2019 Holmes VIP Summer Program Application
FCPS and Fairfax County Department of Neighborhood and Community Services (DNCS) have teamed up to offer a 5 week camp for rising 6th (Glasgow, Holmes, and Poe only), 7th, and 8th graders. Our camp will be a combination of students from the following middle schools: Glasgow, Holmes, Jackson, Kilmer, Poe, and Thoreau. Bus transportation will be provided from various pick-up locations which will be communicated in June prior to the start of camp.

There is a $50 camp supply fee. We will take weekly field trips and pricing information for that will be released after we have notified students of acceptance. Students who do not attend the field trips will not need to pay the field trip fees, but will need to stay home from camp that day as all of our staff will attend the trip. Students will also have the option of choosing which trips to attend.

The staff is led by your local After-School Specialists and trained DNCS staff. Campers will have a great time playing sports, games, doing arts and crafts, exploring concepts in science and technology, and strengthening skills in Math and English.

Dates: July 1, 2019-August 1, 2019 (campers are encouraged to attend all 5 weeks) - camp will not meet on July 4 and 5
Times: 8:00am-4:00pm
Location: Holmes Middle School (Alexandria)
Registration will close on Tuesday, April 30th. All registration fees are due by June 4th (Parent Meeting). Non-paid registrations will be removed from the list and placed on a wait-list at that time. You can expect to receive notice of acceptance status in May.

Mandatory Parent Meeting: Parents/Guardians are required to attend the VIP Camp PARENT Orientation Session in order for their child(ren) to participate in the VIP Teen Summer Camp. Our meeting will be on Tuesday, June 4th, at 6:00 pm, at Holmes Middle School. If you are unable to attend, please let your school’s ASPS know in advance. During this meeting, parents/guardians will have an opportunity to meet the staff, hear about the program, and turn in field trip forms. Students will be moved to the wait-list if parents do not attend this meeting without giving prior notice.

Email address *
Name of Student's Current School *
Your answer
Name of Student's 2019-20 School *
Student Last Name *
Your answer
Student First Name *
Your answer
Student ID Number *
Your answer
Student's Grade in the Fall (2019-2020 School Year) *
Sex *
Home Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Parent/Guardian Last Name *
Your answer
Parent/Guardian First Name *
Your answer
Daytime Phone (Parent) *
Your answer
Email (Parent)
Your answer
Emergency Contact Name (Other Than Parent) *
Your answer
Emergency Contact Phone (Other Than Parent) *
Your answer
Office or Cell Phone *
Your answer
Student will be transported by: *
Required
Family Physician: *
Your answer
Family Physician Phone: *
Your answer
Allergies (Please Specify) *
Your answer
Medication(s) Name/Type; Purpose; Restrictions (FCPS Medication Forms MUST accompany ALL Medication)
Your answer
Other Health Related Information?
Your answer
Program Dates Student Will Attend (select all that apply) *
Required
Elective Selection- Rank in order of 1st (top choice)-9th (least favorite choice). Students may be placed in Math, English, and ESOL classes based on school recommendations. *
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
Art
Cooking
Drama/Tech Crew
Gaming
History
PE
Sports Science
STEAM/Technology
World Cultures
Please initial (Parent) that you have read and agree to adhere to the sections of the Application Packet listed: Program Days/Hours of Operation; Policies & Procedures; Rules of Conduct; Student Information *
Your answer
You must Sign and Return the Signature Page, Emergency Contact Form and Field Trip Permission Slips to your After-School Program Specialist.
Mandatory Parent Meeting: Parents/Guardians are required to attend the VIP Camp PARENT Orientation Session in order for their child(ren) to participate in the VIP Teen Summer Camp. Our meeting will be on Tuesday, June 4th, at 6:00 pm, at Holmes Middle School. If you are unable to attend, please let your school’s ASPS know in advance.
A copy of your responses will be emailed to the address you provided.
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