June 8 August 14. Ages 5 (as of January 1) - 14

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1 June August Ages 5 (as of January 1) - Revised April, 20

2 General Information (Spaces are not reserved without payment - payment is required at time of registration.) Camp Dates: Time: Extended Camp: June th - August th, ten () one week sessions. :00 a.m. - :00 p.m. (Drop off no earlier than :0 a.m. pick up no later than :00p.m.) :00 p.m. - 5:0 p.m. (Pick up no later than 5:0p.m.) Resident Nonresident Groups & Fees: Dolphins (Ages 5, as of Jan. 1st, - years) $1/wk $2/wk Stingrays (Ages - ) $1/wk $2/wk Club Teen (Ages - ) $/wk $1/wk Extended Camp: $ 40/wk $4/wk Registration Fee: Nonrefundable $ 25/child $ 25/child Field Trip Fee: (Long Distance for Club Teen only) $ 40/trip $ 40/trip Camp T-Shirts: Required for field trips $.0each $.0each Late pick-up fees will be assessed if your child is picked up after :00p.m. /5:0p.m. Please Note: If a participant has not been picked up by 5:0pm, staff will attempt to contact the parent/guardian. If the parent/ guardian cannot be reached by 5:45pm, staff will attempt to reach the emergency contacts listed on the child s release form. If staff is unable to reach parent/guardian/emergency contact by pm, staff will contact the Town of Palm Beach Police Department. The Police Department will work with Recreation staff to facilitate pick up of the child through the Florida Department of Children and Families. Town of Palm Beach Resident Registration: Begins February Proof of residency is required. When enrolling your child, payment must be made for camp sessions your child is attending. Ask about our payment plan. We accept Visa, MasterCard, Discover Card, American Express and Debit Cards bearing a credit card symbol. Registration can be done in person or over the phone, or online at palmbeachrecreation.com Phone registration will require a major credit card. Nonresident Registration: Begins March 2 Appropriate forms will be required before the child can begin camp, they are listed below: * Camp Information & Release Form * Copy of the child s birth certificate * Medication Form: (if applicable) * Proof of Residency: Tax Bill, Drivers License/State issued ID Card, Voter Registration, Lease or Purchase agreement ( months or more). Transfer & Refund Policy: A $ fee will be applied to all transfers. To qualify for a refund, you must cancel no later than one week prior to the start of the camp week. A refund minus $25 per refunded week will be given for all cancellations made before the deadline. No Refunds will be given after this deadline. Special Notes: * Campers are required to bring a non-perishable lunch every day. Refrigeration and/or heating is not available. Mark all items with your child s name. * Camp Palm Beach T-Shirts are required to be worn on field trip days. Participants will receive one camp shirt and camp bag. Extra shirts may be purchased at the front desk. * Children should wear light comfortable clothing, sneakers and socks daily. Please review your child s schedule to ensure they are dressed appropriately (i.e. sun screen, bathing suit (one piece/tankini for girls), and towel on water days). Please apply sun screen each day as your child will be outside at some point during the day. * Campers should leave all valuables at home.

3 Registration Form (please use a separate form for each child) Child's Last Name: First Name: Town of Palm Beach Resident Nonresident Please check all weeks you would like your child to attend. (Space is limited so all weeks may not be available.) Camp - Sessions Extended Camp - Sessions Week 1 (June - June ) Week 1 (June - June ) Week 2 (June - June 1) Week 2 (June - June 1) Week (June - June 2) Week (June - June 2) Week 4 (June 2 - July 2 closed July ) Week 4 (June 2 - July 2 closed July ) Week 5 (July - July ) Week 5 (July - July ) Week (July 1 - July ) Week (July 1 - July ) Week (July 20 - July ) Week (July 20- July ) Week (July 2 - July 1) Week (July 2 - July 1) Week (August - August ) Week (August - August ) Week (August - August ) Week (August - August ) Club Teen Long Distance Field Trips June 2- Seaworld July Hollywood Studios Group: (Check One) Number of extra T-Shirts ($.5 each) Dolphin: ages 5 (as of Jan. 1) - Youth Small - Adult Small Stingray: ages - Youth Med - Adult Med Club Teen: ages - Youth Large - Adult Large Visa/MC Discover Amex Cash Check Credit Card # Expiration Date CVV# Name as it appears on Card (Please Print) Signature of Card Holder Transfer & Refund Policy: A $ fee will be applied to all transfers. To qualify for a refund, you must cancel no later than one week prior to the start of the camp week. A refund minus $25 per refunded week will be given for all cancellations made before the deadline. No Refunds will be given after this deadline. Signature

