2019 STEAM SUMMER PERMISSION SLIP: Camp Zehnder - July 5, 12, 17, 26 (trip dates may change based on the scheduling of additional trips)
IMPORTANT NOTE: APPLICATION DATA CANNOT BE SAVED. IF YOU CLOSE THE APPLICATION BEFORE CLICKING SUBMIT, ALL INFORMATION WILL BE LOST.
Email: Chosen@BGCMe.org
Phone: (732) 707-7336
To Make Payments Visit: https://www.bgcme.org/donations-payments/
Trip Information
WHO: Grades K-12

WHAT: Trip to Camp Zehnder facility and pool

WHERE: YMCA Camp Zehnder, 3911 Herbertsville Road, Wall, NJ 08724

WHEN: Friday, July 12, 17, 26 2019, 10:00a-2:00p (return time may vary based on activities, weather, and traffic)

COST DUE MONDAY BEFORE EACH TRIP: $5 (MUST be returned with the permission slip or paid online bgcme.org/donations-payments. Online payments will incur processing fee)

ATTIRE: Casual

YMCA - CAMP ZEHNDER GUEST RELEASE & WAIVER OF LIABILITY & INDEMNITY AGREEMENT
I have read and understand this document and release. *
Additional Information
WHAT TO BRING: I will send my child with a swimsuit and/or sports shirt, sunscreen, water bottle, and towel. *
COST: I understand that I must send my child(ren) to camp with $5 (cash or check) on the Monday before the trip or pay online AT bgcme.org/donations-payments (a processing fee will be applied). *
MEALS: I understand that Breakfast will be served at camp. Lunch will not be provided. STUDENTS MUST BRING A BROWN BAG LUNCH & SNACKS. *
NO CAMP: I understand that any student not attending the trip MUST be kept at home. No staff/students will be onsite at camp. *
MONEY: I understand that campers may have the option to purchase snacks and lunch at Camp Zehnder if time permits and I will send my child(ren) with spending money if desired. *
TRANSPORTATION: I give permission for my child to be transported by BGCM Community Center & Sportsplex staff utilizing passenger vans. Vans will leave camp at 9:30 am and return before dismissal. *
I certify that my child has familiarized themselves with the field trip rules below. *
All students MUST LISTEN and BE RESPECTFUL to BGCM and YMCA Camp Zehnder STAFF. Students must arrive at camp before 9:30 AM. No exceptions! A permission slip will only be accepted with payment and is due the Monday before each scheduled trip.
I agree to instruct my child to obey all rules, regulations, and instructions given by teachers and/or authorized camp personnel. I further agree that no teacher or authorized personnel shall be held responsible or liable for injuries or other mishaps caused by my child’s deliberate disobedience of rules, regulations, or instructions. *
I understand that Camp Zehnder - Pool dates are subject to change based on scheduling of additional trips (ex: college tours, etc.) *
My Child Will Attend the Camp Zehnder & Pool Trips and dates below ($5 each trip) and I will submit payment for this trip. *
Required
First Name (of person completing form - Must be parent or guardian) *
Your answer
Last Name *
Your answer
Camper's Home Phone Number *
Your answer
Parent's Mobile Phone Number *
Your answer
Camper's Street Address *
Your answer
City *
Your answer
State *
Zip Code *
Your answer
Emergency Contact#1: Name, Phone Number, and Relationship to Child *
Your answer
Emergency Contact#2: Name, Phone Number, and Relationship to Child
Your answer
My child(ren) has/have my permission to attend/participate in this supervised field experience (ENTER CHILD(ren's) FIRST AND LAST NAME BELOW. *
Your answer
MY SIGNATURE BELOW INDICATES THAT I HAVE READ AND AGREE TO THE ABOVE AND MY CHILD HAS PERMISSION TO ATTEND THE FIELD TRIP(S) MENTIONED ABOVE ON THE DATES MENTIONED BELOW: *
Your answer
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