Very important information, please read entire packet carefully! PARENT QUESTION/ANSWER PERIOD: Parents and guardians may call the Community Centers, Monday-Friday, 9:00 a.m.- 4:00 p.m. to address concerns pertaining to the Camp Program. Staff will be available by appointment to answer questions relating to the structure of the program, disciplinary procedures, camp guidelines, trip procedures, appropriate camp attire, camp payments and personal situations and concerns.
Shannon Nazzal. Director CALVERT COUNTY DEPARTMENT OF PARKS AND RECREATION Courthouse, 175 Main Street Prince Frederick, Maryland 20678 410-535-1600 301-855-1243 Ext. 2234 vwco.cai.md.us Board of Commissioners Mike Hart Tom Ileji Pat Nutter Evan K. S1auhenhoupt Jr. Steven R. Weems Dear Parents/Guardians, Welcome to the Calvert County Parks and Recreation 2018 Cool Kids Fun Camp Program! We are happy you have selected to participate in our program and look forward to providing your child with a fun-filled recreational experience and a memorable summer. We have designed this packet to provide you with as much information as possible regarding our registration process, rules, regulations, program guidelines and discipline policy. Please read all enclosed information. Your attention to all of the information will assist us in reaching our common goal, which is a safe, fun and enjoyable summer. Camp is open Monday - Friday, from 8:00 a.m. to 5:00 p.m., June 18' - August 10th Closed Wednesday, July 4th Children may not arrive earlier the than designated time each day, as supervision will not begin until then. Children must be picked up no later than designated time. An authorized adult is required to sign your child (ren) in upon arrival and out upon departure from camp each day. In the event your child (ren) is not picked up by designated time, a $10.00 late fee will be charged for every 15 minutes late. There are no exceptions to this policy and the fee can be made by credit card, cash or check, is payable to Calvert County Parks and Recreation. Payments should be made at the Community Centers. You must provide all lunches, snacks, and drinks for your child. Please be aware that refrigeration and microwaves are not available at camp locations. Lunches should be packed in a cooler or a lunch bag with an ice pack. It is recommend that children bring a refillable water bottle to stay hydrated. Healthy and nutrition is of utmost importance in the daily activities of your children. Staff recommends healthy snacks and no sugary drinks. Refunds will only be issued for medical reasons, which prevent continued participation. Please send a plain white t-shirt with your child to camp the first week of camp. Campers will be tie-dying t-shirts to wear on some trips. If you have questions or concerns, please call the coordinators in your district. We look forward to having your child (ren) in our Camp. S annon Nazza firectdf Maryland Relay for Impaired Hearing or Speech: 1-800-735-2258
COOL KIDS CAMP RULES AND REGULATIONS 1. Children should not be dropped off prior to 8:00 a.m. 2. Children should be picked up by 5:00 p.m. ($10 every 15 minutes late) 3. You must sign your child in upon arrival and sign them out upon departure from camp each day. Exception: Unless child has permission from parent or guardian to sign themselves in upon arrival or out upon departure. 4. No weapons!! (toy guns and look-alikes included) 5. No fighting or pushing! 6. No spitting, teasing, name-calling or foul language. 7. No non-prescription drugs, illegal substances, tobacco, or alcohol permitted. 8. Children may not share snacks or lunch. 9. No skateboards, roller skates or roller blades. 10. No bikes! Exception: transportation to camp with proper approval. 11. No fraternization (no kissing or hugging.) 12. Cell phones are allowed for emergency purposes and during designated times. 13. No refunds will be given if a child is suspended on a day of a field trip. 14. Disrespect to staff will not be tolerated. 15. Disruptive children will be dismissed from camp (parents will be called to pick-up their child.) 16. Continued disruption will result in expulsion. 17. Criminal acts will be dealt with accordingly (i.e. - shoplifting, stealing, vandalism / destruction of property, etc.). 18. Staff is not responsible for children's money or personal belongings. Electronic items such as cell phone, IPod, Gameboy, cd s/disc player, etc. are brought at your own risk. Personal gaming devices/equipment will only be allowed for play during designated times. Note: Campers must be responsible for their belongings and should NOT share with others, as some parents may feel some games and music is not suitable for their children. 19. Children must eat in designated areas and should not share food/snacks with others. 20. Children must wear athletics shoes! Exception: May wear flip-flops or sandals when going on a water trip. (No Bare Feet) 21. All camp participants must wear their summer camp T-shirt on designated trips, appropriate clothing on other days and swimsuits on swim days. 22. Campers will be required to pass a swim test (must be able to swim the width of the pool without stopping and/or touching the bottom) NO Back Flips permitted! 23. Please review section on Handling Discipline Problems. 24. Have a rewarding and fun summer!! REMEMBER TO THINK BEFORE YOU ACT!!
