At ISC, we pride ourselves on being SAFE ACCOMMODATING AFFORDABLE ENGAGING

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1 At ISC, we pride ourselves on being SAFE ACCOMMODATING AFFORDABLE ENGAGING Summer Day Camp 650 Kresson Road Cherry Hill NJ, isccherryhill.com Enrollment Forms Sport Camps: Basketball Camp Field Hockey Camp Camp Camp Weekly Program Options: (weeks vary depending on grade level) Ceramics & Painting Video Game Bus & Nutrition Roller Skating Lessons Yoga Dance & Hip Hop Enrichment Camps: Camp Improv Camp Bricks 4 Kids Camp Camp Painting Camp Field Trip by Grade: PK 1 st Tuesdays 2 nd 4 th Wednesdays 5 th 8 th Monday & Thursdays Swim Trip by Grade: PK 1 st Thursdays 2 nd 4 th Mondays 5 th 8 th Tuesdays

2 2018 Summer Camp Registration Checklist Parents, please use this checklist to ensure that all camp paperwork is completed. Please keep a copy for your records. $50 Registration Fee per child ($25 if registered by 2/19/18) Payment enclosed or Registered and paid through PayPal Enrollment Contract Form (front and back of form - 1 per camper) Minimum of 15 days* Credit Card Information (or payment in full) *If the minimum of 15 days are not selected, the day and trips will NOT be reserved. Health & Wellness Record Forms (front and back of form 1 per camper) A recent small photo of your child (You can attach or to Donna@intsports.com) Please include the name of your child on the back of picture or in the . Immunization Records Behavior Management Policy (1 per family) Authorization for Child Release (1 per family) Proof of employment for 10% discount if applicable. (1 per family) Proof may be photo of work I.D. or and from your work sent to Donna@intsports.com. (Parent must be NJ State Employee, Active Military, Virtua Health, Cooper Health Systems, Subaru, Lockheed, PHH Mortgage or Deborah) (1 per family).

3 Basic Information Welcome to the ISC of Cherry Hill s Summer Day Camp! Thank you for entrusting your child s care with us this summer. We assure you, that we will make every effort to make this a positive experience for you and your child. We want our campers and counselors to be a part of a safe, happy and fun environment that shares a common core set of values. This core set of values in interwoven into camper to counselor relationships, as well as our daily activities and decision making. Our hope is to instill a lifelong code of positivity, respect, kindness and acceptance. We are extremely excited to have your child be active and experience all of the opportunities that our Summer Day Camp program offers. Staff With low staff-to-camper ratios, we pride ourselves on offering a safe summer day camp experience from beginning to end! Our staff is selected for their enthusiasm, maturity and experience working with children. Our staff consists of professional educators, current high school and middle school coaches, graduate and undergraduate students. Every staff member is 18 or older and CPR/First Aid/AED certified. They have completed an extensive orientation course and are fingerprinted and background checked through the State of NJ. Camp Groups Campers are placed in separate groups according to the grade level they have completed during the 2017/2018 school year. Children in separate grades cannot be placed in the same group. Each camp group consists of head counselors and counselors. Head counselors have the most experience with ISC Summer Day Camp. They are in charge of planning the daily activities for their group, as well as supervising the assisting counselors in their group. Camper to Counselor Ratios Grade Ratio Ratio on a Field Trip Ratio on a Water Trip PK & K 6:1 5:1 4:1 1 st 7/8 th 10:1 9:1 8:1 Camp & Business Office Hours Camp hours are 9:00am to 4:30pm. Our extended care is provided, at no additional cost, in the morning from 7:00am to 9:00am and in the afternoon from 4:30pm to 6:00pm. Camp business hours are Monday Friday 9:15am to 5:00pm. How to Register Complete and turn in the $50.00 per child registration fee by telephone, fax, mail, online or in person. Registration holds a place for your child in camp. Registration does not guarantee any days, weeks, enrichment camps, field trips or swim trips. To reserve any days, weeks, enrichment camps, field trips or swim trips, please complete the enrollment forms and submit to ISC of Cherry Hill by fax, mail, or in person. Enrollment is first come first serve once your paperwork is completed in its entirety. Enrollment requires a 15 day minimum commitment per child. The last two weeks of camp are reserved for those campers who have been enrolled with ISC Summer Day Camp for 10 days prior to the last two weeks. All completed packets received by April 30 th will have their days, weeks, enrichment camps, field trips and swim trips guaranteed. After this date, we will no longer be able to guarantee the availability of each day, week, enrichment camp, field trip or swim trip. Payments Tuition Payments are due by 9:00am on Wednesday for the following week. Tuition payments are automatically deducted from the credit card you placed on file. You can choose to pay by cash or check, if the payment is received prior to 9:00am on Wednesdays. The person who signs the enrollment contract is responsible to pay for all days selected each week. Please carefully review the payment policies in the enrollment packet and on the enrollment contract.

