National Museum of the Marine Corps Summer Camp Registration Ages 7-10 Thank you for your interest in the National Museum of the Marine Corps Summer Camp program. To register your child for camp please fill out this form. Children will be accepted on a first come, first serve basis. If you have multiple children participating, each child being registered MUST have a separate registration form (please feel free to attach registration forms for multiple children to one email though). Registration Opens on April 4, 2016 at 9am Registration Closes on June 1, 2016 at 5pm (no early or late registration forms will be accepted) Camp Session Registering For: (Please rank your order of preference 1-4) Semper Fun History Camp June 28-30 Aviation Camp July 12-14 Semper Fun History Camp July 26-28 Art Camp August 9-11 To allow the most campers the opportunity to attend camp you may register for only ONE session of camp. If your child wishes to attend multiple sessions they will be placed on the waitlist for the other session(s). If a session is full your child will be placed on a waitlist. Child s Name: Age at Time of Camp: Parent/Guardian Name: Address: City: State: Zipcode: Email Address: Home Phone: Work Phone: Cell Phone: How did you hear about camp? 1 of 6
Emergency Contact Person (in addition to the Parent/Guardian listed above) Name: Relationship: Cell Phone: Work Phone: Home Phone: Camper s Health History Camper is subject to: Asthma Seizures Bee Sting Allergy Food or other Allergies N/A Please Specify Allergies: Any significant medical condition we should know about? Any restrictions from activities? Any accommodations needed by camper? Anything else we should know about your child? Child Release Authorization The following person(s) are authorized to pick up the camper (ID will be checked at pick-up): 1. Name: Relationship: Cell Phone: 2. Name: Relationship: Cell Phone: 3. Name: Relationship: Cell Phone: 2 of 6
Photo Release Authorization I herby give the National Museum of the Marine Corps the absolute right and permission to publish, copyright and use pictures of my child in which he/she may be included who or in part, composite or retouched in character or form. I understand that signing this release does not guarantee publication of a photo. Parent/Guardian Signature: Date: Code of Conduct Please read the following Code of Conduct policies aloud with your child. Please sign this form along with your child. To ensure that camp at the National Museum of the Marine Corps is fun and exciting for everyone, there are some basic rules that must be followed to maintain a safe and healthy environment for all campers. As a camper at the National Museum of the Marine Corps, I agree that I will: 1. Be mindful of my instructors including, Museum staff and security and respect their requests 2. Be responsible for my own actions 3. Keep my hands to myself 4. Respect other camper s property and the property of the Museum 5. Respect my fellow campers 6. Use appropriate language 7. Tell my instructors when I need help or if someone is bothering me I understand that if I break any of the above rules I will be asked not to return to camp for the rest of the session. Parent/Guardian Signature: Date: Child s Signature: Date: 3 of 6
Guidelines Children will be accepted on a first come first serve basis. A wait list will be established after all available slots are filled. Camp hours are 9am to 12:30pm each day. Children will not be able to be dropped off prior to 9am and must be picked-up each day at 12:30pm. Please call to inform staff if you will be more than 15 minutes late picking up your child. If you are more than 15 minutes late picking up your child without prior notice, we will not be able to invite your camper back to the rest of camp. Camp staff will be with the campers, please call the Museum s front office at 703-784-6115 or the Teacher-in-Residence at 703-221-8430 and let them know you will be late. We ask that if you know in advance that your camper(s) will miss days of camp, please DO NOT register them for camp. Many activities build upon what the campers learned the previous days and we don t always have time to catch campers up on what they missed. Children with cellphones are allowed to keep them with them during camp, but only to make emergency phone calls and keep track of time. Campers are responsible for keeping track of their own electronics devices throughout the day. If we see a cell phone being used for social reasons or to play games, we will confiscate it until the end of the camp day. Staff is not responsible for lost or damaged phones - students must keep track of their property. 4 of 6
Snack All campers will need a packed snack and water sent with them to camp each day. Snacks will be kept in the air conditioned classroom until snack time. There are no refrigerators or microwaves. All campers MUST have their snacks with them at checkin. We will not allow campers to check in unless they have a snack with them. We often have campers with peanut and other nut allergies. For the safety of all of our campers, PLEASE DO NOT send peanut or other nut products to camp with your child. Attire Campers should arrive at camp with sunblock and bug spray already applied. Campers should bring a long sleeved shirt or jacket for when they are inside. The Museum s air conditioning can be quite chilly. All campers must wear closed-toed shoes to prevent injury. * Campers enrolled in Art Camp please wear clothing that can be painted in. First Aid Camp counselors have basic first aid kits for minor scrapes, bumps and bruises. Bandages and ice packs will be given out if needed. If your child is seriously hurt and requires medical attention, camp counselors will first call you or your emergency contact to get verbal confirmation to call the ambulance. If the injury is life threatening, we will call 911 first and then call you to meet your child at the hospital. It is imperative that you provide a home, office and cell phone number for both you (parent/ guardian) and your emergency contact. 5 of 6
Please initial and sign the following: I have read and understand the camp guidelines and registration information. I understand that I am required to provide a home, office and/or cell phone number for a parent and emergency contact in order for my child to be considered for registration in Semper Fun, Aviation and Art Camp. I understand that the National Museum of the Marine Corps staff are only responsible for my child during the hours of camp. There is no before and after care provided by staff. I understand that I may drop my child off at 9am and must pick them up at 12:30pm each day. I understand that I may not leave children unsupervised at the Museum. I understand that if I do not call to inform staff that I am running late for pick up (by 12:45pm) my child will not be invited back to camp. Parent/Guardian Signature Date Questions? Please contact: Rebecca Super at 703-784-4464 or helen.super@usmcu.edu Please submit this form via email to Rebecca Super at helen.super@usmcu.edu or National Museum of the Marine Corps 18900 Jefferson Davis Highway Triangle, VA 22172 Attention: Rebecca Super For Office Use Only Date Application Received: Confirmation Sent: 6 of 6