Camp ExplOrion Middle School Day Camp

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Camp ExplOrion Middle School Day Camp This is not your ordinary camp!!! Camp ExplOrion (open to 6 th -8 th graders in Fall 2014) campers will be able to enjoy one of the coolest camps around. Come join in the craziness and explore one week or all ten weeks. There will be different schedules each weekly session. Weekly activities will include: building friendships, exploring the great outdoors, venturing out on field trips, getting your game on with sports, creating artsy masterpieces, acting and improv onstage, conducting science experiments, discovering cool group games, and the list goes on! Our talented and experienced staff will create memories that will last a lifetime. This Camp is located at Lake Orion HS! Regular Camp Hours: 9am to 4pm each day Mon- Fri Week 1 6/19 to 6/20 Welcome to Summer! Week 2 6/23 to 6/27 Random Acts of Fun! Week 3 6/30 to 7/3 Celebrate Good Times, C mon! Week 4 7/7 to 7/11 Explore the Outdoors! Week 5 7/14 to 7/18 Get Your Sports On! Week 6 7/21 to 7/25 Tune into Your Creative Side! Week 7 7/28 to 8/1 Cool Science Stuff! Week 8 8/4 to 8/8 Water We Doing? Week 9 8/11 to 8/15 Where in the World? Week 10 8/18 to 8/22 The Last Hurrah! Choose 3, 4, or 5 days per week! Sign-up for one week or for all 10 weeks!!! Camp cost: $100= 3 Days; $120= 4 Days; $140= 5 Days/Full Week (Before and After Extended Camp Available 7am-9am & 4pm-6pm $6 per session) To Register or for more information: Contact the Community Enrichment Office @ 248-693-5436 or visit our website at: http://rp.lakeorion.k12.mi.us Sponsored by Lake Orion Schools Community Enrichment

Camp ExplOrion Registration Register at the Community Education Office 455 E. Scripps Road, Room #103 Lake Orion, MI 48360 248-693-5436, ext 1 fax 248-814-0203 Summer Office Hours: 8:30 a.m.- 4 p.m. Camper s Name Birthdate Fall 201 4 Grade Camper s School Address City State MI Zip Parent s Home Phone Work or Cell Phone Parent s Email Address T- Shirt Size: Youth: Large Adult: Small Medium Large X-Large Is your camper a student in the Lake Orion School District? Yes No, immunization records must be provided Camp Payment Information Payment Plan - The payment for Weeks 1 thru 4 of camp is due June 13, 2014. Payment for Weeks 5 thru 7 is due July 11, 2014. Payment for Weeks 8 thru 10 is due August 1, 2014. These are the payment due dates for both campers attending all 10 weeks of camp and also those attending only some weeks of camp. Children are not officially registered for a session until the camp balance is paid. If the balances are not paid on time, the child WILL NOT be allowed to begin camp until they are paid IN FULL. Your child must be registered and paid by the Wednesday before attending camp the following Monday. A request for reimbursement must be sent to the Community Education Office in writing before the second day of the week your child is enrolled if an unexpected situation should occur. The Director of Camp and the Coordinator of Camp will decide if the tuition is to be refunded. All billing questions must be discussed with Lori McGraw at 693-5436, #1. 2014 Summer Weekly Rates - No Daily Rates 5 days per week $140 4 days per week $120 3 days per week $100 ` Office Use Only Application Form Emergency Card Immunization Record

Camp ExplOrion Application Form Camper s Name Mother s Name Day Phone Father s Name Day Phone Do both parents reside with child? Yes No Describe visitations rights of parent not residing with child: As a parent, what method of discipline do you use? What is the camper s reaction to this discipline? What do you hope your camper will gain from his/her camp experience? Parent s Agreement 1) I consent to the enrollment of my child in the Lake Orion Community Education Camp ExplOrion Program. 2) I agree to comply with the established policies throughout the course of my child s attendance at camp. 3) I give consent for my child to take part in field trips and participate in Camp ExplOrion activities under proper supervision. 4) I further agree that in case of an accident or injury, emergency medical care may be given in the event that I cannot be contacted immediately. 5) My child is in good health and free from any communicable disease or illness. If my child should become ill, I will notify the camp or main office immediately. 6) I will send my child with a lunch from home on a daily basis. 7) Camp hours are 9:00 a.m. to 4:00 p.m., sign-in begins at 8:50 a.m. and pick-up is at 4:00 p.m. Yes No I give my child permission to attend all field trips throughout the summer and to walk to activities within Lake Orion High School or CERC building areas. Yes No I give my permission to have my child s photograph taken for use on the school web page and/or Enrichment Brochure. If a photo is used on the school website, only a first name is used. Parent/Guardian s Signature Date

