Day Camp 2021

Child Name

Address

Child Date of Birth (Born 2016 to 2009)

Parent/Guardian Name (1st to be called)

This address will receive a confirmation email

Phone

Any friends that your child would like to be grouped with (If possible)?

Child's shirt size:

Parent/Guardian Name (2nd to be called)

Phone

Select Day Camp week(s)

Week 1: July 12-16 Cost: $175 (Sold Out) Week 2: July 19-23 Cost $175 (Sold Out)Week 3: July 26-July 30 Cost $175 (Sold Out) Week 4: August 3-6 Cost $150 (Sold Out) Week 5: August 9-13 Cost $175

Pre Paid Tuck is available up to a max of $2 per day. Please indicate how much you would like to add to your invoice.

Early drop off? $5 per day per child

Yes No

Number of early drop off days required each week:

Late pick up? $5 per day per child

Yes No

Number of late pick ups required each week:

Medical Information

Does your child have any physical, emotional, mental, behavioural concerns or limitations that staff should be aware of?

Yes No

If yes, Please explain

Is your child bringing any medication with him/her?

Yes No

If yes, Please explain

Please list any food or drug allergies your child may have

In the event of an emergency or if medical attention is needed we will contact the listed parents/guardians.
However, if we can not get a hold of parent/guardian, I/we, the Parents or guardians named below, authorize Plattsville Church Personnel to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above.

I/We will inform the church staff if my child has had a communicable disease within the three weeks prior to his/her attendance at day camp. The church has my permission to contact my family doctor.

Conditions of Enrolment and Informed Consent

The Camp Director reserves the right to
dismiss a camper who, in his opinion, is a hazard to the safety and right of others, or who appears to have rejected the reasonable controls of the Day Camp.

The parents or guardians submitting this application are those having legal custody over the child. Conditions of custody, if applicable will be fully communicated in writing to the Church, including a photocopy of the section of any court order referring to visitation rights.

While every precaution shall be taken to ensure the good welfare and protection of the camper, Plattsville Church, its Directors, staff members, employees, or facilities, are hereby released from any and all liability in the event of any accident or misfortune that may occur to the applicant camper.

I give permission for Plattsville Church to use any photograph or video footage my child is in for promotional materials.

The parents/guardians hereby agree to
reimburse the Church for any damage caused by the applicant camper.

Any medical, behavior or one on one conditions have be mentioned on this application.

I have read all sides of this application form, understood the above camper information, and I hereby accept the conditions of enrollment.

Type Name as consent

Deposit. (Invoice for remaining amount will be emailed for payment)

Cancellation Policy: In the event of cancellation, a $50.00 processing fee per week, per camper is non-refundable. There will be no refund for cancellations made after June 30th, 2021.

Description

Big News!

We are excited to announce that we are offering 5 weeks of day camp in 2021!

We are excited to invite you to another great summer of day camp in Plattsville.

But make sure you save the dates on your calendar. Registration includes activity registration fees. Each week is independent and you can sign up for 1-5 weeks. Early Drop off is available for $5 per day per child and late pick up is $5 per day per child.

Week 1: July 12-16
Theme: Superhero Week
Cost: $175

(Sold Out) Week 2: July 19-23
Theme: Mystery Week
Cost: $175

Week 3: July 26-July 30
Theme: Jungle Week
Cost: $175

Week 4: Aug 3-6 *Please note there is no day camp on the Civic Day Monday
Theme: Mad About Science Week
Cost: $150

Week 5: August 9-13
Theme: Olympics Week
Cost: $175

Information for every week:

Drop off at 9:00 am and pick up by 4:30 pm each day
Day Camp will be available for children between 5-12 (Born between 2009-2016)
Detailed information and lists will be sent after registration with all the details.
Kids are to come to day camp with packed lunch.
Snacks will be provided based on the different themes each day.
Tuck will be available for purchase.
Early drop off and late pick up will be available for $5 per day per child per before/after. It will be available from 7:30am - 5:30pm.

Day Camp 2021

Description

Please Fix the Following