Camper s Name LACEY PARKS & RECREATION SUMMER FUN TOUR DAY CAMP 2017 FAX: 360.438.2669 Email: laceyparks@ci.lacey.wa.us (your child is not registered without payment and the registration form) Please follow-up with a phone call, 360.491.0857 M / F (last) (first) (circle one) CHOOSE ONE SITE ONLY PLEASANT GLADE ELEM LYDIA HAWK ELEM Date of Birth Address City ZIP GUARDIAN #1 RELATIONSHIP Name Work Phone Home/Cell Phone Email GUARDIAN #2 RELATIONSHIP Name Work Phone Home/Cell Phone Email Please initial Small Medium *** T-SHIRT SIZE *** Large Small Medium Large Two weeks payment in advance must be made at the time of registration to hold your spot for the summer (check, cash, or credit card). After today, payment is due the Monday prior to the week your child(ren) are attending, or you will be charged a $10 late fee and possibly withdrawn from camp to accommodate the waitlist. Notice Received week prior to camp 100% 1st Camp day 50% 2nd Camp day 0% Camp runs Mon. through Fri.; *Week 2, Mon., Wed.,Thurs.,Friday. Please indicate the week(s) your child will be attending camp. /week; *Week 2 = $135; **Week 9 = $175 Circle Week 1 2* 3 4 5 DATES OF CAMP FEE DATE June 26-30 Water Water Everywhere! July 3-7 Reach for the Stars (no camp July 4) July 10-14 Play Like a Champion July 17-21 Halfway to the Holidays July 24-28 S is for Science ENROLLMENT INMATION $135 PERMISSION TO RELEASE/EMERGENCY CONTACTS Please list below names and phone numbers of anyone, other than yourself, that you authorize to pick up your child from Lacey Parks & Recreation Summer Day Camp. Please list contacts in the order you would like them to be contacted in the event of an emergency. You will always be the first person we attempt to reach. 1. Name Relationship Phone 2. Name Relationship Phone 3. Name Relationship Phone 4. Name Relationship Phone Circle Week PLEASE COMPLETE REVERSE SIDE 6 7 8 9** DATES OF CAMP PAID DATE July 31-August 4 Land Before Time August 7-11 We ve Got Spirit, Yes We Do! August 14-18 I Wanna Rock AUGUST 21-25 OUTDOOR ADVENTURES (Meet at Rainier Vista Comm Park. Bring a sack lunch & snack each day) $175
CAMPER S HEALTH and BEHAVIORAL HISTORY Allergies? (plant, insect, food, medication) Special dietary needs? Please list any medications your child is taking: Describe any behaviors staff should be aware of and explain management of behavior: Please provide any information that you feel would be helpful in the supervision of your child: PARENT/GUARDIAN - PLEASE READ and SIGN BELOW I DO DO NOT give permission for non-prescription medication (non-aspirin product, Neosporin) to be given to my child. I DO DO NOT In case of emergency only, give permission to the physician selected by the camp staff personnel to hospitalize, secure treatment for, and order injections, anethesia, or surgery for my child named on this form. Any directions to the contrary should be specified on this form with signature of parent/guardian. I DO DO NOT grant the City of Lacey permission to use and publish my child s name or otherwise identify my child in association with any photo in which my child appears for editorial, marketing and promotional purposes in print and electronic media. No financial or other liability to me will be incurred by the city or the photographer. Parent/Guardian (signature) Date WAIVER for PARTICIPATION - PLEASE PRINT CLEARLY I fully realize that there are certain inherent risks to which my minor child(ren) will be exposed because of the nature of this activity. Fully understanding those risks, I hereby release the City of Lacey, its officers and employees, from any damages that may be suffered through particiaption in any activity related to the Lacey Parks and Recreation Summer Day Camp. Parent/Guardian/Name (print please) Parent/Guardian (signature) Lacey Parks & Recreation 420 College Street SE 360.491.0857 Child s Name (print please) H:\Summer Day Camp\2017\registration form.indd
SUMMER DAY CAMP 2017 HOW DO I REGISTER CAMP? When registering for summer day camp, you must come in person, complete the registration form, and pay for the first 2 weeks of your child s camp. If you are registering for only 1 week of camp, we will collect your fee for that week at the time you register. You may register for additional weeks, on a space available basis, anytime by calling our office at 360.491.0857. Space is limited and registration is based on first-come-first-served. WHEN DOES REGISTRATION START? Registration will begin Wednesday, March 1st in conjunction with our Spring program registration, Lacey City Hall, 420 College St SE, 6:00am-5:00pm. You can fax, 360.438.2669, or email, laceyparks@ci.lacey.wa.us, your registration form and follow up with a phone call to make payment. Your child will NOT be registered with payment and their registration form. We can accept cash,check, Visa or MasterCard. Following Wednesday, we can accept registration on a space available basis through the summer, Monday-Friday, 8:00am-5:00pm. Acceptable forms of payment are cash, check, Visa or MasterCard. HOW DO I PAY CAMP? Bring your completed registration form and first 2 weeks registration fee to Lacey City Hall, 420 College St SE on March 1st, 6:00am-5:00pm. We accept cash, check, Visa, and MasterCard. You may also fax, 360.438.2669, or email to laceyparks@ci.lacey.wa.us your registration form and follow up with a phone call as soon as possible to make payment. Your child will NOT be registered without payment and their registration form. If you are registered for the whole summer, additional payments can be made over the phone with a Visa or MasterCard, in person at Lacey City Hall or mail a check to Lacey Parks & Recreation, 420 College St SE, Lacey, 98503. See table below for payment due dates. When mailing in payment, allow extra time for mailing to avoid