2016 Summer Camp Registration

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1 Child s Name: Parent Name Parent Phone: 2016 Summer Camp Registration Kroc Camp Policies and Procedures Agreement Form Weekly Fees $117 per child per week (Membership) $155 per child per week (Public) Early Drop Off Early drop off is available from 7:00AM-7:45AM for an additional charge of $25 per week, per camper. Late Pick Up Camp will end at 5:30 p.m. each day; accordingly we ask that your child is picked up by 5:30 p.m. If you must pick up your child up after 5:30p.m. call the center and notify us of your late arrival. A late fee of $2 per minute will be assessed every minute after 6:00 p.m. If your child is not picked up by 6:30 p.m. the authorities will be contacted. Drop-Off and Pick-Up Procedures Parents intending to pick up children prior to 4 p.m. should notify the Kroc staff to prevent activity interruptions. Campers must be signed in and out each day by an authorized adult. Parents and authorized adults may be asked to show valid photo identification. Please make sure that a list of authorized adults for pick-ups and drop-offs is included on the Child Enrollment and Health History Form. Registration Policies & Procedures Payment in full is due one week prior to the beginning of each camp week. Unpaid slots will be given to those on the waiting list for that particular week (see page 4 for weekly due dates). Down Payment A non-refundable down payment of $20.00 is due at the time of registration for each week a camper will be attending Day Camp. Late Registration A $10 late fee will be applied to all registrations that are not paid one week prior to the session start date and campers may attend if space is still available. Membership Advantage Kroc Center members will be given the first opportunity to fill camp slots. Memberships must be current and maintained during the duration of the Kroc Camp(s) registered for. Transfer Requests Requests to transfer camps can be requested and will be granted based on space availability. Requests must be made one week prior to the start of the desired camp week. Insurance Waivers and State Forms A current Assumption of Risk and Liability Waiver, Authorization to Administer Medication, Health History & Emergency Care Plan, Child Enrollment and Health History forms must all be completed and on file prior to each camper s participation in Kroc Center Camp activities. Each space on every form must be completed including the marking of N/A on those portions of the form that do not apply. Camper Age Policy Campers must be the age indicated in the camp description prior to the first day of that camp. Refund Policy and Cancellations No cash or credit card refunds will be issued unless the Kroc Camp session registered for is cancelled by the Kroc Center. Cancellations at least one week prior to the start of a camp session will receive a full credit toward your Kroc Center account minus a $10 processing fee. pg. 1

2 Cancellation less than one week prior will receive a full credit toward your Kroc Center account minus a $25 processing fee. No prorated credits will be issued based on partial attendance at a camp session or missed days due to illness, behavioral issues, or other reasons. Personal emergencies will be handled on a case-by-case basis by the Kroc Camp staff. Credits will not be redeemed for cash or applied to a credit card. Discharge of Enrolled Children The Kroc Center reserves the right to deny services under any of the following conditions: 1. The center has reached capacity for proper operation. 2. Previous failure to comply with payments at time of service (i.e., returned checks). 3. Failure of parents to observe any center policy. 4. A child is a continuing disciplinary problem. 5. Center staff is unable to meet the special needs of the child. We will make every reasonable effort to keep a child in Kroc Camp. If needed, Kroc Staff will consult with parents to make a plan of action for the child to be held to. Please note: A child s appropriate behavior at the center is the responsibility of the parents. Therefore, if it is necessary for The Salvation Army to dismiss a child from the program as a result of behavioral issues, no refunds will be given. General Information Kroc Camp Staff All Kroc Camp staff are trained in First aid, CPR, and AED. All Kroc Camp Staff are trained in The Salvation Army s Safe from Harm program that ensures the protection and safety of children. They will be trained and expected to maintain the highest standards of safety and conduct throughout the summer camp experience. Inclusion The Kroc Center is committed to the inclusion of all children in its programs. Parents and children with special needs should contact the Recreation Supervisor or Director of Programs at least two weeks prior to the start of a desired camp session to determine whether the Kroc Center can provide the appropriate accommodation for your child. Meals Each camper will be provided with snacks at 9 a.m. and 3 p.m., and Lunch at 12 p.m. each day, at no additional charge. Bag lunches brought from home are encouraged and will be refrigerated. Parent Participation and Responsibilities Responsibilities: 1. Call the Kroc Camp director with any schedule changes due to illness, doctor s appointments, vacations, etc. 2. Please DO NOT rely on a sibling to communicate messages regarding absences. 3. Label all of your child s belongings. 4. We discourage any toys or games from home. We will not be responsible for items brought from home. Please keep toys and games at home. 5. We discourage gum or candy brought from home. Please keep gum and candy at home. 6. Soda is discouraged. If it is brought by your child, it will be sent home with your child. 7. Your child will only be able to leave the premises with those you have authorized in writing. They may be asked to show proper identification. This is for the safety of all concerned. Please ensure your authorized list is kept up-to-date. 8. Encourage your child to follow all the rules regarding transportation and participation in the program. 9. Children must be brought into the building by a parent/guardian or an authorized adult designated on the registration form. This person is responsible for checking the child in and out daily. Participation: Parents may become involved with Kroc Camp in many ways. -Visit the Kroc Center. -Share special skills or experiences with children and staff. pg. 2