4 Sibling & Employee Discounts We offer tuition discounts for siblings living in the same household. The child that attends the most number of days is set at the $49.00 rate. The second sibling is discounted to $45.00 per day, and each additional sibling is set at the $36.00 per day rate. We also offer a 10% employee tuition discount. The discount applies to companies who have partnered with ISC Summer Day camp in promoting us as their #1 choice for summer child care. A list of participating companies can be found on our webpage. The 10% tuition discount only applies towards the daily tuition rate. The discount may not be applied towards enrichment camps, field trips or swim trips or any other camp expense. Field & Swim Trip & Enrichment & Sports Camp Field trips and swim trips, enrichment and sports camps are optional and have additional fees. To enroll your child in one of our trips and/or camps you must select the appropriate box on the enrollment contract and submit payment in full for each trip and/or camp. Payment of these trips and/or camps is due by April 30, If this date has past then each selected trip and/or camp fee is due at the time of enrollment. Trips and/or camps are not guaranteed until payment has been completed. Field trips and swim trips, enrichment and sports camps may be added at least one week prior to the trips departure depending on availability. Campers attending a field trip, swim trip and/or enrichment and sport camp must arrive prior to 9:00am. Please carefully review field/swim trip and enrichment camps policies and procedures in the enrollment packet. Late Pick Up / Late Tuition Fee There is a $30 fee for all returned checks for any reason. There is a $30 late fee for any declined credit card payments. There is a $15 late if you pick-up your child after 6:00pm. There is an additional $15 late pick-up fee assessed for every 15 minutes after 6:15pm, until you pick-up your child from camp. Please carefully review the enrollment contracts policies prior to signing the enrollment contract. Refund / Additional Policies There are no refunds, cancellations, substitutions or credits on daily enrollments field trip, swim trip and/or enrichment and sport camps. All balances on field trips, swim trips and/or enrichment and sport camps must be paid by April 30, If this date has past then each selected trip/camp is due at the time of enrollment. If the payment has not been completed, then your campers spot will not be reserved on the trip or camp. If your child is absent or arrives after 9:00am for any reason, you will not receive a credit for the day, field trip, swim trip and/or enrichment and sport camp. Schedule Change Policies Once you have submitted your enrollment contract and enrollment forms you are responsible to complete payment for all of the days, field trips, swim trips and/or enrichment and sport camps selected. However, we understand that situations may arise that warrant a change in your schedule. For these situations, we will make every effort to accommodate these changes based on availability. While we may be able to substitute days, field trips, swim trips and/or enrichment and sport camps on your schedule, we cannot deduct the number of days, field trips, swim trips and/or enrichment and sport camps selected for any reason. You are not able to switch a day that has already passed or the present day that your camper is scheduled to attend. Please carefully review the enrollment contract policies in the enrollment packet. Camp Tuition Fees $49 per day $45 per day for the second sibling $36 per day for any additional sibling

