2010 Roots Summer Camp & Little Sprouts Mini Camp
Student Drop Off & Pick Up Information
· For your child’s safety, please accompany your child into and out of the facility and sign in and out every day.
· Check-in is between 8:15 – 8:30 am for Rec Camp and 8:45 – 9:00 am for Little Sprouts Camp.
· All rec campers need to be picked up no later than 5:30 pm.
Please list those adults to whom your child may be released and picked-up/Emergency Contacts.
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Phone 2 |
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Please list anyone who doesn’t have permission to pick up your child: _________________________________
Please list any friends that your child would like to be place with __________________________ Age _______
Your Child
Does not eat: o Red Meat o Pork o Dairy Products o Poultry o Seafood o Eggs o Other _________________
Allergic to: o Bee Stings o Peanuts o Tree Nuts o Dairy o Sun screen o Other __________________________
Medication allergies/Sensitivities: _______________________________________________________________________
Is an epi-pen needed for any of the allergies above? _________________________________________________________
What type of reaction does your child have to stings? _______________________________________________________
Physician’s Name __________________________________________ Phone _____________________________________
Cancellations
Roots Gymnastics Center wants to remain flexible and provide more options than just weekly camp. In order to do this refunds or credits will not be permitted.
This helps us the staffing and supplies that we need to purchase. Thank you for your understanding.
Parent Initials _________
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*Camp t-shirts available for $12.00 |
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Tropical Adventures WEEK 1 – July 26 - 30 |
Little Sprouts Mini Camp o Full Week o 1 Day for 5 Weeks o 2 Days for 5 Weeks o AM 9:00 – 11:30 o PM 1:00 – 3:30
Recreational Camp o 9:00 am – 4:00 pm o Extended Day *T-shirt CS CM CL AXS AS AM AL TOTAL $_______________ |
Mad Gym Science and Space WEEK 2 – Aug 2 - 6 |
Little Sprouts Mini Camp o Full Week o 1 Day for 5 Weeks o 2 Days for 5 Weeks o AM 9:00 – 11:30 o PM 1:00 – 3:30
Recreational Camp o 9:00 am – 4:00 pm o Extended Day *T-shirt CS CM CL AXS AS AM AL TOTAL $_______________ |
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Tumble in the Jungle WEEK 3 – Aug 9 - 13 |
Little Sprouts Mini Camp o Full Week o 1 Day for 5 Weeks o 2 Days for 5 Weeks o AM 9:00 – 11:30 o PM 1:00 – 3:30
Recreational Camp o 9:00 am – 4:00 pm o Extended Day *T-shirt CS CM CL AXS AS AM AL TOTAL $_______________ |
Fun on the Farm WEEK 4 – Aug 16 - 20 |
Little Sprouts Mini Camp o Full Week o 1 Day for 5 Weeks o 2 Days for 5 Weeks o AM 9:00 – 11:30 o PM 1:00 – 3:30
Recreational Camp o 9:00 am – 4:00 pm o Extended Day *T-shirt CS CM CL AXS AS AM AL TOTAL $_______________ |
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Dinosaurs and Divas WEEK 5 – Aug 23 - 27 |
Little Sprouts Mini Camp o Full Week o 1 Day for 5 Weeks o 2 Days for 5 Weeks o AM 9:00 – 11:30 o PM 1:00 – 3:00
Recreational Camp o 9:00 am – 4:00 pm o Extended Day *T-shirt CS CM CL AXS AS AM AL TOTAL $_______________ |
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Little Sprouts Mini Camp Monday thru Thursday $100.00 Full Week $125.00 1 Day for 5 Weeks $250.00 2 Days for 5 Weeks
Recreational Camp Monday through Friday $180.00 Full Week $10.00/day for Extended Day |
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Payment Information
TOTAL ENCLOSED …………………$________________ Paid by o Check ………… o Credit Card $ ______________
Name on Card: ______________________________ Card Number: _____________________Exp Date: _____
Signature: _________________________________________________________________________________