late fees. If you are already registered and want to add weeks, you can come in to Lacey City Hall or register over the phone with a Visa or MasterCard on a space available basis. WEEK DATE OF CAMP PAYMENT DUE - /week LATE FEE DATE *week 2 - $135 Addt l $10.00 **week 9 - $175 1 June 26-30 at time of registration N/A 2 July 3-7 (no camp July 4) at time of registration N/A 3 July 10-14 July 3 July 5 4 July 17-21 July 10 July 6 5 July 24-28 July 17 July 18 6 July 31-August 4 July 24 July 23 7 August 7-11 July 31 August 1 8 August 14-18 August 7 August 8 9* August 21-25 Camp meets at Rainier Vista August 14 Community Park (field trip every day, bring a sack lunch and snacks) August 15 DATE PAID My Records Notice Received Refund (week prior to camp) 100% 1st Camp day 50% 2nd Camp day 0% Lacey Parks & Recreation Department 420 College St SE Lacey Parks & Recreation Department Tax Payer I.D. #91-081-9427
Summer Fun Tour for ages 6-12 years (participants MUST have completed Kindergarten) June 26 - August 25 Mon. - Fri., 7:30 am - 5:30 pm Offering nine weeks of summertime fun, this program is offered at two sites: Pleasant Glade Elementary 1920 Abernethy Rd NE & Lydia Hawk Elementary 7600 5th Street SE Weekly activities always include movies, swimming, games, sports, arts & crafts, special guests, special events and a field trip* based on each week s theme. In addition, we will have a reading program and an on-site library provided by Timberland Library. Hot lunch and afternoon snack is provided by the Summer Lunch Program. Campers need to bring a morning snack. (except Week #9, you must bring a sack lunch and snacks). A backpack and water bottle is recommended. Camp is limited to 40 campers per site, per week. There is a 6 to 1 child/staff ratio, and 4 to 1 on field trips. Campers are divided into groups by grade level with age appropriate activities and opportunities. Transportation to off-site activities is provided by North Thurston Public Schools buses. Registration Information In conjunction with Spring program registration, Summer Day Camp Registration begins WEDNESDAY, MARCH 1st 6:00 am - 5:00 pm Lacey City Hall 420 College St SE (We can accept cash, check, Visa or MasterCard). Camp Fees: /weeks 1-8 $135/week 2 $175/week 9 (Week 9 meets at Rainier Vista Community Park, field trip* every day; bring a sack lunch and snacks) Completed registration forms are accepted on a first come, first served basis. Two weeks payment in advance must be made at the time of registration to hold your spot for the summer. Payments for remaining weeks registered for are due the Monday prior to the week your child(ren) are attending, or you will be charged a $10 late fee and possibly withdrawn from camp to accommodate the waitlist. Notice Received Refund before 1st Camp Day 100% After 1st Camp day 75% After 2nd Camp day 50% On 3rd Camp day 0% (*FIELD TRIPS ARE SUBJECT TO CHANGE) SUMMER FUN TOUR DAY CAMP 2017 REGISTRATION BEGINS Wed., March 1st 6:00 am - 5:00 pm City of Lacey Parks & Recreation Dept. 420 College Street SE 360.491.0857
Week #1: Water, Water Everywhere June 26-30 Water, water, and more water. We will have water crafts, water games, and go on a water field trip. We will have water relays, a water balloon toss, swimming at a NTPS pool, and a field trip to Wild Waves and Enchanted Village. Week #2: Reach for the Stars July 3 - July 7 (no camp July 4) Put on your skating shoes and join us for a week of summer fun as we reach for the stars. We will travel to Centralia for a private roller skating party at the Roller Drome followed by a movie and snacks at the Olympic Club. Week #3: Play Like a Champion July 10-14 They shoot, they score!!! This week you will play many different basketball games from bump, to horse, to around the world. You will also travel north to see the Seattle Storm tear up the hardwood on their quest to be WNBA Champions. Week #4: Halfway to the Holidays July 17-21 Join us for our summer holiday celebrations! Its halfway through the summer so what better way to celebrate summer than some of our favorite holidays of the year. We will have a different holiday celebration each day, and a holiday party at Burfoot Park. Week #5: S is for Science July 24-28 Discover the mysteries of science, natural wonders and other phenomenon of the world. From science projects to arts and crafts, science will be all around us. To cap off the week we will travel to the Pacific Science Center to watch science come to life, from robots to dinosaurs we will see it all. Week #6: Land Before Time July 31 - August 4 Triceratops, stegosauruses, and raptors, oh my! Learn fun facts, create awesome art projects, and play tons of dino themed games. A trip to the Thurston County Fair and a swim in Long Lake is also in store so put on your adventure hat and join us for an awesome week all about dinosaurs. Week #7: We ve Got Spirit,Yes We Do August 7-11 Special sports games, activities, and crafts are planned for this sports week. We will journey to Cheney Stadium to root on the Tacoma Rainiers and enjoy an All American game of baseball including hot dogs and a soda. Week #8: I Wanna Rock August 14-18 Are you ready to end the summer with a rocking good time? Start practicing your skills for our annual summer camp talent show. We will also head to Stewart Heights for a pool party and a little fun in the sun. Come join us and get ready to rock the summer away. Week #9: Outdoor Adventures August 21-25 Meet at Rainier Vista Community Park EVERY DAY! It s time to celebrate the amazing summer we all spent together, with adventures around every corner. We will meet each morning at RAINIER VISTA COMMUNITY PARK and head out on an adventure to our favorite spots of the summer. Lunches will not be provided this week so please pack a SACK LUNCH every day!