SUMMER 2014 Student Emergency Card Student's Number: Family Phone #: Student's UIC Number: GRADE FALL 2014 Grade Room/Teacher Bus Number Assigned Locker Neighborhood (Orion Oaks only) Student's Name: Last First Middle Date of Birth: Home Phone: Gender Student's Home Address: House Number Street Name Apt. Number City State Zip Student Mailing Address (if different from home): House Number Street Name Apt. Number City State Zip Primary Parent/Guardian Residing With Student: Relationship: Address (if different from student address): Receive Mailings: Place of Employment: Email: Home Phone: Work Phone: Cell Phone: Secondary Parent/Guardian Residing With Student: Relationship: Address (if different from student address): Receive Mailings: Place of Employment: Email: Home Phone: Work Phone: Cell Phone: Parent/Guardian Living Elsewhere: Relationship: Address: Receive Mailings: Place of Employment: Email: Home Phone: Work Phone: Cell Phone: Parent/Guardian Living Elsewhere: Relationship: Address: Receive Mailings: Place of Employment: Email: Home Phone: Work Phone: Cell Phone: Other Children Who Reside in the Home: Name Birthdate Grade Relationship to Student:

Have custody papers been provided to the district: Yes Date: No Custody/Court Conditions: Please list below LOCAL contact in the order to be called in case of illness/emergency so student can be released: (Note: Unless otherwise specified, parents/legal guardian (from front page), will be contacted first.) 1. Emergency Contact Person: Relationship: Home Phone: Work: Cell: 2. Emergency Contact Person: Relationship: Home Phone: Work: Cell: 3. Emergency Contact Person: Relationship: Home Phone: Work: Cell: 4. Emergency Contact Person: Relationship: Home Phone: Work: Cell: 5. Doctor: Phone: Medical Instructions/allergies/physical restrictions: Other special instructions: In an emergency, the information on this card could be imperative to the welfare of your child; thus we ask that you carefully fill it out and promptly return it to your child's school. Also, PLEASE KEEP THE SCHOOL INFORMED OF ANY CHANGES THAT MAY OCCUR DURING THE COURSE OF THE SCHOOL YEAR REGARDING ADDRESS AND PHONE NUMBER(S).This information is also important in the event that the school must be dismissed early due to weather conditions or mechanical failure in an individual building. Your child should know what to do in these situations. Please inform your child of the procedure he/she is to follow WHEN NO ONE IS AT HOME in the event of early school dismissal. I authorize the physician listed on this document to treat my child in the event of serious illness or accident, when I or the other persons listed on the reverse side of this card cannot be reached. Any obligation for medical expenses resulting from treatment in such a case is my responsibility. Permission to transport my child in case of emergency is also given. Signature: Legal Parent/Guardian Date: Legal Parent/Guardian

Lake Orion Community Education Services Camp ExplOrion Payment Form Child(ren) CAMP RATES: 3 DAYS A WEEK -- $100 per camper 4 DAYS A WEEK -- $120 per camper 5 DAYS A WEEK -- $140 per camper EXTENDED CAMP is available daily: $6 Before camp (7 am 9 am) $6 After camp (4 pm 6 pm) A credit/debit card is required for all payments will be processed automatically on the dates shown. PAYMENT DATES: Payment for Weeks 1 through 4 due on June 13 Payment for Weeks 5 through 7 due on July 11 Payment for Weeks 8 through 10 due on August 1 Please complete and sign: Credit Card #: Exp. Date: CV Code: Signature: Date Once you have completed your registration and calendar for your child s attendance, you will receive a statement showing the breakdown of the amounts your credit card will be charged.

