VIEWS: 6 PAGES: 2 POSTED ON: 7/20/2012
live…learn...dream…run GOTR Summer Camp 2010 Through 21st Century Discovery Camp Centennial Middle School – Montrose st 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. Questions? Jill Henwood email@example.com/970.261.5843 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.
Pages to are hidden for
"Olathe Montrose GOTR Summer Camp Flyer 2010"Please download to view full document