EVJCC WINTER CAMP 2016- 17

December 23-January 9- Open to Grades K-8- Hours: 9am-3:30pm- Early & Late Care - Daily Rates Available- Field Trips

Spaces are limited, reserve your spot today! Download regist rat ion form will be available at www.evjcc.org or call 480-897-0588.

For more informat ion, e-mail Jef f Hast at hast j@evjcc.org

SCHOOL'S OUT THIS WINTER BREAK?

COME BACK TO CAMP!

THIS DECEMBER... GO "AROUND THE WORLD"

WITH CAMP RIMON!

Wint er Camp 2016-17 Regist rat ion FormDat es: December 23-January 9 (No Camp on December 26 or January 2). Regist rat ion closes on Friday, December 16.

Camp Day is 9:00am-3:30pm. Minimum Part icipat ion required. Camp day programming include: sport s, art projects, science, music, drama and other Camp Rimon act ivit ies. We will be going on at least 1 f ield t rip a week included in the camp cost . Please drop of f your kids with their own lunch; we will provide one snack a day as well.

Child?s Name: _________________________________      Age: ________   Current Grade: ___________

Child?s Name: _________________________________      Age: ________   Current Grade: ___________

Child?s Name: _________________________________      Age: ________   Current Grade: ___________

Fal l Camp Pricing Opt ions (please check each day or if regist ering f or ent ire camp)

Daily Price: $45/day Early Care (7-9am): $10/day Late Care (3:30-6pm): $10/day

Full Camp: $405 All 9 Early Care sessions: $75 All 8 Late Care sessions: $70

I wish t o regist er f or : (please check t he f ol lowing)

? December 23rd ? Early Care ? Late Care ? December 27t h ? Early Care ? Late Care

? December 28t h ? Early Care ? Late Care ? December 29t h ? Early Care ? Late Care

? December 30t h ? Early Care ? Late Care ? January 3rd ? Early Care ? Late Care

? January 4t h ? Early Care ? Late Care ? January 5t h ? Early Care ? Late Care

? January 6t h ? Early Care ? Late Care ? January 9t h ? Early Care ? Late Care

? Full Camp ($405, 10% of f full price) ? All Early Care Sessions ($90) ? All Late Care Sessions ($90)

TOTAL DUE: $_________________________

Method Of Payment (please check one): ? Cash    ? Check   ? CC on File NO REFUNDS FOR ANY REASON    

Please return signed forms WITH PAYMENT, by e-mailing Jef f Hast , at hast j@evjcc.org, calling 480-897-0588 or dropping of f forms at the f ront desk.My child has my permission to at tend all f ield t rips during Winter Camp. We will be t raveling by school bus. I understand that part icipat ion in any JCC act ivit y involves a risk of accidental injury despite precaut ions put in place by the JCC. Therefore, as a parent /guardian, I will assume all risk (injury or illness) for my child(ren) that may occur during any act ivit ies at the JCC. In case of sudden illness or injury, I hereby give authorit y to any hospital or doctor to render immediate aid as may be required at the

t ime for my child?s health and safety. I understand that any and all medical/dental expenses are my responsibilit y.

· I, t he undersigned, understand that I am obligated to provide up to date and accurate medical records along with

food/medicat ion/allergies pertaining to my children).

· I, t he undersigned, authorize the JCC to use photographs of my children) to be taken and used privately in JCC publicat ions,

market ing materials, internet and promot ional videos.

· By signing this form I acknowledge that I am aware of the potent ial risks of part icipat ing in act ivit ies and/or programs at the JCC and agree to in no way hold the management , agent , or employees of the JCC liable for any injury I/my children) may

sustain.

I have read and understand the above statements.

Parent / Legal Guardian Signat ure: ____________________________  Print ed Name: __________________________

Dat e: _______________________________     E-mail address: ____________________________________