PROGRAM INFORMATION: School s Out Activity Day 2012/2013 (ages: K-8 th ) January 21 February 18 March 25, 26, 27, 28 & 29 9:00am-6:00pm

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PROGRAM INFORMATION: After School Rendezvous 2012/2013 (ages: K-8 th ) Winter Session (Winter Break-Spring Break)Monday-Friday, January 2-March 22 Spring Session (Spring Break-End of School) Monday-Friday, April 1-June 14 After School-6:00pm School s Out Activity Day 2012/2013 (ages: K-8 th ) January 21 February 18 March 25, 26, 27, 28 & 29 9:00am-6:00pm Camp GPCC 2013 (ages: 6-12; age 5 if completed K) Monday-Friday, June 17-August 16 Before Care 8:00am-9:00am Regular Camp 9:00am-4:00pm After Care 4:00pm-6:00pm Teen Camp 2013 (ages: 12-15) Monday-Friday, June 24-August 16 Before Care 8:00am-9:00am Regular Camp 9:00am-4:00pm After Care 4:00pm-6:00pm Playground Camp 2013 (ages: 6-12; age 5 if completed K) Monday-Friday, June 24-August 2 Regular Camp 9:00am-3:00pm After Care 3:00pm-4:00pm FULL TIME GPCC STAFF CONTACT INFORMATION: Mini People Camp 2013 (ages: 3-6) Monday-Friday, June 24-August 2 Regular Camp 9:00am-12:00pm After Care 12:00pm-3:00pm After School Rendezvous, School s Out Activity Days & Camp GPCC- Barbara Griffis 610-313-4062 BGriffis@plymouthtownship.org Teen Camp- Shawn Mazei 610-277-6122 SMazei@plymouthtownship.org Playground Camp- Lucas McCarty 610-313-8680 LMcCarty@plymouthtownship.org Mini People Camp- Dana Clewell 610-277-6127 DClewell@plymouthtownship.org

AFTER SCHOOL RENDEZVOUS Drop Off: Students coming from Colonial School District will be dropped off by the bus at the front door of the Community Center. A counselor will meet the students and walk them to their room. Please let us know if your child will not be attending that day. If your child is in K-5 th grades we will call to make sure you know they did not arrive at Rendezvous. Pick-Up: If you pick your child up prior to 5:30pm you will have to come into the building. A sign will be a the front door directing you to their location. After 5:30pm you may pick your child up at the back door closest to the playground. Who Can Pick Your Child Up? Mom, dad or legal guardian. If someone other than these people are picking your child up we need to be notified in writing. The only exception is if someone other than these people are picking your child up on a regular basis. late. Students will be at the front desk if you are late picking them up. Snack: An after school snack and drink will be provided to the students when they get off the bus. Please make sure we are aware of any food allergies. Homework: We are a recreational program. We do not focus on homework. At times the students will be able to get some homework done but our staff is not trained to help with this. Average Day: Each day the students will participate in an activity. On nice weather days they may do their activity out in the park. Students signed up for the Active Zone program will enjoy the Active Zone 2-3 days per week. The children are in their room until approximately 4:30 PM. They then move to their planned activity and stay come back to the room at approximately 5:20 PM. Swimming: Swim days are only on Fridays (due to the pool availability). Email reminders will be sent. Make sure you are on our email list. Dress: Please send your student in sneakers. No sandals please. Do not send them in good clothes. Some art projects get messy and we do play outside in the nicer weather. School s Out Activity Day Drop Off: Children should be walked into the building in the morning and dropped off in the correct room. Ask the front desk for their room assignment. Pick-Up: You must come in to the building to sign your child out. Who Can Pick Your Child Up? Mom, dad or legal guardian. If someone other than these people are picking your child up we need to be notified in writing. The only exception is if someone other than these people are picking your child up on a regular basis. Please let us know if it is someone different than the person who dropped your child off. late. Students will be at the front desk if you are late picking them up. Average Day: Different activities such as sports, specialty projects and swimming will be planned.

