A.M. $90 Flight Camp (July 11-14) $90 Spanish Camp (July 11-14) $90 Tightline All Day $170 Camp Splash $180 Foundational Skills Wrestling Camp $170 Star Wars Camp A.M. $90 TOTAL DUE: Week 4 Week 9: August Lego Camp A.M. $90 Lego Camp P.M. $90 Lego Camp All Day $180 TOTAL DUE: Week 9 TOTAL DUE: Week 8 Online Registration Available! Help Send a Kid to Camp Code: ZZ. I would like to help contribute to sending a kid to camp that otherwise would not be able to attend. I have included the following amount in my payment: $5 $10 $15 Other: $ (Indicate Amount) T-SHIRT ORDER ONE T-Shirt is included in the fee. Campers are required to wear T-shirt for Summer Camp, Campnastics, Extreme Recess Sports Camp, and Camp Splash for field trips. Shirts are issued one time per child; not one per camp week. Lost shirts or additional purchases are $7. Circle requested size. Selecting the proper shirt size is the responsibility of the parent. SIZES MAY RUN SMALL Additional or lost shirts are $7 each. Fully completed CAMPER DATA SHEET must be provided at time of registration. Refund Policy: A request for a refund must be received in writing 7 days prior to the start of a program. Once the program has begun, a prorated refund based on participation may be approved if requested in writing and with medical verification. This written request must be received prior to the end of the program. A $10 administrative fee per child per session will be deducted for the total refund, regardless of circumstances, unless the program has been canceled. No refunds will be considered after a program has ended. T-shirt and late pick-up fees are non refundable. Transferred registrations are non-refundable Child Sizes Adult Sizes S M L XL XXL Mail-in payments only accepted at: Community Services Attn: Registration Office 8190 Port Tobacco Road Port Tobacco, MD Registration Packets may be faxed to: Webtrac@CharlesCountyMD.gov OFFICE USE ONLY Make checks payable to: Charles County Commissioners Cash M/O Check M/Cd VISA DISC Name on check/card Ck/Card # Expiration Sec # Household #

9 MEDICATION CONSENT FORM I. CAMP OPERATOR This form must be completed fully in order for youth camp operators and staff members to administer the required medication or for the camper to self-administer medication. A new medication administration form must be completed at the beginning of each camp season, for each medication, and each time there is a change in dosage or time of administration of a medication. Prescription medication must be in a container labeled by the pharmacist or prescriber. Nonprescription medication must be in the original container with the instructions for use. Nonprescription medication includes vitamins, homeopathic, and herbal medicines. An adult must bring the medication to the camp and give the medication to an adult staff member. II. CAMP INFORMATION YOUTH CAMP NAME PHYSICAL ADDRESS Charles County Department of Community Services 8190 Port Tobacco Road CITY Port Tobacco STATE MD ZIPCODE III. PRESCRIBER S AUTHORIZATION CHILD S NAME DATE OF BIRTH CONDITION FOR WHICH MEDICATION IS BEING ADMINISTERED: EMERGENCY MEDICATION [ ] YES [ ] NO MEDICATION NAME DOSE ROUTE TIME/FREQUENCY OF ADMINISTRATION IF PRN, FREQUENCY IF PRN, FOR WHAT SYMPTOMS KNOWN SIDE EFFECTS SPECIFIC TO CHILD MEDICATION SHALL BE ADMINISTERED (NOT TO EXCEED 1 YEAR) PRESCRIBER S NAME/TITLE FROM TO This space may be used for the Prescriber s Address Stamp TELEPHONE FAX ADDRESS CITY STATE ZIPCODE PRESCRIBER S SIGNATURE (Parent cannot sign here) (ORIGINAL SIGNATURE OR SIGNATURE STAMP ONLY) DATE IV. PARENT/GUARDIAN AUTHORIZATION Completion of the Medication Consent Form relieves the Charles County Government, its agents, employees, or representatives of any responsibility for ill effects resulting from the administration of the medicine. I request the authorized youth camp operator/staff to supervise the camper in selfadministration if authorized as prescribed by the above prescriber. I certify that I have legal authority to consent to medical treatment for the child named above, including the administration of medication at the facility. I understand that at the end of the authorized period, an adult must pick up the medication, otherwise it will be discarded. I authorize camp personnel to communicate with the prescriber as allowed by HIPAA. PARENT/GUARDIAN SIGNATURE DATE HOME PHONE # CELL PHONE # WORK PHONE # V. AUTHORIZATION FOR SELF ADMINISTRATION AND SELF CARRY I consent that the child named above is able to self-administer the medication listed. I authorize self-administration of the above listed medication for the child named above under the supervision of an authorized youth camp operator/staff member. The child named above may self-carry emergency medication if indicated below. Campers may ONLY carry labeled albuterol inhalers, epipens, and oral glucose on their person during camp if there is a specific physician order that states the medication must be on their person and this form is signed below. If a camper MUST carry one of these medications, it must be in a fanny pack attached to their person at all times. PRESCRIBER S SIGNATURE PARENT/GUARDIAN S SIGNATURE SELF CARRY EMERGENCY MEDICATION (Check One) [ ] YES [ ] NO [ ] Not emergency medication SELF CARRY EMERGENCY MEDICATION (Check One) [ ] YES [ ] NO [ ] Not emergency medication DATE DATE Department of Community Services * 8190 Port Tobacco Road * Port Tobacco, MD 20677* * Fax MD Relay Service: 711 * Relay TDD: * Equal Opportunity County *

10 SUNSCREEN CONSENT FORM The Office of Environmental Health and Food Protection no longer considers sunscreen a medication requiring a prescriptive order. Appropriate sunscreen use is important to prevent skin damage and skin cancer in children. The Maryland Department of Health and Mental Hygiene and The Department of Community Services, encourages the appropriate use of sunscreen during summer activities. At the same time, sunscreen can cause allergic reactions in a small number of children, and parents will need to be involved in decisions regarding sunscreen use for their child. Authorization by parent/guardian is needed in order for your child to apply/use sunscreen. Campers Name: Camp Location: Parents must supply and label all listed sunscreen Sunscreen: Required Field Check only one box: My child is allowed to apply sunscreen directly. No assistance from staff is necessary. Staff is allowed to assist my child applying sunscreen. Completion of the Sunscreen Consent Form relieves the Charles County Government, its agents, employees, or representatives of any responsibility for ill effects resulting from the administration of the medicine. Parent/Guardian Signature: Date: Parents are still encouraged to apply sunscreen to their child before the child attends camp for the day. Department of Community Services 8190 Port Tobacco Road Port Tobacco, MD MD Relay Service: 711 Relay TDD: Equal Opportunity County Say No To Drugs