5 Weekly Programs Weekly programs are free for our campers to enjoy and are offered as electives Weekly programs are optional, not mandatory, for campers. Other elective choices will be available to your camper to participate in during the weekly program offering. Weekly programs are typically offered during the 2 nd elective period for 2 nd 8 th grades from 3:30pm to 4:15pm. Each week we will select certain grades to participate in these programs. Weekly Program Day of the Week Description Ceramics and Painting Tuesdays Campers will enjoy painting ceramic objects. New ceramics introduced each week. Roller Skating Tuesdays Our PK & K Campers will learn the basics of roller skating each week. This 45- minute program will emphasize gaining comfort on skates, exercise and fun! Yoga Tuesdays PK & K Campers will love our playful yoga practice, while older campers will benefit from fun, more challenging yoga sequences and mindful relaxation techniques. Wednesdays Each week our campers will have the opportunity to sign up for & Nutrition Instruction. This program will be hands on. Campers will learn about new foods and the importance of good health and exercise. They will also make a yummy kidfriendly recipe that is safe, tasty and healthy! Splash Day Wednesday & Thursdays This takes place outside in our water play & splash area on our giant slip-n-slide, giant slide and water balloon battle stations. Video Game Bus Thursdays Our campers will have the opportunity to sign up for the Video Game Bus that has a full range of video game tournaments, vibrant HD flat panel TVs and the hottest game consoles on the market. Dance Thursdays Campers will enjoy this interactive dance program that teaches new moves, team work and boosts self-confidence. Campers will learn new choreography each week and be able to perform their dance in front of our camp during roll call. Special Guest Wednesdays & Fridays A list of special guest appearances can be found on the Special Days calendar. Camp Swim Trip Fees $9 per camper per trip Campers must be checked in camp by 9:00am to attend a swim trip. Please carefully read the enrollment packet to understand all of our policies and procedures for attending a swim trip. (Camper must be checked in by 9:00am!) Camp Swim Trip Schedule Grade Day of the Week Cost PK, K & 1 st Thursdays $9.00 per week per camper 2 nd, 3 rd, & 4 th Mondays $9.00 per week per camper 5 th, 6 th, & 7/8 th Tuesdays $9.00 per week per camper Swim Lessons Swim Lessons are available for all campers from K 8 th grade. Pre-K are not permitted to take swim lessons. The cost for seven 30-minute lessons is $125. Ratio of Camper to Instructor is 5:1. Lessons are taught in a group setting. Swim Lessons will be conducted by the Swim Instructors at Swim Club from 10:30am to 11:00am. Campers must also be enrolled in the Swim Club Trip on each lesson date. There are no make-up days for swim lessons. If your child misses a lesson a credit will not be issued. After the swim lesson your camper is brought back to join their group at Swim Club. Camp Swim Lesson Schedule Age Group Swim Lesson Dates PK, K, 1 st Every Thursday: July 5 th August 16 th 2 nd, 3 rd, 4 th Every Monday: July 2 nd August 13 th 5 th, 6 th, 7 th, 8 th Every Tuesday: July 3 rd August 14 th