4 Town of Palm Beach Recreation Department Camp Information & Release Form Child s Last Name: First: M.I. Address: City: State: Zip: Age: D.O.B. Phone/cell phone: address: Proof of Age is required. (i.e. birth certificate, passport) Mother s Name: Daytime Phone: Father s Name: Daytime Phone: Person to contact in case of emergency when parent cannot be reached: Name: Daytime Phone: Relation: Name: Daytime Phone: Relation: Family Doctor: Phone: Please list any special medical issues, allergies or instructions you feel staff should be aware of. A medical form (available at the Recreation Department main office) must be filled out by your physician in order to dispense any medication. Additional person(s) authorized to pick up your child: Person(s) unauthorized to pick up your child. Program Waiver and Release of All Claims: I agree to waive all claims my minor child/ward or myself may have as a result of participating in the Town s Recreation Program(s). I further agree to fully release and discharge the Town of Palm Beach, its officers, employees, and representatives from and against any and all losses, damages, injuries of any kind as a result of either myself or my minor child/ward s participation in such Recreation Program(s). In the event of an emergency, I authorize the Town of Palm Beach officials to secure from any licensed hospital, physician, and /or medical personnel any treatment deemed necessary for my minor child/ward s immediate care and agree that I will be responsible for payment of all medical service rendered. I give consent to use any photograph taken of me or my minor child/ward during recreation activities, classes or programs for future Recreation brochures and promotional material. Transfer & Refund Policy: A $ fee will be applied to all transfers. To qualify for a refund, you must cancel no later than one week prior to the start of the camp week. A refund minus $25 per refunded week will be given for all cancellations made before the deadline. No refunds will be given after this deadline. I have read and fully understand the Town of Palm Beach Policies & Discipline Procedures and the Program Waiver and Release of All Claims, which includes permission to secure treatment and release of photos as well as the Transfer & Refund Policy. I also understand payment is due in full at time of registration to guarantee space for my child and a late fee may be charged if my child is picked up after :00p.m./5:0p.m. My child (Club Teen only) has permission to walk home/to my work from the Recreation (please initial) Signature of Parent/ Guardian Date

5 POLICIES & DISIPLINE PROCEDURES Camp & Field Trip Rules: 1. Everyone at camp is to be treated with respect. 2. Campers must be signed in and out with their counselors daily.. Profanity or obscene and abusive language or gestures will not be tolerated. 4. All Campers are expected to follow the directions of staff with respect. 5. Fighting under any circumstance will not be tolerated and may be grounds for expulsion.. Dangerous behavior, including horseplay, which could cause harm to others is unacceptable.. Running in the facility is not permitted.. Sitting or standing on any equipment (pool tables, ping pong, etc) is not allowed. Equipment must be used appropriately and in the designated areas. Campers are responsible for the equipment they use and for its replacement if it is lost, damaged or destroyed in a malicious manner.. All Campers must wear camp shirt on field trips.. Personal belongings are the responsibility of the camper. We encourage campers to leave excessive money and all valuables at home. Cell phones, I-pods, MP players, PSP s DSi s, etc. are not permitted at camp (Long Distance Trips are the only exception).. Campers must stay with their group at all times unless permission has been given otherwise.. Campers must follow all field trip location rules and directions of facility staff. 1. Campers must wear attire of appropriate style, fit and length. Bikini s are not allowed. Tankini or one piece suits must be worn. Sneakers must be worn daily. Campers may bring flip flops, crocs for water activities. Disciplinary Actions: The following consequences will result if camp rules are broken. Severity of consequences will correspond to degree of infraction, which will be determined by the Camp Supervisor. 1. Verbal Warning 2. Time Out/Privilege taken away. Time out and meeting with Camp Supervisor 4. Parent Conference 5. Suspension/expulsion from program. Consistent breaking of rules and lack of cooperation may result in suspension or expulsion from camp. Please read the preceding rules and disciplinary actions with your child and make sure he/she understands them. Your support of this disciplinary procedure is important and will help to ensure the safety of your child while participating in the Recreation Department s Summer Camp Program.

