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Public Summer Camp 2011 Info

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Public Summer Camp 2011 Info Powered By Docstoc
					 New this year: 5 year olds entering Kindergarten in the fall can now attend camp too!
Camp Location
• Ken-Caryl Ranch House for students entering grades K - 3.
• Ken-Caryl Community Center for students entering grades 4 - 6.

Camp Schedule
• Camp dates: June 1—August 19.
• Daily hours: 6:45am - 6:00pm, Monday - Friday.
• Daily activities: We play hard! We go swimming every day and spend most of our time
  outside. Daily activities include science, art, sports, group games, and more! You may also
  register for optional swimming, Spanish and dance lessons when you receive your email
  confirmation. A detailed weekly schedule will be available each Monday of camp.
• Special activities (in addition to the excitement of swimming, science, art, cooking, games):

                                   Grades K-3                     Grades 4-6**
                                 (Ranch House)                 (Community Center)
        Monday                   Tennis Lessons                  Regular Camp Day
        Tuesday                     Field Trip                     Tennis Lessons

        Wednesday                Tennis Lessons                       Field Trip
        Thursday                Regular Camp Day                   Tennis Lessons
        Friday                Fun on the Move Day*              Fun on the Move Day*

      *Fun on the Move Day is a walking field trip or all-day activity (i.e. talent show).
      **Have a 6th grade camper that feels too old for camp? Check out our Middle School
      Leadership Corps and weekly Middle School Camps for students entering 6th—8th grade.

• Families may register for full weeks (Monday—Friday), 3 days per week (Monday,
  Wednesday and Friday) or 2 days per week (Tuesday and Thursday). Priority is given to full
  week registrations.
• Registration forms are available at the Ranch House or at Please
  mail or drop off registrations any time during April 4-8. The lottery closes at 6pm on April 8.
• All available spots are filled through a random draw of the lottery. Full week registrations
  are given priority and processed first. All remaining spaces are filled with part-week
• All families will be contacted between April 11-22 to confirm their registration.
Registration Fees
                        T/TH Week           M/W/F Week                    Full Week
Resident                $64.00              $96.00                        $150.00
Non-Resident            $74.00              $111.00                       $175.00
There is a $20 per week, non-refundable/transferable deposit due with completed forms
before your child is enrolled in summer camp. This deposit is applied to the weekly fee. The
remainder of the registration fees will be billed in monthly invoices.
Our Staff
• We believe the quality of our program is due to our amazing staff. Our camp counselors
  are fun, talented college students or graduates with extensive experience working with
  youth. Our camp counselor to student ratio is 1:8. All counselors are trained in CPR, First
  Aid, AED, Positive Behavior Management and Vehicle Safety. Our enthusiastic staff serve
  as activity leaders and mini-bus drivers.
Field Trips
• Ranch House field trips (grades K - 3) are each Tuesday. Community Center field trips
   (grades 4 - 6) are each Wednesday. Field trip destinations will include ice skating,
   amusement parks, bounce houses, water parks, and much more!
• Field trip transportation is either in Jeffco School District buses or Ken-Caryl Ranch
• The field trip schedule and camp invoices will be emailed to you.

Packing List
Please bring the following items to camp each day:
• Lunch and 2 snacks
• Tennis shoes on tennis days
• Clothes that can get dirty
• Swim suit & towel
• Swim Shirts! Please bring a swim shirt daily for the pool (to be worn with or over a swim
   suit). You may provide your own swim shirt or order a swim shirt on your registration form
   for $14. Swim shirts run small. For a sizing chart please visit All
   campers must wear a swim shirt to enter the pool.
Changes & Cancellations
Deadline                        Cancellations
On or before 5/16/11            Full refund less $20 deposit/week. Cancellation must be made for exact
                                schedule chosen (i.e. full week must cancel full week—no partial or daily
                                cancellations can be accepted). We cannot accept any switches for other
                                days or weeks.
After 5/16/11                   No refunds or changes available. Full payment due for all registered

• You will be contacted during the weeks of April 11-22 to confirm your registration.
• You will receive a confirmation email with additional information and invoices.