6 Camp Field Trip Fees PK 1 st Field Trips Dates Cost per date * Tuesday, June 19 th Tuesday, July 24 th $20.00 Tuesday, August 28 th per trip FunPlex Waterpark Tuesday, June 26 th $29.00 Please Touch Museum Tuesday, July 3 rd $29.00 Johnson s Farm Tuesday, July 10 th $28.00 Aquarium Tuesday, July 17 th $33.00 CoCo Key Water Resort Tuesday July 31 st $34.00 Storybook Land Tuesday, August 7 th $41.00 Discovery Museum Tuesday, August 14 th $26.00 Movies (TBD) Tuesday August 21 st $ nd 4 th Field Trips Dates Cost per date * Wednesday, June 20 th Wednesday, July 25 th Wednesday, August 29 th $20.00 per trip FunPlex Wednesday, June 27 th $32.00 Medieval Times* Wednesday, July 11 th $60.00 Zoo Wednesday, July 18 th $32.00 iplay America Wednesday August 1 st $44.00 Franklin Institute Wednesday, August 8 th $33.00 Sahara Sam s Wednesday, August 15 th $34.00 Movies (TBD) Wednesday August 22 nd $ th 7/8 th Field Trips Dates Cost per date * Thursday, June 21 st Thursday, July 26 th Monday, August 27 th $20.00 per trip Escape the Room Monday, June 25 th $41.00 Monday, August 20 th per trip FunPlex Thursday, June 28 th $32.00 Speed Raceway** Monday, July 2 nd $35.00 Thursday, August 2 nd per trip Rock Climbing** Thursday, July 5 th $26.00 Outdoor Laser Tag** Monday, July 9 th $40.00 Thursday, August 9 th per trip Medieval Times* Thursday, July 12 th $60.00 Six Flags Monday, July 16 th $56.00 Ocean City Beach & Boardwalk Thursday, July 19 th Monday, August 6 th $20.00 Parkour Academy** Monday, July 23 rd $44.00 Hurricane Harbor Monday, July 30 th $44.00 Dorney Park Monday, August 13th $50.00 Sahara Sam s Thursday, August 16 th $34.00 Movies (TBD) Thursday, August 23 rd $25.00 Camp Field Trips *Lunch is included ** Waiver required Camp field trips are optional and have additional fees. Campers must be checked in camp by 9:00am to attend a field trip. Please carefully read the enrollment packet to understand all of our policies and procedures for attending a field trip. If your camper arrives at 9:01am or after they will not be permitted on the field trip and no credit will be issued. Campers must bring a brown bag lunch, unless the trip includes a lunch. Campers must wear their camp t-shirt on every field or swim trip. If not, they will be provided one by the camp and your credit card will be charged $6.00. Please note that a camper is only able to attend one field trip, swim trip, enrichment or sport camp per day. This is due to the trip and camp times.

7 Camp Enrichment & Sport Camp Fees Enrichment and sports camps are optional and may have additional fees. Camp Dates Description Cost per week Basketball 6/25-6/28 Campers will learn the basics of dribbling, passing, shooting, defense, and footwork, and to challenge the use of both the dominant and non-dominant hands. No equipment is required. Free Field Hockey Mad Science Mission Code 7/2-7/5 Campers will participate in basic skills and drills, games and fun activities. Course teaches campers new moves and techniques that will make each camper a more complete player. Equipment Required: Field Hockey Stick, Mouth & Shin Guards. 7/9-7/12 Discover the world of coding! All digital games, apps, computers, websites, and machines need programs to run; learn to code like real programmers do! Join in a scavenger hunt, solve puzzles, play tag, unravel the secrets of the Hanoi Tower, and learn coding skills in our online gaming environment. Collaborate with fellow Mad Scientists, identify problems, test solutions, and debug your programs. This is your <Mission:Code> should you choose to accept it! 7/16-7/19 Paint & Take Home Pottery, Mosaics, Canvas Art and Jewelry Making are all part Art & Painting of this fun course. 7/16-7/19 Campers will learn the basics of passing, dribbling, shooting and defense. Instructors also challenge campers to use both the dominant and non-dominant feet, emphasizing the importance of proper footwork and ball control, field awareness, and adequate spacing among players. Shin guards are required. Mad Science Crayola & Nutrition Improv 4 Kids Bricks 4 Kids Flag Football 7/23-7/26 *Grades K - 5 Only 7/30-8/2 & 8/20-8/23 8/6-8/9 *Time: 2:30-4:30PM Crayola World of Design is a summer camp that takes kids on a journey to the edges of their imagination - and beyond! They learn about Mars, the rainforest, and cities of the future, and get engaged in the creative design process to solve real-world problems. Each camp day focuses on a specific field of design, and our young architects, illustrators, and graphic designers develop their ideas from concept, to sketch, to finished product. They bring their concepts to life by experimenting with Crayola products, and exploring art techniques like sculpting, storyboarding, mixed media, and collage. Combining art, design, fun active games and inspiring themes from around the world, this camp is designed to inspire! Class will include chef hat, apron, cookbook of recipes made together in camp and meals to take home. This is an interactive cooking course where campers become the chef! Chefs will transform processed and pre-packaged kid favorites into healthier homemade versions such as mac and cheese, pancakes, snack bars and more! This camp is laugh out loud funny from beginning to end! Our instructors work closely with the campers using Improv Comedy. This camp also includes Stand-Up and Sketch comedy to get campers excited about communication, team work and leadership skill sets. This camp aims to strengthen public speaking, focus, eye contact, listening skills in our campers. 8/13-8/16 Using specialized LEGO Technic pieces such as gears, axles, and electric motors, campers work in pairs to construct a variety of Bricks 4 Kidz models, as well as build creations of their own during our free-play periods. Our camps keep the pace fast and the action going with LEGO Bricks, games and more to ensure kids will have plenty of LEGO fun! 8/20-8/23 Campers will participate in basic skills and drills, games and fun activities. Flag Football camp teaches campers plays and standardized flag football rules. No equipment is required. Free $165 $165 each Free $165 $100 each $125 $165 Free

