Summer Camp at Wesley Gardens 2016 Registration

Transcription

1 Summer Camp at Wesley Gardens 2016 Registration Camper Information (Please use a separate form for each camper) Camper s Name Goes by Camper s Age Grade Fall 2015 Male/Female Home Address City/State Zip School attending Church Affiliation Please check weeks desired: T-shirt size Youth Small (6-8) June 6 10 Youth Medium (10-12) June Youth Large (14-16) July Youth XLarge (18-20) Parent/Pick Up Information Mother s Name Father s Name Mother s Cell Father s Cell Mother s Father s List person(s) other than parents authorized to pick up child from camp: Name Cell phone Relationship Model of Car Name Cell phone Relationship Model of Car Name Cell Phone Relationship Model of Car I understand the Summer Camp at Wesley Gardens is not a licensed child care facility. I also understand this program is not required to be licensed by the Georgia Department of Early Care and Learning and this program is exempt from state licensure requirements. Parent Signature Date

2 Medical/Emergency Information Emergency Contact Information #1 Name Cell Phone #2 Name Cell Phone Doctor s Name Office Phone Doctor s Address Hospital Preference Please list all health reasons which may prevent your camper from participating in camp activities. Please list all allergies or dietary restrictions Please list all current physical conditions or psychological concerns requiring medication, treatment or special restrictions or considerations while at camp? For example: asthma, heart trouble, diabetes, ADD, ADHD, etc. Medications If your child needs medication during camp hours you must complete a medical authorization form which allows us to dispense the medication. All medications, authorization forms and dosage directions must be received by the Camp Director in order for any medication to be given. Medication should NEVER be sent to camp with a child. The Camp Director will be responsible for administering the medication unless other arrangements are made. This policy applies to all prescription and OTC medications.

3 Parent Permissions Transportation My child will need transportation to and from Summer Camp at Wesley Gardens and has permission to ride in a van driven by Summer Camp Staff or Wesley Monumental Staff. Pick up and drop off from Wesley Monumental UMC transportation fee $40 Pick up and drop off from Habersham Village transportation fee $40 Photos/Digital Images Photos will be taken during Summer Camp at Wesley Gardens and may be used in Wesley Monumental UMC promotions, including brochures, website, and social media. It is my/our understanding that the children s names will not be used. I/We also understand that the Wesley Monumental United Methodist Church will not be held liable for any misuse of these pictures by third parties. Emergency Medical Authorization and Release has my permission to participate in the various Summer Camp activities (including but not limited to: worship, singing, art, crafts, island exploration, science activities, water games and recreation). I further give my permission for the camp directors, camp counselors, church representatives, or leaders of the activities to secure necessary medical treatment for this child at an appropriate medical facility as deemed necessary in the event that I (or those responsible adults named on the registration form) cannot be reached for such permission. In consideration of my child s registration and participation in Wesley Monumental United Methodist Church Summer Camp at Wesley Gardens, I hereby release Wesley Monumental United Methodist Church and their representatives from any liability for accident or injury during these activities. I release and promise to indemnify, defend, and hold harmless the Wesley Monumental United Methodist Church for any injury arising directly or indirectly out of the Summer Camp at Wesley Gardens activities, whether such injury arises out of the negligence of the Wesley Monumental United Methodist Church, the Participant, or otherwise. As Parent/Guardian of the child, I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Georgia. I agree that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of the Release, which shall continue to be enforceable. BY MY SIGNATURE, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THIS CONSENT AND WAIVER. Parent Signature Date

4 Camp Fees Please read carefully The fee for Summer Camp at Wesley Gardens is $150 per week per child. Applications must be signed and submitted to Wesley Monumental with 50% of the camp fee due with the registration in order for the camper to be accepted. We accept cash or checks for camp fees. Checks should be made payable to Wesley Monumental UMC with WG Camp written on the memo line. Applications are processed on a first come, first serve basis and may be dropped off or mailed to Wesley Monumental, 429 Abercorn, Savannah, GA Payment of the remaining 50% of camp fees and fees for transportation are due as shown below: Camp week 6/6 6/10 Deadline for transportation and final payment Camp week 6/20 6/24 Deadline for transportation and final payment Camp week 7/25 7/29 Deadline for transportation and final payment May 23rd June 6th July 11th Failure to pay the remaining 50% of camp fees by the deadline will result in your registration for camp being cancelled and your previous payment will be refunded as detailed below. Refunds are available if a camper cancels with at least a two week notice or if a camper s balance is not paid by the deadline for final payment. A $35 processing fee will be withheld from all original payments. Letters confirming acceptance to camp will be sent once your application has been processed. We would prefer to send confirmations by so be sure your address is legible on your application. Your confirmation letter will contain additional details about your camp week.

5 Discipline Policy Summer Camp at Wesley Gardens should be a memorable and enjoyable experience for all children who attend. The inappropriate, disruptive, abusive or dangerous behavior of even a single child can disrupt that experience for an entire group. To prevent this from occurring we have established a discipline policy. On the first day of each session, this policy will be reviewed with the children so everyone has a clear understanding of appropriate behavior for camp. We will strive to avoid issues that require discipline by keeping the children engaged in activities and redirecting them when necessary. Unacceptable behavior will initially be addressed by the Camp Counselor for the child s group and will be consistent with the frequency or severity of the unacceptable behavior. Possible consequences could include the loss of the privilege of participating in a specific activity, the loss of participating in a special event or being placed on probation for the remainder of the week. Recurring incidents will be handled by the Camp Director. Children are inquisitive, curious, noisy, messy and active and we expect those behaviors. The behaviors listed below could place the child or the children in the group in danger and are not allowed. 1. Refusing to remain with the assigned group during activities. 2. Repeated use of unacceptable language. 3. Continuing rude and discourteous behavior toward staff members and other campers. 4. Refusing to follow basic safety rules 5. Repeated intentional excursion into unauthorized areas. We encourage you to discuss this policy with your child before they begin coming to Summer Camp.