COOL KIDS CAMP HANDLING DISCIPLINE PROBLEMS Discipline for children may range from a 15-minute time out period to permanent suspension. Parents will be notified of all disciplinary problems and procedures either by phone, onsite conference and/or written notification. I. Time Out Camper will be subject to a 15-30 minute time out period and either phone and/or a letter will notify parents. An onsite conference is warranted. A. Camper fails to comply with rules, regulations and procedures and has been verbally warned two or more times. 1. First Written Warning: 15-minute time out. 2. Second Written Warning: 30-minute time out. II. In Camp Suspension (ICS) This procedure will allow campers to be disciplined by remaining at the campsite for an extended time-out period. During this period, the camper will not be allowed to participate in daily activities; however, camper will be placed in a nearby area, and will be given educational activities such as writing, reading, drawing, word search, etc. If ICS falls on a trip day, camper will be assigned to stay with the camp director for the duration of suspension. A parent/child/director/administrative staff conference is warranted. A. Camper continues to be defiant of rules, regulations, and procedures, has received three or more 15-30 minute time out periods, and/or has received three or more written warnings. Parents will be notified either by phone and/or a letter. An onsite conference is warranted. 1. Discipline will range from one hour to a full day of ICS. In the event a camper fails to comply with rules, regulations and procedures while placed in ICS, camper will be subject to Suspension. (See Suspension Section) III. Suspension Camper will be subject to two or more days of suspension. Parents will be notified by both phone and a follow up letter. Parent/child/director/administrative staff conference is warranted. A. Camper continues to be defiant of rules, regulations, and procedures and/or has received multiple timeout periods and/or two or more ICS. 1. First and/or Second Suspension: 2 to 3 days. 2. Third Suspension: 5 days, with possible permanent suspension, providing outcome of conference. IV. Immediate/Permanent Suspension Camper will be subject to removal from the campsite at once. Parents and/or guardians are required to pick-up the child immediately. An immediate phone call and a follow-up letter will notify parents. Parent/child/director/administrative staff conference is warranted. A. Camper displays gross defiance of rules, regulations and procedures. (Fighting, drugs, weapons, and shoplifting/stealing. 1. Discipline will range from one week to Permanent Suspension providing outcome of conference. NOTE: If suspension and/or immediate suspension date(s) includes and/or occurs on a trip day, camper will NOT be allowed to attend, and NO money will be refunded!
COOL KIDS CAMP TRIP RULES Dear Parents/Guardians, Please be sure to go over the following information with your child/children: 1. Children must listen to Camp Directors at all times. 2. Children must follow ALL rules and regulations governing trip procedures. A. Answer "HERE" and raise hand to roll call (attendance check). B. Campers should be quiet during attendance check unless name is being called. C. No loud talking or foul language on the bus. D. No standing or walking while the bus is in motion. E. No throwing objects from the bus windows. F. Do not place hands out the window. G. No eating on the bus. H. Do not leave trash on the bus. I. Must travel in groups of 2 or more and stay with the Camp Directors. The buddy system - Always check for the person you have been assigned to walk with. 3. The danger of child abduction. A. Many children/teens are lured away from shopping malls and other places by child abductors and others. B. Child abductors may use tactics such as promising children/teens candy, money, T.V. ads, jobs, etc. C. Children and adults may let their guard down when offered money. 4. Remember the consequences of shoplifting. 5. Children must report "ON" time for check-ins and departure. Children should report to Camp at 8:00 a.m. on all trip days unless otherwise informed. 