8 PK 1 st Grade Enrollment Contract To enroll your child in ISC Summer Day Camp, please fill out this two sided form and select the dates that you would like your child to attend. You must select a minimum of 15 days. You must pay for all the dates, trips and camps that you select. Swim Lessons (K & 1 st Grade only). $ % Discount Please place an X in the to indicate the day, trip, or camp you would like to reserve. You may only select one field trip, swim trip, enrichment or sport camp per day as they take place at the same time. 6/18 6/22 June 18 6/25 6/29 June 25 7/2 7/6 July 2 7/9 7/13 July 9 7/16 7/20 July 16 7/23 7/27 *K & 1 st Only Monday Tuesday Wednesday Thursday Friday July 23 * 7/30 8/3 July 30 8/6-8/10 August 6 8/13 8/17 August 13 8/20 8/24 August 20 8/27 8/31 August 27 June 19 June 26 FunPlex Water July 3 Please Touch Museum July 10 Johnson s Farm July 17 Aquarium July 24 * July 31 CoCo Key August 7 Storybook Land August 14 Discovery Museum August 21 Movies (TBD) August 28 June 20 June 27 July 4 Closed July 11 July 18 July 25 * August 1 August 8 August 15 August 22 June 21 June 28 July 5 July 12 July 19 July 26 * August 2 August 9 August 16 August 23 June 22 June 29 July 6 July 13 July 20 July 27 August 3 August 10 August 17 August 24 August 29 August 30 August 31 Parent/Guardian Signature: Date: Continued on reverse side

9 2 nd - 4 th Grade Enrollment Contract To enroll your child in ISC Summer Day Camp, please fill out this two sided form and select the dates that you would like your child to attend. You must select a minimum of 15 days. You must pay for all the dates, trips and camps that you select. Swim Lessons $ % Discount Please place an X in the to indicate the day, trip, or camp you would like to reserve. You may only select one field trip, swim trip, enrichment or sport camp per day as they take place at the same time. Monday Tuesday Wednesday Thursday Friday 6/18 6/22 6/25 6/29 7/2 7/6 7/9 7/13 7/16 7/20 7/23 7/27 7/30 8/3 8/6-8/10 8/13 8/17 8/20 8/24 8/27 8/31 June 18 June 25 Basketball July 2 Field Hockey July 9 July 16 July 23 July 30 August 6 Improv August 13 Bricks 4 Kids August 20 June 19 June 20 June 26 Basketball July 3 Field Hockey SED July 10 July 17 July 24 July 31 August 7 Improv August 14 Bricks 4 Kids August 21 June 27 FunPlex Basketball July 4 Closed July 11 Medieval Times July 18 Zoo July 25 August 1 iplay America August 8 Franklin Institute Improv August 15 Sahara Sam s Bricks 4 Kids August 22 Movies (TBD) August 27 August 28 August 29 June 21 June 22 June 28 Basketball June 29 July 5 Field Hockey July 6 July 12 July 13 July 19 July 20 July 26 July 27 August 2 August 3 August 9 Improv August 10 August 16 Bricks 4 Kids August 17 August 23 August 24 August 30 August 31 Continued on reverse side

