Great Beaver Adventure Camp 2018 GIRL SCOUTING THROUGH THE YEARS

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1 DATE: Thursday June 7, 2018 through Sunday June 10, 2018 TIME: THURSDAY THROUGH SATURDAY 8:30 AM to 4:30 PM SUNDAY ONLY- EARLY DISMISSAL 8:30 AM to 2:00 PM (PLEASE ARRIVE ON TIME) LOCATION - Carlisle YMCA Camp Thompson, 800 Pine Grove Road, Gardners, Pa PHONE TRANSPORTATION - Bus transportation is available to and from camp from specific bus stop locations. REGISTRATION DEADLINE Registration fees as listed below if postmarked by May 15, 2018 Registrations postmarked after May 15 th will be accepted on a space-available basis and a late registration fee of $8.00 should be included. T-Shirt for each camper Registrations received after T-Shirt deadline may receive a blank shirt. Please indicate T-shirt size on the registration form. HOW TO SELECT A UNIT LEVEL: Please DO NOT select your UNIT based on who may be leading the unit. Girls of particular Troops will NOT necessarily be placed with leaders from their troop who are running units. All placement is based on date of receipt of registration and number of girls per age unit and Camp Directors reserve the right to limit the number of girls per unit as needed for appropriate supervision. Once a unit is full, the camper may be placed in a second or third option as space allows. We CANNOT guarantee that you will receive a particular UNIT and strongly recommend that you list an alternate preference for unit as available. UNIT AGE LEVELS Daisy (Grades K-1), Brownies (2-3), Juniors (4-5) and Cadette (6-8) Determine the grade the camper will complete at the end of this school year. If grade completed and following grade are both in same age level that is your unit level. (Example: Grade completed is 2 nd and next grade is 3 rd Unit should be Brownies) If grade completed is one age level and following grade falls into the next age level, we recommend selecting the higher age level. (Example- If Grade completed is 3rd and next grade is 4th- we recommend selecting a Junior Unit since camper will bridge to Juniors the following school year). Only Grade 3 Brownies will be considered for overnight brownie unit. PROGRAM AIDES USE A SEPARATE REGISTRATION FORM DAISY/BROWNIE UNIT cost: $40.00 (2-DAY UNIT- SAT/SUN ONLY) Special unit for girls entering Grade K through completing Grade 2. If you feel your daughter is not ready for four days at camp,let her come for just Saturday and Sunday. She will experience a lot of the same activities as the four-day camp swimming, crafts, and campfire. We recommend that campers completing Grade 2 who have attended camp previously opt for a 4-day brownie unit. UNIT #1- DAISY/BROWNIE (2-DAY) BROWNIE TRY-ITS cost: $65.00 (4-DAY UNIT- NO OVERNIGHTS) Unit for campers entering Grades 2-3 next year. UNIT #1- SCIENCE MAGIC UNIT #2- OUTDOOR ADVENTURE BROWNIE TRY-ITS cost: $74.00 (4-DAY UNIT- ONE OVERNIGHT SAT to SUN) Unit for campers Grade 3 or just finishing Grade 3. UNIT #3- PLANTS & ANIMALS JUNIOR BADGES cost: $74.00 (4-DAY UNIT- 1 OVERNIGHT SAT) Unit for campers entering Grades 4-5 next year. UNIT #1- YOUR OUTDOOR SURROUNDINGS UNIT #2- TROOP CAMPER CADETTE IP cost: $86.00 (4-DAY UNIT- 2 OVERNIGHTS FRI & SAT) Unit for campers entering Grades 6-8 next year. UNIT #1- OUTDOOR COOK (LIMIT 8 GIRLS ONLY) UNIT #2- STAR FINDER FOR MORE INFORMATION CONTACT: Mary Ann Antoine, Camp Director (cell) or MAAScout@aol.com Melinda Shenck, Business Manager or mshenck@selectmedical.com (preferred)

2 How to Register for Great Beaver Adventure Camp 1. MUST complete a registration form and health history forms (pages 3-5) for each camper. If you list allergies for camper, please also complete the Allergy Questionnaire on pages 6-7. Send the forms with payment (payable to GSHPA - GBAC) to the Business Manager listed on the bottom of page Financial Assistance has changed this year--- Carlisle Community will be responsible for providing financial assistance for local day camps. NOTE: A payment of $10.00 ($25.00 if using bus transportation-fa does not pay for transportation) must be sent with your registration to reserve your space at camp while we process your request. In order to qualify for Community Financial Aid for GBAC you must already have qualified and applied for FA from GSHPA for the scouting year. Direct any questions to the Business Manager. 3. Registrations will be accepted up to the deadline date or until the program is full. (Capacity may be reached before the deadline expires.) 4. Campers will receive an (letter if no address supplied) prior to the event, which will provide further details on the program, meals, equipment needed, bus schedule, directions, etc. 5. Event fees are not transferable and are refunded only if the application is not accepted, if the session is canceled, or if a physician's written statement is submitted. 6. Non-Girl Scouts must pay an additional $15.00 which covers membership in Girl Scouts of the U.S.A. and accident insurance. Fee will register the camper with GSHPA until September 30, This will require completion of an additional Membership Registration form which will be sent to you following submission of your application. 7. Great Beaver Adventure Camp is staffed by volunteer adults and childcare may be provided for younger children of adult volunteers. (Pixie Program-- $7.00 per child PER DAY) Separate registrations required for Pixies and Volunteer Adults Pixies must be potty-trained and able to walk to qualify. 8. Registered Adult Volunteers who work at camp all four days will receive A REFUND of 1/3 of the fee for one designated camper they have registered for the event. Refunds will be mailed after camp has concluded and Volunteers may opt to donate their refund to GBAC. 9. Program Aides must complete Program Aide training. Information regarding Program Aide Training will be sent as needed 10. We CAN ACCEPT GO DOUGH as payment for registration fees. Bring a New Camper to Great Beaver Bring a new camper to Great Beaver! If you get a girl to come to the 4-day Great Beaver camp who DID NOT attend last year, you ll receive $10 off your registration fee ($5 off if she comes for the 2- day camp). You and the new camper do not have to be in the same unit.