2014 Camp ExplOrion Weekly Attendance Child s Name Phone # Parent Name You will be responsible for payment for all weeks requested Credit Card (VISA, MasterCard, Discover) Please check off your choice of days you may choose 3, 4 or 5 days per week If you need before and/or after care, please check the appropriate boxes June 16-20 Week 1 Monday, 16 Tuesday, 17 Wednesday, 18 Thursday, 19 Friday, 20 June 23-27 Week 2 Monday, 23 Tuesday, 24 Wednesday, 25 Thursday, 26 Friday, 27 June 30 July 3 Week 3 Monday, 30 Tuesday, 1 Thursday, 2 Thursday, 3 NO CAMP TODAY July 7-11 Week 4 Monday, 7 Tuesday, 8 Wednesday, 9 Thursday, 10 Friday, 11 July 14-18 Week 5 Monday, 14 Tuesday, 15 Wednesday, 16 Thursday, 17 Friday, 18 July 21-25 Week 6 Monday, 21 Tuesday, 22 Wednesday, 23 Thursday, 24 Friday, 25 July 28 Aug 1 Week 7 Monday, 28 Tuesday, 29 Wednesday, 30 Thursday, 31 Friday, 1 Aug 4-8 Week 8 Monday, 4 Tuesday, 5 Wednesday, 6 Thursday, 7 Friday, 8 Aug 11-15 Week 9 Monday, 11 Tuesday, 12 Wednesday, 13 Thursday, 14 Friday, 15 Aug 18-22 Week 10 Monday, 18 Tuesday, 19 Wednesday, 20 Thursday, 21 Friday, 22 ***************************************************************************************************************************************

Camp ExplOrion 2014 MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY Welcome to Summer! 16 17 18 19 20 No Camp- No Camp- No Camp- Meet & Greet Inflatable s Schools Out Celebration! June Random Acts of Fun! School In Session School In Session School In Session *Bring your socks 23 24 25 26 27 Outdoor Scavenger Putt Putt Golf Teambuilding Every Day Heroes Pay It Forward Day Hunt in Bald Mountain Field Trip Games Celebrate Good Times, Come On! Wear Camp Shirt 30 1 2 3 4 Chinese New Year Armed Forces Day- Hump Day Camper Skit Day NO CAMP US Marine Corps Visit Celebration July Explore the Outdoors! Have a fun weekend! 7 8 9 10 11 Tie Dye & Kite Day Trail Ride Survival Day & Archery Independence Oaks Bike Day Cookout Canoe Field Trip Wear Camp Shirt Get Your Sports On! 14 15 16 17 18 Sand Volleyball Frisbee Golf Flag Weird Sports Day ExplOrion Olympics Football/Soccer

July Tune into Your Creative Side! MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY 21 22 23 24 25 Art Mania World Music Concert with Detroit Art Institute Favorite Food & ExplOrion s Got Guy Lewis Field Trip Dance Moves Galore Talent Show July/August Wear Camp T-shirt Cool Science Stuff! 28 29 30 31 1 Water We Doing? Sunergy (Projects w/ the Sun) Minute to Win it Water Games Myth Busters Cool Experiments Microscope Critter Viewing Rocket Building & Launching Up Close w/ Reptiles & Amphibians 4 5 6 7 8 Stony Lake Fishing Derby Squirt Gun Capture the Flag Water Relays & Ice Cream Sundaes August Where in the World?? Picnic Bring sack lunch NO WEAR CAMP SHIRT NO NO NO NO 11 12 13 14 15 Build Your Own Piñata The Island Guys Caribbean Steel Pan Band Cultural Games & Crafts Day Hooray for Africa! Camper Show & Tell The Last Hurrah! 18 19 20 21 22 Game Show Day High Ropes Course Cooks Dairy Field Trip Zany Mystery Day Last Day of Camp Wear Camp T-shirt Campers Choice