Swimming: We swim during each Activity Day. Please pack a bathing suit and a towel. Snack & Lunch: You must pack a snack and a lunch for each Activity Day. Dress: Please send your student in sneakers. No sandals please. Do not send them in good clothes. Some art projects get messy and we do play outside in the nicer weather. CAMP GPCC Drop Off: Campers may be dropped off in front of the building or at the back door during curb side drop off. Pick-Up: If given permission, campers may sign themselves out. Otherwise a parent or guardian must sign them out daily. Please see map of curb side pick-up (in your registration packet). Who Can Pick Your Camper Up? Mom, dad or legal guardian. If someone other than these people are picking your child up we need to be notified in writing. The only exception is if someone other than these people are picking your child up on a regular basis. With written permission campers can sign themselves and their siblings out. Once they are signed out they are not the responsibility of Camp GPCC. late. Campers will be at the front desk if you are late picking them up. Trips: Campers must be registered and paid for each trip. On average one trip is planned per week. Average Day: When not on trips campers will participate in many different activities. The can include sports, special projects, swimming and free time. The campers change activities hourly. Lunch/Snack: Campers will need to pack a lunch and snack daily. Some trips do not allow for packed lunches. Check with the counselors on these specifics. Swimming: Swim days are offered on non-trip days. They will use both the Leisure and Lap Pools. Dress: Please encourage your camper to wear sneakers every day, unless the trip is a swimming trip. Camper s attire should be family friendly. This includes their bathing suits. TEEN CAMP Drop Off: Campers may be dropped off in front of the building or at the back door during curb side drop off. Pick-Up: If given permission, campers may sign themselves out. Otherwise a parent or guardian must sign them out daily. Who Can Pick Your Camper Up? Mom, dad or legal guardian. If someone other than these people are picking your child up we need to be notified in writing. The only exception is if someone other than these people are picking your child up on a regular basis. With written permission campers can sign themselves and their siblings out. Once they are signed out they are not the responsibility of Camp GPCC. late. Campers will be at the front desk if you are late picking them up.

Trips: Campers must be registered and paid for each trip. On average two trips are planned per week. Average Day: When not on trips campers will participate in many different activities. The can include sports, special projects, swimming and free time. Lunch/Snack: Campers will need to pack a lunch and snack daily. Some trips do not allow for packed lunches. Check with the counselors on these specifics. Swimming: Swim days are offered on non-trip days. They will use both the Leisure and Lap Pools. Dress: Please encourage your camper to wear sneakers every day, unless the trip is a swimming trip. Camper s attire should be family friendly. This includes their bathing suits. PLAYGROUND CAMP Drop Off: Campers are dropped off at the main parking lot (near the softball field) next to Plymouth Elementary. Pick-Up: Campers are picked up in the same parking lot. Each age group has specific pick up locations. Who Can Pick Your Camper Up? Mom, dad or legal guardian. If someone other than these people are picking your child up we need to be notified in writing. The only exception is if someone other than these people are picking your child up on a regular basis. With written permission campers can sign themselves and their siblings out. Once they are signed out they are not the responsibility of Playground Camp. late. Average Day: Different activities such as sports, specialty projects and activities will be planned. Swimming: Swimming trip to the GPCC are planned throughout the summer. See your camp calendar for specific dates. On these days please send your camper with a bathing suit and towel. Snack & Lunch: You must pack a snack and a lunch for each Activity Day. Dress: Please send your student in sneakers. No sandals please. Do not send them in good clothes. Some art projects get messy. At times the campers participate in water activities and they may get wet on these days. MINI PEOPLE CAMP Drop Off: Campers must be walked into the camp room each day and signed in. Pick-Up: Campers are picked up in their camp room each day. They must be signed out. Who Can Pick Your Camper Up? Mom, dad or legal guardian. If someone other than these people are picking your child up we need to be notified in writing. The only exception is if someone other than these people are picking your child up on a regular basis. late. Campers will be at the front desk if you are late picking them up. Snack: Please pack a snack for your camper daily. If you child is signed up for Kiddie Café please pack a lunch as well.

Average Day: Each day is themed and the campers participate in active and passive activities that go along with the theme. We have special guests come visit on occasion and the campers have swimming and water days scheduled weekly. Please check the camp calendar for these exact dates. Swimming: One swim day is offered each week. On these days please send your camper in their bathing suit and pack a change of clothes and a towel. Dress: Please send your camper in sneakers. No sandals please. Do not send them in good clothes. Some art projects get messy and we do play outside in the nicer weather. ****Every student/camper must have a Certification of Medical Fitness and Vaccination Status on file at the Community Center. These forms are good for one year.**** Please see the next page for this form.