6. Trip wristbands must be worn through the duration of the trip. Removal of wristband will be subject to disciplinary procedures. (See Disciplinary Section) OTHER INFORMATION TRIP LOCATION PICK-UP: In order to pick up a child from a trip location, the following procedures are necessary. A written request must be submitted to the Camp Director three working days prior to trip day! (See form in trip packet or pick-up from the Camp Director). This written request must include the following information: current date, child's name, trip location and date, reason for trip location pick up, approximate time of pick up, parent s cell, work and/or home phone numbers, the name of the person(s) who will be picking up the child (ren), and a parent signature. NOTE: Parents must see Camp Director and a District Coordinator before taking the child from trip site. Must bring Paper Bag lunches on field trips! No Coolers Please! Disposable Items Only!! Remember children will have to carry leftover items with them for the remainder of the trip. NO siblings will be allowed to attend trips. Parents and guardians are welcome providing bus availability. TRIP WRISTBANDS Safety Trip Wristbands must be worn through the duration of the trip. Wristbands should NOT be REMOVED until camp directors give permission to remove. Removal of wristbands will only be permitted when campers have returned to camp location. If a wristband comes off by default, camper must immediately ask Camp Director for a replacement. If wristbands are removed intentionally, camper will be subject to an immediate trip suspension. Thank you for your cooperation! LIVE PLAY SWIM
COOL KIDS FUN CAMP 2018 TRIP INFORMATION Campers MUST arrive at 8:00 a.m. on all trip days unless otherwise informed. CMS-Calvert Middle School PPMS Plum Point Middle School MHES Mt. Harmony Elementary school DES-Dowell Elementary School SLES St. Leonard Elementary school NECC Northeast Community Center June 19 th, July 3 rd, 19 th, 26 th, August 2 nd and August 9 th COVE POINT SWIMMING POOL, Lusby, Maryland Campers will enjoy the swimming pool at Cove Point Park. Campers should bring a bag lunch and plenty of liquids. Ice cream and snacks are available for purchase. Lifeguards are on duty. Shower facilities are available. Campers who CANNOT swim should remain in the shallow end of the pool. NOTE: Back flips are not allowed! Swim test is required! Bring sunscreen and a beach towel. Camp T-shirt should NOT be worn on this trip. BUS PICK-UP: DES/SLES-11:45 a.m.; CMS-11:15 a.m.; PPMS 11:15 a.m.; MHES/NECC-11:00 a.m. Campers will be at Cove Point Pool from 12:00 p.m. 4:00 p.m. BUS RETURN: DES/SLES-4:15 p.m.; CMS-4:45 p.m.; PPMS 4:45 p.m.; MHES/NECC-5:00 p.m. June 21 st & July 12 th Flagship Premium Cinemas, Prince Frederick, Maryland Campers will enjoy an exciting movie at the great Flagship Premium Cinema in Prince Frederick, Maryland. Movie Title TBA! Possible movie ratings: G & PG. Show Time: TBA Camp T-shirt should NOT be worn on this trip. BUS PICK-UP & RETURN TIMES: TBA June 29 th SKY ZONE, White Plains, Maryland Campers will enjoy an indoor trampoline experience. Socks and Camp T-shirts required. Parents must complete an online waiver (Sky Zone Release of Liability and Assumption of Risk) prior to trip participation. - GO TO https://waldorfstore.skyzone.com/waiver/ to sign wavier. Present a hard and/or phone copy to Parks & Recreation staff (proof of completion), by June 25th. BUS PICK-UP: DES/SLES-9:00 a.m.; CMS-9:15 a.m.; PPMS 9:15 a.m.; MHES/NECC-9:00 a.m. Campers will be at Sky Zone from 10:00 a.m. - 12:00 p.m. & lunch at 12:30 p.m. at Hallowing Point Park BUS RETURN: DES/SLES-2:00 p.m.; CMS-1:45 p.m.; PPMS 1:45 p.m.; MHES/NECC-2:00 p.m. July 6 th CLIMB ZONE, Laurel, Maryland Campers will enjoy an indoor rock climbing experience. Children may bring or purchase lunch from a local restaurant. Parents must complete an online waiver (Climb Zone Release of Liability and Assumption of Risk) prior to trip participation. www.climbzone.us - GO TO sign wavier by July 2 nd. Sneakers or climbing shoes required. Camp T-shirts required. BUS PICK-UP: DES/SLES-9:15 a.m.; CMS-9:35 a.m.; PPMS 9:35 a.m.; MHES/NECC-9:45 a.m. Campers have lunch at 11:00 a.m. at a local restaurant and be at Climb Zone from 12:00 p.m. - 3:00 p.m. BUS RETURN: DES/SLES-4:45 p.m.; CMS-4:25 p.m.; PPMS 4:25 p.m.; MHES/NECC-4:15 p.m.
