Oasis Christian Youth Ministry Presents Camp H2O Summer Reading Enrichment Program 4524 East Brookstown Dr. Baton Rouge, LA 70805

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1 Oasis Christian Youth Ministry Presents Camp H2O Summer Reading Enrichment Program 4524 East Brookstown Dr. Baton Rouge, LA Are you looking for a summer of reading enrichment and fun???? Then look no further than OCC Summer Camp! Open to students in grades K-5. Come and drink from the oasis where your child will discover the fun and adventures of reading. Campers are grouped according to grade and will participate in developmentally appropriate activities such as, academic enrichment, technology time (computer lab) team building games, arts and craft and an end of program recognition. Our high energy staff will help your child have fun, make memories, have new experiences, create friendships and practice skill mastery in an atmosphere where KIDS READ TO ACHIEVE!!!! Tuition includes: Breakfast, lunch, and certified teacher Some of the fun activities planned for campers include: Literacy Enrichment Technology Time Arts and Craft Team Building Activities Camp hours: 8:00am to 12:00pm, Tuesday Friday 4 Week Session, Start Date Tuesday, June 2 st End Date Friday, June 26th Cost: $80/child + $25 registration fee/child Please return this enrollment form to Oasis Christian Church with your payment. Checks should be made out to OCC. Child s Name Parent s Name Grade/School ( ) Phone Address If you prefer to sign up by the week, the cost is $25 registration fee and $20 per week. Amount enclosed $ Cash Check Money Order I am also interested in Before Care (7-8am) $25/week or $7 per day Date 1

2 HELP US LEARN MORE ABOUT YOUR CHILD My child likes to My child would like to learn more about I would really like to see my child I learned about the H2O Summer Camp Program from TERMS OF AGREEMENT: Each student wishing to enroll in H2O Summer Camp must submit a completed Registration Form, a $25 Non-refundable Registration Fee. TUITION IS NON- REFUNDABLE. CODE OF CONDUCT: With your enrollment materials, each student will receive the H2O Code of Conduct. It is the parent s responsibility to review these rules and ensure your child understands them. Our Code of Conduct is strictly enforced at all times. Failure to comply can result in removal from class, limitation or exclusion from performances or dismissal from the H2O Summer Camp. NO REFUNDS will be made for time lost due to behavior issues. We are an Equal Opportunity organization and we do not discriminate on the basis of race, color, sex, sexual orientation, age, religion, national or ethnic origin or physical disability. H2O Staff reserves the right to deny, cancel, sever or suspend a child s enrollment if deemed in the best interest of the camper or the camp. There will be no refunds. There will be no Make Up Days if a camper misses days of camp. I authorize the officials of the H2O Camp Program to act on my behalf while my child is in their care, including the power to authorize emergency medical treatment. I also give permission for my child to take part in all camp activities and trips and release the OCC, OCC staff, H2O staff, H2O Board of Directors and all entitles associated with the H2O Camp from all liabilities for any and all damage and/or injury that may occur on or off the H2O Camp property during any given camp day. Please initial HERE PHOTOGRAPHY POLICY H2O Summer Camp reserves the right to use photographs and video taken during classes, performances and other programs for the promotion of the organization. Any student, parent or guardian who does not wish to be photographed or have a child photographed, must notify the H2O staff upon registration. YES, I have read the Photography Policy and APPROVE the use of any photos or video of my student. No, I have read the Photography Policy and DO NOT approve the use of any photos or video of my student. I have read, understand and agree to all the terms of agreement and items discussed in this enrollment form for my child, prior to signing this application. Date Copy of Parent/Guardian State Issued Identification is needed 2