Plymouth Township Certification of Medical Fitness and Vaccination Status For Participants in Summer Camp / Recreation Program Plymouth Township is committed to providing a healthy, safe and affordable recreational experience to residents and their guests. Due to resident concerns and to safeguard program participants, Plymouth Township must request confirmation from all program participants that they are medically fit to participate and that they meet minimum public health vaccination standards. Please have the participant s physician complete the below. Medical/vaccination certification forms obtained for school or day care purposes will also be accepted in place of this form. Note: Your child will not be permitted to participate until this form is returned. TO BE COMPLETED BY PARENT: Name of Participant (Print): will be taking part in a summer camp / recreation program to include the following physical activities: (Provide examples of activities or attach a program description): TO BE COMPLETED BY PHYSICIAN: By affixing my signature below, I certify that based on my examination of the participant: Check One: He/she is physically able to participate in the activity without requiring accommodations He/she is physically able to participant in the activity but requires the following accommodations: (please specify): Check One: He/she is up-to-date with vaccinations required under Title 28 Pa. Code 23.82 (School Vaccinations) and/or Title 28 Pa. Code 27.77 (Childcare Vaccinations). Ref: http://www.pacode.com/secure/data/028/chapter23/subchapctoc.html http://www.pacode.com/secure/data/028/chapter27/s27.77.html He/she is medically exempt from vaccinations as per Title 28 Pa. Code 23.84 (a) Parents/guardians are claiming exemption from vaccination on religious grounds per Title 28 Pa. Code 23.84 (b) Certification Physician Name (Print): Physician Signature: Date: Name and Address of Practice: >>RETURN FORM WITH PROGRAM REGISTRATION MATERIALS<<

ADMINISTRATION OF MEDICATIONS TO MINOR CHILDREN Please read if we will be giving your child any medication while they are in our care. This includes prescription & non-prescription medication Participating Programs: Summer Playground Program Mini People Camp GPCC Teen Camp After School Rendezvous & School s Out Activity Days Who will administer? Summer Playground Program- the camp director will be required to have a first aid certification Mini People- certified camp counselors, programming department, aquatics & lifeguard department and fitness department Camp GPCC- certified camp counselors, programming department, aquatics & lifeguard department and fitness department Teen Camp- certified camp counselors, programming department, aquatics & lifeguard department and fitness department After School Rendezvous & School s Out- certified counselors, programming department, aquatics & lifeguard department and fitness department Plymouth Township Parks & Recreation will: Only allow a staff member over the age of 18 and who is fully certified in First Aid (American Red Cross or the American Heart Association) to administer any prescription and nonprescription medication Keep all medication stored in a locked area of the facility that is out of reach of children, including EpiPens and inhalers Keep a detailed medication log Parents/Guardians will: Provide written consent for the administration of the prescription or nonprescription drug (Fill out the Medical Authorization and Release Form) Ensure prescription or nonprescription medication is in an original container Provide written instructions for the administration of the medication. Instructions on a prescription label are acceptable Put a label on the medicine container identifying the name of the child the medication is for Pick up the medication immediately after its effective date or on the child s last day of the program

Medical Authorization and Release I hereby authorize Plymouth Township and its employees, volunteers and agents to administer the following medication to my minor child(ren) as specified: Child Name Age Medication Dosage I understand and agree that Plymouth Township, its program personnel, Board members, officials, employees, departments and affiliated entitles shall not be liable in any way for any personal injuries sustained by my minor child as a result of administering the above described medication(s) and that the administration of those medications is subject to the Liability Waiver and Release which is incorporated herein by reference. I also hereby authorize Plymouth Township to secure emergency medical care for my minor children should they suffer any injury or otherwise require such care while participating in any Plymouth Township sponsored programs. Should it be necessary for any Plymouth Township program personnel to provide any emergency medical care for my minor child(ren), I acknowledge and understand that Plymouth Township, its program personnel, Board members, officials, employees, departments, agents and affiliated entities shall not be liable in any way for any personal injuries arising from such care and that all such activities are also subject to the Liability Waiver and Release. Intending to be legally bound hereby, and with full authority, I acknowledge, agree to and accept the terms of this Medical Authorization and Release on behalf of myself and my minor children. Print Name: Signature: Date: Name(s) of minor children:

EMERGENCY CONTACT INFORMATION (After School Rendezvous only) Child s Name: Birth Date: Age: Address: City: State: School: Grade: Parent/Guardian #1 Name: Relation: Cell #: Home #: Work #: Email Address: Parent/Guardian #2 Name: Relation: Cell #: Home #: Work #: Email Address: Parent/Guardian #3 Name: Relation: Cell #: Home #: Work #: Email Address: Sibling(s) Participating: Age: MEDICAL INFORMATION Is your child being treated for any of the following: Diabetes Asthma ADD ADHD Autistic Spectrum Allergies Please explain: Other Medical Conditions Please explain: Medication: Any other medical information we should be aware of?

INCLEMENT WEATHER CANCELLATIONS & CLOSINGS In the event of inclement weather, the GPCC will post messages regarding program cancellations and building closings on the website, and on our phone message. Due to the large quantity of participants in our programs, we are regretfully unable to contact each person when changes must be made due to the weather. To check on the status of your program or the GPCC hours, please... Check the Community Center s website at www.plymouthcommunitycenter.org Call the GPCC at (610) 277-4312 In the event of inclement weather and the Colonial School District (#305) is closed or will be closing early, all recreation programs held at Colonial School District facilities will be cancelled. All cancelled recreation programs will be made up at the next available date.