July 11 th HALL AQUATIC CENTER, Prince Fredrick, Maryland Campers will enjoy the swimming pool at HALL AQUATIC CENTER. Campers should bring a bag lunch and plenty of liquids. Ice cream and snacks are available for purchase. Lifeguards are on duty. Shower facilities are available. Campers who CANNOT swim should remain in the shallow end of the pool. NOTE: Back flips are not allowed! Swim test is required! Bring a beach towel. Camp T- shirt should NOT be worn on this trip. BUS PICK-UP: DES/SLES-11:30 a.m.; CMS-11:45 a.m.; PPMS 11:45 a.m.; MHES/NECC- 11:30 a.m. Campers will be at Hall Aquatic Center from 12:00 p.m. 4:00 p.m. BUS RETURN: DES/SLES-4:30 p.m.; CMS-4:15 p.m.; PPMS 4:15 p.m.; MHES/NECC-4:30 p.m. June 26 th, July 17 th LORD CALVERT BOWL, Huntingtown, Maryland Campers will spend a day at Lord Calvert Bowl. Socks are required! No outside food or drinks are allowed. Food is available for purchase. Once slice of pizza and soda will be provided. Camp T-shirt should be worn on this trip. BUS PICK-UP: DES/SLES-10:30 a.m.; CMS-10:45 a.m.; PPMS 10:45 a.m.; MHES/NECC- 10:30 a.m. Campers will be at Lord Calvert Bowl from 11:00 a.m. 1:30 p.m. BUS RETURN: DES/SLES-2:00 p.m.; CMS-1:45 p.m.; PPMS 1:45 p.m.; MHES/NECC-2:00 p.m. July 24 th SIX FLAGS, Upper Marlboro, Maryland Total excitement! Water fun, roller coasters, and much more! Campers will spend the day experiencing amazing thrill rides and water adventures. Pack a bag lunch and extra money to purchase food at the park. Bring a swimsuit if you plan to visit the water park. Do not forget the sunscreen! NOTE: Rest stop will be permitted as needed. Camp T-shirt MUST be worn this trip! DES/SLES CAMPERS SHOULD REPORT to CAMP at 7:40 a.m. CMS CAMPERS SHOULD REPORT to CAMP at 7:50 a.m. PPMS CAMPERS SHOULD REPORT to CAMP at 7:50 a.m. MHES/NECC CAMPERS SHOULD REPORT to CAMP at 7:50 a.m. Adult volunteer/chaperone maximum of (4) are needed for this trip. Please see chaperone comments and form in this packet. BUS PICK-UP: DES/SLES-8:40 a.m.; CMS-8:50 a.m.; PPMS 8:50 a.m.; MHES/NECC-9:00 a.m. Campers will be at Six Flags from 10:15 a.m.-4:30 p.m. BUS RETURN: DES/SLES-6:05 p.m.; CMS-5:55 p.m.; PPMS 5:55 p.m.; MHES/NECC-5:45 p.m.
TRIPS AT-A-GLANCE DATES June 19 June 21 June 26 June 29 July 3 July 6 July 11 July 12 July 17 July 19 July 24 July 26 July 31 August 2 August 7 August 9 TRIPS COVE POINT SWIMMING POOL FLAGSHIP PREMIUM CINEMAS LORD CALVERT BOWL SKY ZONE COVE POINT SWIMMING POOL CLIMB ZONE HALL AQUATIC CENTER CALVERT THEATRE LORD CALVERT BOWL COVE POINT SWIMMING POOL SIX FLAGS COVE POINT SWIMMING POOL WATKINS REGIONAL PARK COVE POINT SWIMMING POOL CHGC FOOT GOLF COVE POINT SWIMMING POOL OTHER INFORMATION: TRIP LOCATION PICK-UP: In order to pick up a child from a trip location, the following procedures are necessary. A written request must be submitted to the Camp Director three working days prior to trip day! (See "FORM" in packet or pick up from the Camp Director). This written request must include the following information: current date, child's name, trip location and date, reason for trip location pick up, approximate time of pick up, parent home and work phone numbers, the name of the person(s) who will be picking up the child (ren), and a parent signature. NOTE: Parents must see Camp Director and a District Coordinator before taking the child from trip site. Must bring Paper Bag lunches on field trips! No Coolers Please! Disposable Items Only!! Remember children will have to carry leftover items with them for the remainder of the trip. NO siblings will be allowed to attend trips. Parents and guardians ONLY! Bus pick-up and return times are estimated.