3 GREAT BEAVER REGISTRATION FORM (PLEASE PRINT CLEARLY) Camper s Name Street City Zip Code Telephone Reg. Girl Scout Y N; Troop # School grade completed, June 2018 Age Previous Camp Experience (# of years) Day Camp Resident Camp UNIT FEES (Sat/Sun) Daisy/Brownie $40.00 Brownie $65.00 Brownie $74.00 (Overnight) Junior $74.00 Cadettes $86.00 (PROGRAM AIDES have separate registration form) REFER TO FIRST PAGE FOR CORRECT UNIT LEVEL CAMP FEE $ NOTE: Add $8 after May 15 th LATE FEE $ PIXIE FEE Pixies $7.00 (per child, per day) Separate Registration Required for Pixies UNIT CHOICE 1 st Choice 2 nd Choice Buddy Camper Name LIST ONLY ONE- MUST register for same unit BUS CHOICE $15.00 fee BUS FEE $ BUS STOP LOCATIONS- CIRCLE ONE: Carlisle STOP- TBD Family Dollar (Mt. Holly) Plainfield Unimart Saylor's Park & Ride Keck s Store T-SHIRT SIZE (Included if registration received by May 24 th After deadline will be included only as available and may be plain shirt) Circle one: Youth M L Adult S M L XL XXL A UNIT PHOTO will be provided to each girl this year at no charge Bring a friend to camp who didn t come last year Discount $10.00 for 4-day or $5.00 for 2-day Friend s name: FRIEND DISCOUNT $( ) $15 Girl Scout Registration fee (if not currently registered): GSUSA REG. FEE $ You will receive an with additional information regarding registration (Registration completed now will be valid from 10/1/2016 through 9/30/2017 only) $10 SPACE RESERVATION FEE RESERVATION FEE $ (if applying for financial assistance from Community) GO DOUGH CREDITS GO DOUGH SUBMITTED $( ) GO DOUGH CARD NUMBER TOTAL ENCLOSED: $

4 ALLERGIES FOOD ALLERGIES (please circle one) MEDICATION ALLERGIES (please circle one) OTHER ALLERGIES (i.e. Latex) (please circle one) IF YOU CIRCLE YES FOR ANY OF THE ABOVE, YOU MUST LIST ALLERGIES ON THE HEALTH HISTORY FORM (pg. 5) AND COMPLETE THE ALLERGY FORM QUESTIONNAIRE (pgs. 6-7) PLEASE FILL OUT ONE OF THE FOLLOWING PERMISSION STATEMENTS: My child,, has my permission to participate in all camp activities including swimming. OR My child,, may participate in all camp activities except:. Please check ONLY ONE: We DO OR DO NOT permit photos of our child for Girl Scout publicity. PARENT/GUARDIAN SIGNATURE DATE PARENT OR GUARDIAN . Confirmations will be ed when possible AND IS OUR PREFERRED METHOD OF CONTACT. SEND REGISTRATIONS TO: Melinda Shenck 39 Cold Springs Road Carlisle, PA Please make checks Payable to GSHPA-GBAC INTERESTED IN BEING AN ADULT VOLUNTEER? Yes, please contact me by Phone: AND/OR me at DAYS AVAILABLE: THURS FRI SAT SUN ALL 4 DAYS Are you currently Registered as an Adult Volunteer with Girl Scouts? Do you have a current background check for GSHPA?

5 Health History and Emergency Information CAMPER (Last, First) Operations or serious injuries (dates) Recent Hospitalization Does your child have any physical or emotional conditions that might affect her participation in the Great Beaver program? Please describe. You may be contacted for clarification. Is your child on any regular medication? If yes, please list Has your child menstruated? Any special consideration? Family Physician s Name Phone Allergies Chronic or Recurring Illness Hay Fever Ear Infections Behavior Asthma Heart Disease Bleeding/Clotting Disorders Insect Stings Convulsions Other Ivy, Oak, etc. Diabetes Other LIST ALL KNOWN ALLERGIES: (Include food allergies) You will also need to complete the attached Allergy Questionnaire form (pgs. 6-7) if you list any allergies. We understand that event fees are not transferable and are refunded only if the application is not accepted, if the session is canceled, or if a physician s written statement is submitted. In no event will the Girl Scouts in the Heart of Pa. Council, its officers, leaders or agents be held liable for any first aid rendered or treatment, drugs and medicine or surgical procedures performed pursuant to this consent. The undersigned do hereby give our permission to the officers, leaders or agents of Girl Scouts in the Heart of Pa. Girl Scout Council to obtain and administer such medical aid or assistance as might be required for the immediate care of our child in the event that such help of an emergency nature should become necessary. Parent or Guardian signature Parent or Guardian s Name (print) Address during camp Parent s telephone number during camp (home) (work) (cell) Other Emergency contact during event: (Name) Telephone) (Relationship)

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