3 -Donate books, toys, crafts or other useful treasures. -Participate in fund raising events. -Accompany children on field trips. -Bring your lunch and eat with your kid! Release of Children to Impaired Persons If a parent or authorized person appears to be impaired, the center staff will follow these steps for the safety of the children: 1. The staff will express concern for the condition that the person appears to be in, and will state the danger that their condition places the child in. 2. The staff will try to contact the other parent or authorized person to pick up the child. 3. If another authorized person in unavailable to pick up the child, the Kroc Center staff may contact the proper authorities if it is determined to be in the best interest of the child(ren) not to leave the center. 4. If the person refuses the above procedures and attempts to leave the center with the child, staff will call local law enforcement. 5. Under no circumstances will staff intervene and take the child home. These procedures are in place and will be carried out for the safety of all involved. Swimming Assessment Check one: My child CAN swim My child CAN NOT swim Please list any swim classes your child has taken and where the class was held. (Internal Kroc use only) Camper completed Kroc Swim Test on: Comments: Acknowledgement of RJKCCC Behavioral Policies and Media Release: I give permission to The Salvation Army to use photographs or videos in which my child appears for education and public relations purposes. Camper safety is our top priority. Campers are expected to follow the behavioral standards of Safe, Trustworthy, Accountable, Respectful, and Together (S.T.A.R.T.) in addition to keeping hands and feet to themselves, listening to all instructions and staying with the group. I understand that if my child does not adhere to these expectations, disciplinary consequences will occur. Repeat or more serious acts such as fighting, theft, and possession of weapons/drugs will result in immediate suspension or expulsion. Signature: Date: Information regarding Kroc Camp can be found in the Kroc Camp Handbook. Contact the Recreation Supervisor to learn more at pg. 3

4 Week Dates Theme Camp Ext. Care Weekly Cost Total Paid Staff Initials Payment Due 1 June 13 th -17 th June 10 th 2 June 20 nd -24 th June 17 th 3 June 27 th -July 1 st June 24 th 4 July 4 th -8 th July 1 st 5 July 11 th -15 th July 8 th 6 July 18 th -22 nd July 15 th 7 July 25 th -July 29 th July 22 nd 8 Aug 1st-5t h July 29 th 9 Aug 8th-12th Aug 5th 10 Aug 15th-19th Aug 12th Week 1 Spy Kids Camp Team Building Camp Around the World Camp Dr. Seuss Week Week 6 Space Art Camp Time Traveler Camp Kroc H20: Junior Lifeguard (Ages 9-12) Outer Space Week Week 2 Culinary Camp Soccer Camp Game Show Mania Camp Kroc H20: Under the Sea Week 7 Science Explorer Camp Football Camp Construction Camp Disney Week Week 3 Artful Antics Camp Ultimate Sports Camp Kroc H2O: Under the Sea (Ages 9-12) Sports Week Week 8 Set Design Camp Volleyball Camp Kroc H20: Junior Lifeguard (Ages 7-8) Mad Scientist Week Week 4 Imaginarium Camp Music and Movement Camp Survival Camp Kroc H20:Under the Sea (Ages 7-8) Cooking Week Week 9 Amazing Race Camp Theater Camp Inventor Camp Kroc H20: Junior Lifeguard Week 5 Fitness Fun Camp Storytellers Camp Grossology Camp Outdoor Adventures Week 10 Kroc Olympics Dance Camp Super Sports Camp Animal Week Overnight camping opportunities to be held at Army Lake Camp in East Troy, WI. See Camp Director for more information. pg. 4