TRIP WRISTBANDS: Safety Trip Wristbands must be worn through the duration of the trip. Wristbands should NOT be REMOVED until camp directors give permission to remove. Removal of wristbands will only be permitted when campers have returned to camp location. If a wristband comes off by default, camper must immediately ask Camp Director for a replacement. If wristbands are removed intentionally, camper will be subject to an immediate trip suspension. Thank you for your cooperation! PARENT CHAPERONES for AMUSEMENT PARK TRIPS: Parent-chaperones will be needed for the large amusement park trips. Chaperones must be 18 & older and will be required to supervise additional campers. The first four chaperones who sign up with the completed Background Consent form will receive one admission ticket to the park and bus seating if space is available. Please return the consent form to your camp director. Parents, who are interested in becoming a chaperone, should sign-up immediately. See chaperone information in packet. SPECIAL EVENTS & ACTIVITIES TEACH ME SOMETHING NEW DAY Special guest instructors will visit the camp site throughout the summer, teaching & sharing talents such as dance, karate, Zumba and fitness. READ AT CAMP PROGRAM 20-30 minutes daily, after lunch campers may read and/or do educational activities such as word searches, crossword puzzles, etc. STEPS FOR KIDS PROGRAM This program will be provided by the Calvert Memorial Hospital Health and Wellness Center. The program offers and teaches about healthy and nutritious food choices. This program will be held onsite throughout the summer. END OF THE SUMMER PARTY August 10 th It s so hard to say good-bye! Campers will enjoy an end of the summer party with good food and fun.
SUMMER CAMP TRIP PICK UP FORM (MUST BE SUBMITTED NO LATER THAN 3 DAYS PRIOR TO TRIP) Name of child: Camp Location: Trip Location: Trip Date: Approximate Time of Trip: Reason for Trip Location Pick Up: Name of individual picking up child and phone number: (Print Name) (Phone Number) Parent s Cell Phone Number: Parent s Work Phone Number: Parent s Home Phone Number: Printed Name of Parent: Signature of Parent: Date:
Additional Summer Camp Trip Information Calvert County Parks & Recreation Background Screening Instructions for Summer Camp Chaperones Protecting the welfare of children is a top priority. Calvert County Parks & Recreation feels strongly that keeping children safe begins with a thorough background check of all volunteers. 1. Use the secure link below to begin the application: https://ssci2000.secure-screening.net/escreening/oapp_loginentrance.asp?mode=direct&code=33820n 2. Fill out all information indicated with the red asterisk on the Welcome Page. Please note, it is imperative that you use your legal first and last name. Select BACKGROUND SCREENING for the position for which you are applying and click Login. 3. Read through the instructions on the Background Check Release Electronic Signature Confirmation page and provide the necessary information indicated in red. Once completed, click I Agree. 4. Complete the Personal Information Section with a telephone number and select the position for which you are applying. Please note, if your position is listed, type N/A in the box above the list of options. Finally, read through the Certification located at the bottom of the page. Type your name and date at the bottom of the form and click I Agree once completed. 5. The submission will then to be sent to Calvert County Parks and Recreation accordingly ------------------------------------------------------------------------------------ Cut here and return to Parks & Recreation staff by June 25 th SkyZone Release of Liability & Assumption of Risk CONFIRMATION of online COMPLETION I have completed the online SkyZone (Print - Parent s Name) wavier form for my child. (Print - Child s Name) Parent s Signature: Date: ------------------------------------------------------------------------------------ Cut here and return to Parks & Recreation staff by July 5 th ClimbZone Release of Liability & Assumption of Risk CONFIRMATION of online COMPLETION I have completed the online ClimbZone (Print - Parent s Name) wavier form for my child. (Print - Child s Name) Parent s Signature: Date:
SUMMER CAMPS 2018 LOCATIONS NORTHERN DISTRICT - 410-535-1600 ext.8210 Recreation Coordinator..Bob Branham Assistant Recreation Coordinator.Paul Lundberg Cool Kids Fun Camp Mt. Harmony Elementary School (MHES) (Ages 6 9) Cool Kids Fun Camp Northeast Community Center (NECC) (Ages 10-13) CENTRAL DISTRICT - 410-535-1600 ext. 8200 Recreation Coordinator..Doris Holland Assistant Recreation Coordinator...Nate Smith Cool Kids Fun Camp Calvert Middle School (CMS) (Ages 6-9) Cool Kids Fun Camp Plum Point Middle School (PPMS) (Ages 10 13) SOUTHERN DISTRICT - 410-586-1101 EXT. 4 Recreation Coordinator..Diane Holloway Assistant Recreation Coordinator...Sandy Abell Cool Kids Fun Camp St. Leonard Elementary School (SLES) (Ages 6-9) Cool Kids Fun Camp Dowell Elementary School (DES) (Ages 10-13)
SUMMER CAMP CHILD REGISTRATION Camp Location: Age of Camper: Child s Name: Last First Middle Date of Birth: Address: City: State: Zip: Parent/Guardian Name: Email: Home Phone: Work Phone: Cell Phone: Parent/Guardian Name: Email: Home Phone: Work Phone: Cell Phone: WAIVER RELEASE I HEREBY GIVE PERMISSION FOR MY CHILD TO PARTICIPATE IN ALL ACTIVITIES AND ATTEND ALL TRIPS SPONSORED BY THE CALVERT COUNTY DIVISION OF PARKS AND RECREATION. IN CONSIDERATION OF THE DIVISION'S ACCEPTING MY CHILD INTO THIS PROGRAM, I AGREE TO WAIVE AND FOREVER DISCHARGE CALVERT COUNTY, ITS EMPLOYEES AND AGENTS HARMLESS OF & FROM ANY INJURIES SUSTAINED BY MY CHILD WHICH OCCURS WHILE ENROUTE TO OR FROM OR PARTICIPATING IN ANY ACTIVITY SPONSORED BY THE AFOREMENTIONED PARTIES. NOTE: This release does not obligate your child to attend any or all scheduled trips or activities. SIGNATURE OF PARENT OR GUARDIAN DATE SIGN OUT RELEASE UPON DROPPING OFF AND PICKING UP MY CHILD FROM THE CAMP, I AGREE TO INFORM THE SUMMER CAMP STAFF AND SIGN THE APPROPRIATE FORM, INCLUDING DATE AND TIME I DROPPED OFF AND PICKED UP MY CHILD. IN THE EVENT, I AM UNABLE TO PICK UP MY CHILD, I AGREE TO CALL THE SCHOOL/ CENTER AND INFORM THE DIRECTOR WITH THE NAME OF THE INDIVIDUAL I AUTHORIZE TO PICK UP MY CHILD. I AGREE TO PROVIDE THE PARKS AND RECREATION DIVISION WITH THE NAMES OF INDIVIDUALS I AUTHORIZE TO PICK UP MY CHILD WHEN I AM UNABLE TO DO SO MYSELF. (SEE NAMES LISTED BELOW.) I REALIZE IT IS MY RESPONSIBILITY TO KEEP THIS LIST UPDATED AND ACCURATE. SIGNATURE OF PARENT OR GUARDIAN DATE CHILD S WALK/RIDE BIKE/SIGN-OUT PERMISSION RELEASE I GIVE MY CHILD PERMISSION TO WALK AND/OR RIDE HIS/HER BIKE TO/FROM CAMP AND PERMISSION TO SIGN HIM/HERSELF IN/OUT OF CAMP EACH DAY. CAMPER MUST BE AT LEAST 11 YEARS OF AGE TO SIGN IN/OUT OF CAMP. NOTE: CALVERT COUNTY PARKS AND RECREATION CAN NOT BE HELD ACCOUNTABLE ONCE YOUR CHILD HAS SIGNED OUT SIGNATURE OF PARENT OR GUARDIAN DATE AUTHORIZED PERSONS FOR PICK-UP NAME PHONE NUMBERS 1. 2. UNAUTHORIZED PERSONS FOR PICK-UP NAME PHONE NUMBERS 1. 2. Please notify Parks and Recreation Staff of any changes or additions immediately. ---------------------------------------------OFFICIAL USE ONLY----------------------------------------------- DATE RECEIVED: STAFF INITIALS:
CAMPER HEALTH HISTORY Child s Name: The following information is required: 1 st Emergency Contact (Parent or Legal Guardian): 2 nd Emergency Contact (Other than Parent Above): Child s Physician: Phone: Phone: Phone: HEALTH INFORMATION: 1. Are there any health problems including physical, psychiatric, or behavioral problems of which we need to be aware? NO YES, Explain: 2. Are there any medications, dietary restrictions, allergies, or special needs that we need to be aware of to ensure that your child s camp experience is positive? NO YES, Explain: IMMUNIZATION INFORMATION: For campers who reside within the United States, a United States territory, or the District of Columbia: 1. State/territory in which child resides: 2. Is this child exempt from any immunizations? [ ] NO [ ] YES, List them: OR For campers who reside outside the United States, a United States territory, or the District of Columbia: 1. Country in which child resides: 2. Attach Department form DHMH-896 (record of vaccination or immunity) Parent or Legal Guardian s Signature: Date:
COOL KIDS CAMP 2018 Checklist I understand that by signing and returning this document that I have carefully and completely read and agree to the following: I have read completely and understand the rules and regulations regarding summer camp. I have discussed the rules and regulations and explained their ramifications to my child/children who will be attending the camp. I understand that all requested medical, immunization, and all related camp information / paperwork must be supplied and completed at the time of registration. My child: will not require prescription medication while attending camp. will require prescription medication while attending camp, and I understand that all medical forms will be completed by the start of camp. I will follow the Maryland State Certification guidelines regarding prescription medication for my child/children. I understand that certification includes that any prescription sent to camp for my child/children MUST BE IN THE ORIGINAL CONTAINER FROM THE PHARMACIST and ONLY A SINGLE DAY S SUPPLY OF MEDICATION IS PERMITTED TO BE SENT TO CAMP DAILY PER CHILD. My child will be dropped off (signed in) and picked up (signed out) by an authorized adult at the appropriate times. Camp Only: Between 8:00 a.m. and 5:00 p.m. I understand that CCPR is not responsible for items my child/children bring to camp. CCPR contracts for use of Calvert County Public School buses for trip transportation. I understand that I am responsible for providing appropriate materials and supplies for field trips as directed (example: Bag lunches only. No coolers!). Child must wear appropriate clothing and footwear when attending camp. See camp information packet for details. Staff may apply sunscreen to my child if my child asks for assistance. My child may attend an Appropriate PG rated movie if a G rated movie is not available. My child can swim and can pass the required swim test. Swim test Must be able to swim the entire width of the pool without stopping and/or touching the bottom. In the event of any informational changes I will notify CCPR staff immediately. By signing below I signify that I agree to follow, abide, and adhere to all camp rules and regulations at all times. Child s Name Camp Location Guardian s Signature Date ****CCPR Staff Signature Date ****
COOL KIDS FUN CAMP 2018 Monday-Friday 8:00 a.m. 5:00 p.m. June 18 August 10 Ages 6-9 and 10-13 Calvert Middle School, Prince Frederick, MD- 551901 (Ages 6-9) St. Leonard Elementary School, St. Leonard, MD- 551902 (Ages 6-9) Mt. Harmony Elementary School, Owings MD 551995 (Ages 6-9) Plum Point Middle School, Huntingtown, MD 551903 (Ages 10-13) Dowell Elementary School, Dowell, MD 551904 (Ages 10-13) Northeast Community Center, Chesapeake Beach, MD - 551996 (Ages 10-13) PICK-A-WEEK This program is formatted into a weekly structure. This means parents can pick and pay for specific weeks. A $25 deposit is required at the time of registration. Payment is due in full by payment deadline for each week. Pick & choose early LIMITED REGISTRATION! WEEKS DATES COST/REG. Payment Deadline Week A: June 18-22 $105.00 6/1 Trips: Cove Point Pool & Flagship Cinemas Week B: June 25-29 $142.00 6/8 Trips: Calvert Bowl & Sky Zone Week C: July 2-6 $125.00 6/15 Trips: Cove Point Pool & Climb Zone Week D: July 9-13 $114.00 6/22 Trips: Hall Aquatic Center (DES @ CPP) & Calvert Theater Week E: July 16-20 $100.00 6/29 Trips: Calvert Bowl & Cove Point Pool (DES @ Hall Aquatic Center) Week F: July 23-27 $169.00 7/3 Trips: Six Flags & Cove Point Pool Week G: July 30-August 3 $104.00 7/10 Trips: Watkins Regional Park & Cove Point Pool Week H: August 6-10 $96.00 7/17 Trips: Foot Golf (CHGC) and Cove Point Pool Three weeks advanced registration required! The minimum of 35 campers are needed in order to host each weekly camp. Sign-up early! A $10.00 late charge will accrue 3 Mondays before the actual camp week. Example: Week A Camp June 18-22, a late charge of $10.00 will be applied on Friday, June 1 st. For more information please call your local community center. CAMP LOCATION: ACTIVITY # CHILD S NAME: PARENT S SIGNATURE: DATE: