OMS Virtual Summer Camp Registration Form
RSU#13 21st Century Summer Camp will be a Virtual Online Program via Zoom.

We will meet on Zoom Monday-Thursday from 11am-12pm each day for 8 weeks: July 6th, 2020 through August 27th, 2020.

This hour of Virtual Summer Camp will be a safe and educational space where students can check in with Summer Camp Staff (familiar faces from Afterschool) and friends each day. It's a great way to start off the day by visiting with friends online, play a few games, try a new project or activity. Each day will include games, questions, trivia, and fun challenges. It's a great way to stay connected and make use of your school iPad this summer. We will be here rain or shine. Register for the camp and show up on the days that work for you!

Register Now to receive a Summer Camp Kit of Fun! (A box we deliver to your door with small games, art supplies, sports equipment and other fun stuff)
Student First Name *
Student Last Name *
Student Email *
Grade you are going into in the Fall *
Physical Address where we could drop off a Summer Kit. Please include street address/number AND town/city *
Parent /Guardian Name - #1 *
Parent/Guardian Phone Number - #1 *
Parent/Guardian Email - #1 *
Parent/Guardian Name #2
Parent/Guardian Phone Number #2
Emergency Contact Name *
Emergency Contact Phone Number *
Virtual Summer Camp Guidelines & Expectations.
I permit my child to participate in 21st Century Online Summer Camp on Zoom.
In the event that I am not present while my student is online and emergency occurs in our house and I cannot be reached by phone, I authorize 21st Century Summer Camp staff to contact emergency services (911) for my child.
I release 21st Century Summer Camp staff, volunteers and Board of Directors from responsibility or expense for any injuries incurred by my child while participating in online summer camp programming.
I understand that my child may be invited to try various enrichment activities, cooking or science experiments, physical activities, under the remote, online supervision of summer camp staff.
I give my consent for my child’s photograph, name, quotes, and artwork to be used in summer camp and afterschool publicity and fundraising materials.
I understand that summer camp staff may contact school staff or other service providers to discuss my child’s school records, standardized test scores, grades, behavioral issues, medications, correctional system involvement, and other issues.
I understand that summer camp staff may share my child’s registration information with partner organizations.
I understand that if my student is suspended or removed from RSU#13, they will be unable to participate in summer camp programming.

These agreements are in place to ensure the success and enjoyment of all youth.
If a youth fails to follow these rules, he or she may be asked to leave the online activity or online program.
Parents agree to: contact the Program Coordinator if any issues or concerns arise.
Students agree to: turn off and put away all other electronic devices while participating online;
wear clothing that is appropriate while online;
not bring online, or be under the influence of drugs, alcohol or cigarettes while online;
not bring weapons online.
Students agree to make others feel welcome, to respect all adults, youth and self online.
Students agree to: a zero tolerance policy for any bullying behavior.
Bullying is the use of aggression with the intention of hurting another person.
Bullying can be unfriendly intent, excluding, tormenting, any use of violence, racial taunts, graffiti, gestures, sexually abusive comments; homophobic, transphobic, or focusing on the issue of sexuality, name-calling, sarcasm, spreading rumors, teasing, cyber or text bullying. All students and parents agree to a no-bullying atmosphere.
Sign off to show you agree to the above Guidelines/Expectations by checking off each bubble below *
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