Valley Heights Summer Camp 2020
Due to continued health and safety precautions there will be changes with camp this summer.
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This enrollment form contains information for the months of June and July.
Please read the questions and answer completely. We will provide a student and family guidance document via email and on the Valley Heights website in the near future.

CAMP WILL OPERATE MONDAY - THURSDAY BOTH MONTHS

Dates: KRR Camp will operate June 15 - June 25 (Grades K-3)
21st CCLC Camp Exploration will operate July 6 - July 23 (Grades K-6)

Times: Camp will operate from 8:30 am - 2:30 pm both in June and July.
Students may not be dropped off or enter the buildings any earlier than 8:00 am.

Transportation will not be provided due to health and safety precautions. Because of this, we will operate in both grade schools in both months. Families will be required to get their students to the schools.

STUDENTS WILL ATTEND CAMP IN THE TOWN IN WHICH THEY RESIDE.

****ATTENDANCE MAY BE LIMITED****

Please note that the above information is our present plan, however if there is a change with the COVID-19 guidelines we will adjust accordingly to assure the safety of all.

If you have questions, please contact:
Tony Yungeberg: Phone: 785-363- 2211 email: tyungeberg@valleyheights.org
Sammie Parker: email: sparker@valleyheights.org
REGISTRATION WILL CLOSE MONDAY, MAY 18th
YOU MUST FILL OUT A NEW FORM FOR EACH INDIVIDUAL STUDENT
Student First Name *
Your answer
Student Last Name *
Your answer
Will you attend Camp in June, July or Both? *
Regular attendance is a requirement this year for health guidelines. Will there be any dates you will not plan on being at camp? (Ex. vacations, doctors appts...) Please elaborate below.
Your answer
Current Grade (2019-2020 school year) *
Address *
Your answer
City/town *
Parent/Guardian Name(s) *
Your answer
Parent/Guardian Phone Number *
Your answer
Additional Parent/Guardian Phone Number
Your answer
Parent/Guardian email *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Secondary Emergency Contact Name *
Your answer
Secondary Emergency Contact Phone Number *
Your answer
Medical Information : *
Is your student allergic to any of the below
Is your student allergic to any of the below
Required
If your child becomes seriously ill or is injured, and you or your emergency contact cannot be reached within a reasonable length of time, may we have your permission to take or send your child for emergency care to the nearest hospital or doctors office? *
PHOTO RELEASE: Pursuant to Public Law 98-380 (Family Privacy Act) Valley Heights, USD 498 does release rosters and directory information etc. That is also the practice of the Valley Heights Community Education. Publications may include but are not limited to website, publications, social media, and presentations. This particularly relates to pictures that may be published in the newspaper, in the USD 498 newsletter, or included in our informational reports to our 21st CCLC funding service or its partners. *
Liability and Medical Emergency: In consideration of my being able to participate in educational, recreational, social and/cultural classes, programs, and projects, I do hereby waive all claims for damage or loss to my person or property (or to the person or property of my minor son or daughter whose name appears below) and all demand and liability which may be caused by any act or failure to act of and by, and I do hereby release, discharge and hold harmless the Community Education, the cities of Blue Rapids and Waterville, the USD #498, its board members, administrators, representatives, employees, and the owner, managers and lessees of any real property on which such programs may be carried out. *
By typing your name below you confirm that you have read and understand the participant agreement and agree to its contents. *
Your answer
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