SCCS Summer Camp Registration 2018
Join us this summer for two weeks of summer camp fun! We will offer a variety of activities including arts and crafts, creative movement, and soccer. (Check back soon for more detailed class descriptions.) Week One is June 4-8 and Week Two is June 11-15. The camp day is from 9:00 a.m. to noon, with optional Stay and Play from noon until 4:00 p.m. each afternoon.

Week Three (June 18-22)
Learning with Legos with Mr. Ravenhill (brick building challenges, Lego storytelling, brain-stretching games, team-focused activities and hands-on Lego fun for master builders of any age or experience level)
Kids' Pilates with Ms. Rachel (Dothager)
Food & Fractions with Ms. Rae
Art & Movement with Ms. Aubree (i.e., giant marble painting with a tennis ball, kinesthetic movement picture study, and Pollack-inspired action painting!)

Cost
One week of camp: $100.00 for one child and $80 for each additional sibling
Stay and Play: $40 per week or $10 per day per child.

Please submit one form, in full, per child.

If you have any questions regarding summer camp please contact Julia Wickes at jwickes@sccommunityschool.org.

I am registering my child for: *
Required
I am registering my child for Stay and Play (noon - 4 pm) for the following days/weeks: *
Check the boxes of all days that apply to your child. Stay and Play cost is $40 per week or $10 per day.
Required
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Grade entering for Fall 2018 *
Parent or Legal Guardian *
Your answer
Phone Number *
We will use this phone number if we need to contact you during summer camp.
Your answer
Email *
Your answer
Please list two additional emergency contacts. *
Please include: name, relationship, and phone number.
Your answer
Snacks/Food Allergies *
Please note all food allergies. Snacks will be provided by the SCCS Summer Camp program. Examples are: graham crackers, goldfish, fruit snacks, string cheese, carrots. If alternate food needs to be provided to accomodate your child, we ask that you provide a well-labeled snack to your child's Class Assistant at the beginning of the week. Please mark N/A below if this does not apply to your child.
Your answer
Medical Conditions/Limitations *
Please note all medical conditions or physical limitations your child has. Due to the active nature of our summer camps and the lack of handicap accessibility at the school building, we may not be able to accommodate every child's needs. We will contact you within 2 business days upon receiving your registration form to discuss your child's needs further, prior to your payment. Please mark as "N/A" below if this does not apply.
Your answer
Learning / Social / Emotional Issues *
Please note all learning, social, or emotional diagnoses your child has, or concerns that you have regarding these issues for your child. Due to the active and learning emphasis of our summer camp programs and staffing limitations, we may not be able to accommodate every child's needs. We will contact you within 2 business days upon receiving your registration form to discuss your child's needs further, prior to your payment. Please mark as "N/A" below if this does not apply.
Your answer
Comments *
Please provide any additional information you think we need to know regarding your child and their participation in the SCCS Summer Camp program.
Your answer
Liability Release: I hereby release, acquit, and forever discharge South City Community School, the Heads of School, members of the SCCS Board, and SCCS Summer Camp staff and volunteers from any and all claims, causes of action, damages, or judgments, whether in contract or in tort, for any injuries including personal that may be incurred arising out of or in any way connected to my child's participation in the events and activities of the SCCS Summer Camp/s.
Media Release: South City Community School has permission to photograph or record my child and/or I at the SCCS Summer Camp/s. I authorize SCCS to use these photographs or digital/video records in brochures, advertising, the school’s website, and presentations.
Please type your name below to agree to this media release.
By checking the box below, you agree to submit payment to SCCS by check on the first day of summer camp. *
Cost for one full week of camp is $100 (each additional child is $80). Stay and Play cost is $40 per week or $10 per day. Payment must be made in cash/check to South City Community School. Please bring payment on the first day of camp.
Submit
Never submit passwords through Google Forms.
This form was created inside of South City Community School. Report Abuse - Terms of Service - Additional Terms