5 Help Us Get To Know Your Child This form has been prepared to provide accommodations and support for our Kroc Camp members and their families. Directions: Carefully read and thoroughly complete each answer. Clearly print all responses. Ability Profile: Describe your child s level of ability (physical, academic, etc.): What type of living assistance/accommodations does your child need? Indicate which of the following Kroc Camp activities your child may need accommodations for in order to successfully participate. If known, please list the type of accommodation(s) requested below. Arts & Crafts Board or Card Games Dancing Computers Reading Movies Swimming Open Gym Team Sports Group Games (tag, parachute, etc.) Music Classes Free Time Youth Clubs Other Other Accommodations: Are there any medical concerns that would prevent your child from participating in an activity in the Kroc Camp program? If yes, please provide additional information. Note: Any medications that need to be taken while attending Kroc Camp must be dropped off in their original container with the prescription label; parents must complete the Authorization to Administer Medication form before leaving the medication with Kroc staff. Getting to know your CHILD! Parents, please work with your child to complete the following sections. This information will help us get to know him/her better and how we can best support a successful experience at the Kroc Center. List three things you like to do for fun: I am looking forward to trying the following activities at the Kroc Center: Arts & Crafts Movies Board or Card Games Swimming Dancing Open Gym Computers Team Sports Reading Group Games (tag, parachute, etc.) Music Classes Free Time Youth Clubs Other pg. 5

6 Draw us a picture of yourself with words (i.e., I love to swim & ride my bike; I collect rocks and do not like meeting new people). For Parents: If known, how would you describe your child s learning style? (i.e., visual, auditory, kinesthetic) List anything that upsets (stresses) your child, such as; loud noises, large crowds, having to stop in the middle of an activity, etc. List any techniques or tools that help your child calm down when stressed (i.e., speaking quietly, having something to hold, taking a deep breathe, etc.) What tips or tricks work for you, school or other recreation settings to help your child with the following situations: Making new friends Speaking respectfully to others Avoid using hands/feet in ways that hurt others or him/herself Staying with his/her assigned group Being helpful in groups (picking up after lunch, playing with a team, etc) What positive reinforcements help your child to recognize when s/he is doing good job? Please understand that poor choices (negative behavior) result in negative consequences. We anticipate all campers will show safe, respectful and acceptable behavior. In the unlikely event your child earns negative consequences; please tell us what you find to be the most effective in correcting the behavior. My Child needs the following: His/Her own schedule Hand signals to change behavior Verbal reminders (example: It s time to get ready for the next activity) How many times? Visual reminders (pictures or cards with 10 minutes & 5 minute reminders) of when it is time to get ready. Incentive/Sticker chart A Behavior/Success Plan Partial participation in the following activity area(s): To sit next to a staff. When and Why? Parents, please read the below expectations for EVERY participant with your child and sign acknowledging your understanding. Safe following directions and room rules Truthful being honest in our words and actions Accountable listen to all instructions given by staff and choose to follow directions. Respectful keep hands and feet to oneself; choose to use hands and feet for helping, not hurting. Together stay with the group and in assigned areas at all times and include everyone. I have read and shared with my child the expectations that Kroc Camp members must follow. Parent Signature: Date: pg. 6

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