3 Special Needs We are fully committed to the participation of all individuals in our programs, and will make every effort to meet your child s needs based on our available resources. If your child has any special needs, please contact Catasha Jackson, Camp Coordinator at (225) or prior to registration. Full payment for each week is due prior to the week start date. PAYMENT MUST BE RECEIVED by the due dates noted below. Week 1 May 31, 2015 Week 2 June 7, 2015 Week 3 June 14, 2015 Week 4 June 21, 2015 Parent Statement of Understanding I understand that, when my child(ren) arrives in the morning, I may not leave my child(ren) at the program sites unless I have signed in with H2O camp staff I understand H2O Camp Staff is mandated by state law to report any suspected cases of child abuse or neglect to the appropriate authorities for investigation. I understand that H2O Camp is not responsible for lost, damaged, or stolen articles. I understand program fees are NOT refundable. Classes missed due to weather, holidays, choice of party, disruptive behavior may not be made up, credited, or refunded. Participant Waiver of Liability: I, the parent/person having legal custody/guardianship of the minor(s) participating in Camp H2O programs, give permission for the minor(m) and myself along with other registered participants by me to participate in H2O Camp ( Camp ) activities. We are physically able and mentally prepared to participate in all activities at the camp including activities such as: walking, running, and exercising. In consideration of said participants being permitted to attend and participate in the Camp, I hereby: (1) acknowledge that I have read and voluntarily sign this waiver, (2). H2O Camp, Oasis Christian Church, its directors, officers, employees, volunteers and agents (collectively Releasees ) from all liability for us for any loss, damage, injury, or death, whether caused by Releasees or otherwise, while we are at Camp, (3). I agree not to sue Releasees for any loss, damage, injury, or death, and I will indemnify and hold harmless Releasees from any loss, liability, damage, or cost they may incur due to said participants participation in Camp, even if caused by the negligence of Releasees, Date 3

4 (4). I assume full responsibility for, and bear the risk of, any loss, damage, injury, or death, due to negligence of Releasees, (5) I do hereby authorize the H2O Camp, as agent for the undersigned, to consent with respect to said participants, to any x-ray examination, anesthetic, medical, dental, or surgical diagnosis or treatment, including hospital care, which is deemed advisable by the H2O Camp or any healthcare provider, whether such diagnosis or treatment is rendered at Camp, the office of a healthcare provider or at a hospital. I understand that the H2O Camp is not responsible for costs incurred for medical care, and I agree to reimburse H2O Camp for any medical costs paid for the care of the participants. I intend this waiver to be as broad and inclusive as is permitted by the laws of Louisiana; if any portion hereof is held invalid, I agree the balance shall continue in full force and effect. For our participation in activities to be conducted by H2O Camp, I hereby give my permission and consent, now and for all time, to make, reproduce, edit, broadcast or rebroadcast any video film, footage, sound track recordings and photo reproductions of said participants and/or our narrative account of our experience at H2O Camp for publication, display, sale or exhibition thereof in promotions, advertising and legitimate business uses without any compensation to, and/or claim, by us. Please list names of individuals who may pick up camper. Only the names listed will be authorized to pick up the camper. If any additional persons need to be added to this list, the request must be in written form and submitted by the parent / guardian. NAME RELATIONSHIP TO CAMPER NAME EMERGENCY CONTACT PHONE NUMBER RELATIONSHIP TO CAMPER Date 4

5 Oasis Christian Church 2015 Summer Camp H2O Registration Form Date rec d Name of Camper: Sex: M / F Age as of 6/1/15: Grade as of 9/1/15 Sibling of: T-Shirt Size (circle one) Youth S Youth M Youth L Adult S Adult M Adult L Adult XL Adult XXL School: District of Residency: Street Address: City/State/Zip: Name of Parent/Guardian: Relationship to child: Please all information/updates/billing regarding H2O Camp to the following address(es): Primary Phone: Secondary Phone: If your child has any allergies, please indicate to what, if any, medications he/she will be taking during the camp day: REGISTRATION FEE: There is a one-time, NON-REFUNDABLE REGISTRATION FEE of $25 for all first time campers that includes (1) t-shirt. Camp Tuition: $20/weekly or $80 (month) + $25 registration fee Date 5

6 Please return the completed registration form, $25 registration fee to: Attn: Oasis Christian Church Youth Ministry H20 Summer Camp 4524 E. Brookstown Dr. Baton Rouge, LA Checks are payable to Oasis Christian Church. To pay via a credit card, please contact church at (225) An application can be obtained online at For additional information, please contact, Catasha Jackson, Camp Coordinator at (225) or Camp H2O Schedule 7:00am 7:55am Before Care 8:00am 8:40am Breakfast 8:45am 8:55am Morning Routine (Pledges, Chants) 9:00 am 9:55am Literacy Enrichment 10:00am 10:30am Technology Time 10:35am 11:00am Activity/Free Time 11:05am 11:55a`m Lunch 11:56am 12:00pm Pick Up 6

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