Questions? Please contact Melissa at (303) 979-4070 ext. 136 or
                    Part-Week Summer Camp Registration
                               “Part-week” camp is either Mon/Wed/Fri or Tues/Thurs.
                        All forms returned between April 4-8 will be processed in the lottery registration.
                       Full-week registrants receive priority over part-week registrants.
 Please note we only process COMPLETE registrations including this form and the Consent & Release Form.

Child’s Name
Parent Name(s)
Street Address                                              City, State, Zip
Home Phone                                                  Cell Phone(s)
Work Phone(s)                                               Grade in Fall 2011
Date of Birth                                               Email
Resident           Non-resident
Names & grades of other siblings enrolling in camp:

Check appropriate facility (Fall 2011 Grade)                         Fees:

                                                                     Residents: M/W/F $96/week, T/Th $64/
____ Ken-Caryl Ranch House (Entering grades K - 3)                   week

                                                                     Non-residents: M/W/F $111/week, T/Th
____ Community Center (Entering grades 4 - 6)                        $74/week

  Field trip & tennis schedule for 2011
  Ranch House (Grades K—3): Field trip on Tuesday, tennis lessons on Monday & Wednesday.
  Community Center (Grades 4—6): Field trip on Wednesday, tennis lessons on Tuesday & Thursday.

Week                 Ranch      Community       M/W/F      T/Th
                     House        Center                                 Entering 6th grade & ready for
                                                                                something new?
June 1-3*                                      (Wed/Fri)    (Th)    Ken-Caryl Ranch offers a variety of summer
                                                                    programs for middle school students.
June 6-10                                                           Week-long theme camps include
                                                                    skateboarding, disc golf, art, robotics, rock
June 13-17                                                          climbing and more! The Middle School
June 20-24                                                          Leadership Corps builds leadership skills
                                                                    through fun service projects, games and trips.
June 27-July 1                                                      Please visit our website at www.ken-
July 5-8**                                    (Wed/Fri)    for more information or call
(No Camp 7/4)                                                       Melissa at (303) 979-4070 ext. 136.

July 11-15

July 18-22
July 25-29
Aug. 1-5
Aug. 8-12
Aug. 15-19
*Please note camp begins on Wednesday, June 1. Fees are $64/res,      Please complete reverse side
$74/NR for Wed/Fri; $32/res, $37/NR for Thurs. only.
**Please note no camp on Monday, July 4. Fees are $64/res, $74/NR
for Wed/Fri.
                                 Cancellation Policy
                                 Deposits are non-refundable and non-transferable. No daily cancellations or refunds.
                                 Deadline                      Cancellations
                                 On or before 5/16/11          Full refund less $20 deposit/week. Cancellation
                                                               must be made for exact schedule chosen (i.e. M/W/F
                                                               must cancel M/W/F—no partial or daily
                                                               cancellations can be accepted).
                                 After 5/16/11                 No refunds or changes available. Full payment
                                                               due for all registered weeks.

I have read and understand the above cancellation policy. I understand that any cancellations before
5/16/11 must be for the entire week as scheduled. I understand that I am responsible for the full
amount due for all registered weeks if I do not cancel on or before 5/16/11. I understand that there
are no daily or weekly changes, switches, cancellations, credits or refunds after 5/16/11.

Parent Signature:

Swim Shirts

Swim Shirts are required to protect campers from the sun. You may purchase your own or order one
now at a discounted rate of $14. Swim shirts run small. For an exact sizing chart please visit Campers must wear swim shirts to enter the pool.

Kids: ______Blue _____Yellow _____Pink                  Kids size:    ____XS ____S ____M ____L ____XL

Adults: ______Blue _____Yellow _____Pink                Adult size: ____XS ____S ____M

Payment Information

______ # weeks registered x $20 deposit/week            = _____________ (Deposit due at time of registration)

_______ # of Swim Shirts x $14                          = ______________ (Due at time of registration)

         Total due at time of registration              =______________

□ Visa           □ Mastercard                □Discover          □ American Express        □ Check #______
                                                                                          (Payable to KCRMD)

Credit Card #:______________________________ Expiration Date: _______

Cardholder’s Name:________________________________________________

Cardholder’s Signature:_____________________________________________

You will be invoiced for the remaining costs. Payments are due at the beginning of each month.