10 5 th 8 th Grade Enrollment Contract To enroll your child in ISC Summer Day Camp, please fill out this two sided form and select the dates that you would like your child to attend. You must select a minimum of 15 days. You must pay for all the dates, trips and camps that you select. Swim Lessons $ % Discount Please place an X in the to indicate the day, trip, or camp you would like to reserve. You may only select one field trip, swim trip, enrichment or sport camp per day as they take place at the same time. Monday Tuesday Wednesday Thursday Friday 6/18 6/22 6/25 6/29 7/2 7/6 7/9 7/13 7/16 7/20 7/23 7/27 *5 th Grade Only 7/30 8/3 8/6-8/10 8/13 8/17 8/20 8/24 8/27 8/31 June 18 June 19 June 25 Escape Room Basketball July 2 Speed Raceway Field Hockey July 9 Laser Tag July 16 Six Flags July 23 Parkour Academy * July 30 Hurricane Harbor August 6 Ocean City Improv August 13 Dorney Park Bricks 4 Kids August 20 Escape Room August 27 June 26 Basketball July 3 Field Hockey July 10 July 17 July 24 * July 31 August 7 Improv August 14 Bricks 4 Kids August 21 June 20 June 21 June 27 Basketball July 4 Closed July 11 July 18 July 25 * August 1 August 8 Improv August 15 Bricks 4 Kids August 22 June 28 FunPlex Basketball July 5 Rock Climbing Field Hockey July 12 Medieval Times July 19 Ocean City July 26 * August 2 Speed Raceway August 9 Laser Tag Improv August 16 Sahara Sam s Bricks 4 Kids August 23 Movies (TBD) August 28 August 29 August 30 June 22 June 29 July 6 July 13 July 20 July 27 August 3 August 10 August 17 August 24 August 31 Continued on reverse side

11 Camp Enrollment Contract Parent s Phone: Credit Card #: Exp: CVC: (We do not accept American Express.) Is this credit card number different than siblings? Yes / No Billing Zip Code: Parent Acknowledgment of Field/Swim Trip and Enrollment Contract In order to guarantee a place for your child, for all of the days that you have selected, we must receive this form no later than April 30, We will still accept Enrollment Contracts after that date; however, all of the days may not be available. You will be notified if any of the days you have selected are full when we process your contract. There is a 15 day minimum. If you wish to reserve the last 10 days of camp, you must be enrolled 10 days prior to the last 10 days of camp. (initial) My child has permission to engage in all camp activities and to be transported to and from the field/swim trips that I have selected for him/her. I have read and understand the camp enrollment packet regarding the guidelines on all field and swim trips and camp activities. I understand that my child must be inside the building before 9:00am in order to attend the field/swim trip. I understand that I will receive no reimbursement for missing a day, camp, field or swim trip due to any reason. (initial) Payment is due by 9:00 am on Wednesday for the following week. We will automatically run your credit card at this time. If you prefer, you can pay with a check or cash prior to 9:00 am on Wednesday. Once your credit card has been charged, there will be no credits issued. All payments received after 9:00 am on Wednesday will be applied to your next camp week. Daily tuition rates are $49/1 st child, $45/2 nd child and $36/child for each additional child. (initial) There are no refunds, cancellations, substitutions, or credits on enrollments of days, trips or camps. If your child is absent, for any reason, you will not receive a credit for that day. (initial) ADDITIONAL FEES: Your credit card will be automatically charged $15 from 6:01 6:15 pm and $15 for every 15 minutes after that when picking up after 6:00pm. You will be charged a $30 fee for checks returned for any reason. You will be charged $30 for all credit card payments that are denied. (initial) To enroll your child in any/all of the camp field/swim trips and/or enrichment camps, please complete this form and send with payment in full. Please enclose a check in the full amount or we will automatically run your credit card on April 30, 2018 for the amount of the field/swim trips and/or enrichment camp. We will still accept field/ swim/ enrichment enrollments after that date; however, all the days may not be available. Campers must arrive before 9am to attend any trip or camp. (initial) Campers that are removed from camp for any reason will not receive a credit for the camp week in which the incident occurred. Campers that are removed from camp for any reason will not be refunded for any field trips that have been paid in advance. (initial) I have made a copy/taken a photo of my Enrollment Contract(s) to keep for my records.. (initial) I, the parent/guardian of, have read and initialed the Parent Acknowledgement/ Camp Enrollment Contract which shall become my obligation to ISC of Cherry Hill. I fully understand this obligation and the reasons for its implementation. I agree to pay for all days, trips and camps that I have selected. Please sign below indicating that you have read and understand our Camp Enrollment Contract and our Camp Packet containing the Policy and Procedures. Parent/Guardian Signature: Health and Wellness Form Date:

12 Parent Information Camper Information Health & Wellness (1 per camper) Child s Name: Grade as of January 2018: D/O/B: Boy/Girl Returning Camper New Camper Home Address: City/Zip: Camper s Shirt Size (circle one): YS YM YL AS AM AL AXL Child Lives With: Both Parents Mother Father Other If other, please explain: Referred by: (Must be listed at time of enrollment) How did you hear about our camp:? Please include a photo of your child for our records. You may also a photo to put into their digital file. (PLEASE INCLUDE CAMPER S NAME ON THE BACK OF PHOTO) Parent/Guardian (1) Name: Home #: Home Address: City/Zip: Work #: Ext.: Cell#: (This will receive all camp information and notices) Parent/Guardian (2) Name: Home #: Home Address: City/Zip: Work #: Ext.: Cell#: (This will receive all camp information and notices) Please answer all of the questions (1-7) below (Use additional paper if necessary) 1. What does your child like to do in his/her free time? 2. Describe how your child interacts with his/her peers: 3. Have there been any major changes in your family situation in the past year (family move, separation, divorce, death, new school, birth, etc.) If so, what effect did this have on your child? 4. Is your child or family receiving any special help with emotional concerns or behavior at school or home? (Psychiatrist, counselor, social worker, etc.) If so, please explain. (Use additional sheet if necessary) 5. Is there anything else you would like us to know about your child that will aide us in helping him/her have a safe and enjoyable summer? Any specific concerns about your child? (Use additional sheet if necessary) 6. Any photos/video footage taken while your child is at camp may be used for promotional purposes in print media and/or internet promotion. No financial compensation is available should such a picture/video be used. If you DO NOT wish to have your child appear in photos/video used to promote our camp, please initial: 7. If you DO NOT wish to have your child watch a movie with a PG rating, please initial:

13 Health & Wellness (page 2) Has your child been identified as needing support or supplemental services during the school year in any of the following areas? Please check all that apply: Academic Speech Emotional (i.e. anxiety, fears) Please describe the nature of these services: Behavioral (i.e. ADD/ADHD) Personal/Social Language Health (i.e. diabetes, allergy) Physical Does your child have an Epi Pen? If so, will your child be bringing the Epi Pen to camp? Does your child use an inhaler? If so, will your child be bringing the inhaler to camp? Is your child allergic to any medication/ animals/ insect stings? Does your child take any daily medications? Does your child have any medical/physical restrictions? Please Circle If Yes, please explain: If Yes, please list the medication and dosage: If Yes, please circle: Asthma Hearing Loss Diabetes Convulsions Other If Other, please explain: Does your child have any FOOD ALLERGIES? *All campers with food allergies will be seated at a table designated for food allergies.* Are there foods that you do not wish your child to have? Do you give us permission to administer Tylenol* to your child? If Yes, please list the foods that your child is allergic to: Please list: If yes, please list your child s weight and correct dosage: Camper Weight Chewable: tablets Liquid: tsp *Please note we will not administer Tylenol without calling you directly first. We are required by the NJ Department of Health and Senior Services to have a current copy of each camper s Immunization Records on file. If your child attended our camp in 2017 and has not had ANY new immunizations, you may check below and we will use last year s records as long as they were new (we can only reuse immunization records once). All others MUST have this updated and returned to us prior to attending our camp or attach an updated copy from your physician s office. No changes the immunization records on file summer since 2017 HEALTH AND WELLNESS AGREEMENT I certify that the health history information provided on this form is correct. My child has permission to engage in all camp activities and be transported to and from field/swim trips that I have selected for him/her. In the event that I cannot be reached in an emergency, I give my permission to the physician selected by the camp to hospitalize and secure proper treatment for my child as named above. I will notify the Camp Director if there is a change in my child s medical information in writing. Parent/Guardian Signature: Date:

14 AUTHORIZATION FOR CHILD RELEASE One form per family In addition to the parents/guardians listed on the Health and Wellness form, ISC of Cherry Hill requires that parents/guardians provide a list of authorized persons who may pick-up their child from ISC Summer Day Camp. The names of all authorized persons must be on file with the Camp Office prior to your child s attendance. Only authorized persons will be permitted to pick-up children from the camp. To make changes to this form you may do so by ing the Camp Director. Please make sure that any person (including parents/guardians) picking up your child has photo proof of identification at all times. PLEASE NOTE: Under no circumstances will we release campers to anyone who is not listed below. I authorize the following individuals to pick up my child from ISC Summer Day Camp: Name: Ph1: Name: Ph1: Name: Ph1: Name: Ph1: Name: Ph1: Name: Ph1: Relationship: Ph2: Relationship: Ph2: Relationship: Ph2: Relationship: Ph2: Relationship: Ph2: Relationship: Ph2: AUTHORIZATION FOR CHILD RELEASE AGREEMENT I hereby give permission for the people on my authorization for child release form to pick-up my child from ISC Summer Day Camp. I will inform them that proper photo identification must be presented at the time of pick up or my child will not be released in their custody. Parent/Guardian Signature: Date:

15 BEHAVIOR MANAGEMENT POLICY One form per family The ISC Summer Day Camp wants all of our campers to have a rewarding and memorable experience. In order for this to take place, there are a few rules campers are expected to follow. Please review the following rules and discipline measures with your child to ensure that he/she has a safe, positive and, most importantly, fun summer. Camp Rules: 1. Be kind and respectful to yourself, others, and camp property. 2. Listen and follow directions. 3. Keep hands, feet, all other body parts and objects to yourself. 4. Be responsible for your personal belongings at all times (not PK and K campers) 5. Leave expensive toys/cell phone at home. We are not responsible for the loss or theft of these items. 6. If you have a problem always tell a counselor or a director immediately. Camper Consequences: 1. Redirection of camper 2. Verbal warning or time-out 3. Visit to Camp Director and phone call home (Child will speak to parents at that time) 4. In the event that a second phone call is necessary, the child may be suspended from camp. 5. Parent will be notified in writing of the date the child will be permitted to return to camp. 6. In the event of severe, consistent or excessive failure to follow the rules, the camper will be suspended or removed from camp. Camper must be picked up within 1 hour of parent notification. 7. There are no refunds, credits or substitutions for any days a child has been suspended from camp. 8. If the camper severely endangers the physical, mental or emotional health of another individual, the camper will be expelled from the camp. 9. ISC reserves the right to terminate a child s enrollment at our discretion. Parent Notification PARENT/GUARDIAN AGREEMENT: I, the undersigned, have carefully read and gone Parent/Guardian over the above Notification rules and consequences with my child. I agree with the above policy, and understand that in the event my child is suspended or expelled from camp for failure to follow the rules, I will not receive a refund for any camp monies for that time. If my child is removed from the camp for any reason, I will not receive a refund for that week or for any field/swim trips paid in advance. My contract will be terminated at the end of the week that the camper was removed. Parent/Guardian Signature: Date:

Camp AB Summer Day Camp June 5, 2017 August 4, :00 am 5:00 pm Extended Day 7:00 am 6:00 pm

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