Olathe Montrose GOTR Summer Camp Flyer 2010 by B2k03kwJ


                                       GOTR Summer Camp 2010
                                         Through 21st Century Discovery Camp

                                          Centennial Middle School – Montrose
                    June 21        – June 24th * 7:30 a.m. – 12:00 noon * Monday – Thursday

                                                     *** OR ***

                                      Olathe Elementary School - Olathe
                          June 28 – July 1 * 8:00 am – 4:00 pm * Monday – Thursday
                                            Transportation available

live… healthy eating and cooking, individual and team challenges, crafts and celebrating girls!
   learn...about inspiring women and girls, the media, your community, and yourself!
        dream…personal achievement, life and career possibilities, goal setting!
                  run… a variety of fun running and physical activities daily!
 Girls on the Run will be offering a summer program, in conjunction with 21 st Century Summer Programs. The camp
      is open to all girls who have completed 2nd, 3rd, 4th or 5th grades (and going into 3rd-6th grade). Girls from
  everywhere (including Montrose, Olathe and Delta County) are welcome. Size is limited so early registration is
                                 encouraged. Both camps will be run by GOTR coaches.
           To register, please complete the form on the reverse side and mail form and registration fee to:
    GOTR Summer Camp, c/o Jill Henwood, 4952 5586 Road, Olathe, CO. or return it to Jill Henwood at Olathe
                                                   Elementary School.

                                                      Jill Henwood
                                          Girls on the Run Camp
                                          Summer 2010 – Montrose and Olathe
                                          In conjunction with 21st Century –Discovery Camp!
                                          Registration Deadline: May 20th
                                          Girls must be entering 3rd – 6th grade in Fall 2010
                                          Camp size is limited – register early!
                                          Mail registration to: GOTR Summer Camp, C/O Jill Henwood
                                                                 4952 5586 Road, Olathe, CO 81425

Student Name: _______________________________________ Grade as of Fall 2010: ___________________________

School as of Fall 2010: ______________________________________________________________________________

Circle ONE camp date and location:                       Centennial Middle School                                 Olathe Elementary School
                                                         June 21- 24th                                            June 28th – July 1
                                                         7:30 – 12:00                                             8:00 am – 4:00 PM
                                                                                                                  Transportation Available

Parent(s)’ or Guardian(s)’ Name(s): ____________________________________________________________________

Physical Address: ___________________________________________________________________________________

Mailing Address (if different): _________________________________________________________________________

Phone Numbers: Home: ______________________Work: ____________________ Cell: _________________________

Email Address: _____________________________________________________________________________________

Local Emergency Contact (other than Parent or Guardian): __________________________________________________

Phone Numbers: Home: ____________________Work: ____________________ Cell: ____________________

Transportation Home – Please check your choice:

_____      I will pick my child. The only other person(s) allowed to pick up my child is (are):

I understand that my child will not be released to anyone other than a Parent, Guardian, or person listed above unless there is written authorization.

_____ My child has permission to walk home when the session ends.

Medical Concerns for the Discovery Camp Site Coordinator: _______________________________________________

Physician to call in case of an emergency:___________________________________ Phone: _____________________

As a parent/guardian of ____________________________________, I understand that the Montrose County School District RE-1J
does not provide medical insurance for student injuries but does make voluntary student accident insurance available.

______ I choose to enroll my child in KIDGUARD Accident Insurance. (If you choose to enroll your child, the
         appropriate forms will be made available to you. Please refer to the form for plan options and pricing.)
______ I DO NOT choose to enroll my child in KIDGUARD Accident Insurance.

Fees:     _______ $45 per Session – full lunch price           _______ $25 per Session – reduced lunch price
              _______ $15 per Session – free lunch price. Checks should be made payable to 21 st Century Discovery Camp.

Amount paid: _________________________________________
Upon receipt of your registration, a letter or email of confirmation will be sent to you, along with any other pertinent information.

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