                          To register: Mail or drop off this form at the Ranch House between April 4-8.
                                        You will receive a confirmation call by April 22nd.

                        Questions? Please contact Melissa at (303) 979-4070 or
                                           Ken Caryl Ranch Youth Programs
                                         Emergency Consent and Release Form
                                                 Summer Camp 2011

 Child’s Name:                                            Birth date:
 Address:                                                 Home Phone:
 School:                                                  Grade in Fall 11:
 Parent’s Name:                                           Parent’s Name:
 Employer:                                                Employer:
 Work Phone:                                              Work Phone:
 Work Address:                                            Work Address:
 Cell Phone:                                              Cell Phone:
*Please put a star next to the best way to reach you.

Name(s) of person(s) other than parents to whom the child may be released: Check box for none [ ]
Name:                               Relationship:               _Phone:_________________
Name:                               Relationship:                Phone:_________________

Persons other than parents to be notified in an emergency situation when parents are not available:
 Name:                                                        Name:
 Phone:                                                       Phone:
 Address:                                                     Address:

 Name:                                                        Name:
 Phone:                                                       Phone:
 Address:                                                     Address:
The undersigned, as the parent(s) and/or lawful guardian(s) of                              , a minor, hereby grant(s)
permission for said minor child to participate in Ken-Caryl Ranch Youth Programs and related activities sponsored by
the Ken-Caryl Ranch Metropolitan District (the "District"). I/We hereby verify that the named minor child is physically
capable of such participation as determined by me/us and/or our family physician.

I/We hereby agree, on behalf of the undersigned and the minor child that we will abide by the rules and regulations of
the District, its affiliated organizations and sponsors. Recognizing that certain unavoidable hazards and risks are an
inherent part of any physical activity and the possibility of physical injury associated with Ken-Caryl Ranch Youth
Programs and in consideration for the District accepting my/our child for its programs and activities (the "Programs"),
I/we hereby release, discharge and/or otherwise agree to hold harmless and indemnify the District, its employees,
agents and associated personnel, including the owners or leasers of fields and facilities utilized for the Programs, on
behalf of my/our child, as well as said child's legal representatives, heirs and assigns, from any injury, death, loss or
damage, whether to person or property, other than that resulting from the sole negligence of the District, as a result
of my/our child's participation in the Programs and/or transportation to or from the same, which transportation I/we
hereby authorize.

In the event my/our child is injured or becomes ill, please contact either parent or the emergency contact listed in the
information section above. If contact with a parent, guardian or emergency contact cannot be made or is not
possible, I/we hereby authorize the District personnel in charge to seek and consent to any first aid or medical
treatment necessary to stabilize or treat my/our child until I/we can be contacted.

Parent/Guardian signature: _______________________________________                 Date:___________________

                                            Continued on other side
                                                HEALTH FORM

Past illnesses: CHECK those that the child has had and give approximate dates:

Chicken Pox                   Rubeola                Rubella_________
Rheumatic Fever               Asthma                 Hay Fever_______
Diabetes                      Mumps                  Epilepsy ________
Whooping Cough                Poliomyelitis          Other __________
Surgery/Accidents/Illnesses/Chronic or Handicapping Problems:___________________
Describe any condition requiring special attention by staff:________________________


                                          MEDICAL INFORMATION

 Medications:                                                  Frequency:

 If medications will be administered at the program please request a medicine permission form.
 Family Doctor:                                                Address/Phone:

 Preferred Hospital:                                           Address/Phone:

 Health Insurance Company:                                     Policy #:

 Family Dentist:                                               Address/Phone:

Please initial all those that apply:

_____ I give permission to KCRMD to use my child’s photograph or artwork in Ken-Caryl Ranch publications.

_____ I give permission for my child to participate in field trips and excursions involving walking, KCRMD
       transportation and Jefferson County School District buses.

_____ I give permission for KCRMD to apply Rocky Mountain Sunscreen SPF 30 on my child’s exposed skin.
       This sunscreen is waterproof, PABA free and peanut-oil free.
       Special Instructions:

_____________________________                       ________________
Parent/Guardian signature                           Date