6 JUNE Chocolate Fun Camp Karaoke Ice Cream Social Nature Art JULY AUGUST Stuffed Animal Pet Show Marine life 2 Build A Bear Calypso Bay Water PB Zoo & Fountains* Chuck E Cheese 1 25 Picnic in the Park Beach Ball Volleyball 1 Wacky Water Days* 2 Box Cars Wacky Relays 1 Picnic & Scavenger Hunt 20 Celebrity chefs 2 Paper Mache 0 Box Car Derby Chuck E Cheese 21 Mad Hatters 2 Playmobile Fun Park 1 Calypso Bay Water Pirate Adventure Calypso Bay Water 2 Science & Aquarium 2 Costume & Pizza Party Science & Aquarium Movie Madness 2 Mad Hatter Parade & Party 0 2 Joey s Outback Adventures CLOSED Backwards Day Rehearsals 4 Marine Life Chuck E Cheese 5 Calypso Bay Water Outrageous Obstacles 1 Museum of Discovery & Sci. 1 Butterfly World Chuck E Cheese Camp FUN Day* D O L P H I N S Schedule is Subject to Change Please pick up a Camp Connection on Mondays for updated information Campers must wear sneakers on a daily basis! *Water Activities: Bring bathing suit, towel & sunscreen needed

7 JUNE Oreo Challenge Box Cars Marine Life JULY Lion Country Safari* Box Car Derby 2 Team Trivia Challenge Wii Challenge 1 PB Zoo 25 Canoe/kayak 1 2 S T I Science & Aquarium Chocolate Fun CLOSED N Headphone Karaoke 1 Adventure Golf PB Zoo* Midtown Beach Ultimate Scavenger Hunt Planet Air Museum of Discovery & Sci. G 20 Celebrity Chefs 21 Wacky Water Wars* 2 Build A Bear R 2 Ice Cream Social Clay crafts 2 Planet Air Outrageous Obstacle /cookout A AUGUST Science Fun Rehearsals 4 Mini Olympics & Toga Party 5 Canoe/Kayak Schedule is Subject to Change 1 Camp FUN Day* Y S Please pick up a Camp Connection on Mondays for updated information Campers must wear sneakers on a daily basis! *Water Activities: Bring bathing suit, towel & sunscreen needed

8 JUNE Mad Science Planet Air Build A Bear JULY Marine Life 2 Chocolate Fun Headphone Karaoke 1 Nerf Wars 25 Water Wars* Catamaran & snorkeling* 1 Rapids* 2 SeaWorld - Orlando C L U 2 Game room Tourney Marine Life CLOSED B The Amazing Race Canoe/Kayak Fear Factor 1 Planet Air Adventure Golf 20 Celebrity Chefs 21 PB Zoo 2 Hollywood Studios- Orlando T 2 Science & Aquarium 2 Box Cars 2 Box Car Derby & cookout 0 1 Canoe/Kayak E AUGUST Marine life 4 Rehearsal & Pizza 5 Mini Olympics & Toga party 1 Ocean Adventure* Camp FUN Day* E N Schedule is Subject to Change Please pick up a Camp Connection on Mondays for updated information Campers must wear sneakers on a daily basis! *Water Activities: Bring bathing suit, towel & sunscreen needed

9 MEET & GREET Saturday, June :00a.m.-:00a.m. Come out and meet the Counselors and Staff of Camp Palm Beach. We will have games and activities as well as light refreshments. Camp shirts and bags will be available for pick up. We encourage all new campers to attend. TALENT SHOW Thursday, August 1 :0a.m-:00p.m. Enjoy the show as our campers showcase their talents. All campers are encouraged to participate and will be able to practice throughout the summer for this end of the camp finale. Light refreshments will be served.. CAMP CONNECTION We strive to provide the best possible experience for you camper however, sometimes it is necessary to make changes to the schedule of activities. The Camp Connection, available every Monday, is your up-to-date camp guide detailing each weeks field trips and activities, proper dress for the day, changes to the schedule, etc. Please remember, your camper should arrive in sneakers and appropriate shorts, shirt daily. If you have any questions or concerns regarding camp, please call the main office at Thank you...we look forward to a great summer!