1. automotive and vehicles
2. campers and rvs

CAMP ANCALA 2015!
Welcome to Camp Ancala 2015! We are looking forward to an
exciting summer of golf, tennis, swimming, and much more!
Our camp program is offered for children ages 5-12. Camp is open
to Ancala Country Club Members and Non Members.
Please read through this packet carefully. Registration Packets
must be completed at the time of registration.
One packet per child
If you have any questions, please contact
Club Reception 480-391-1000 ext. 210 or email [email protected]
CAMP ANCALA 2015
REGISTRATION:
Registration packets are available at Club Reception Desk or www.ancalacc.com.
Full payment is required at the time of registration.
WEEKLY FEES:
$300 Week - Members (8:00AM-3:00PM)
$325 Week – Non Members (8:00AM-3:00PM)
*Applicable tax applies
If you cancel your registration on or before May 16, 2015, you will forfeit
a $50 non-refundable weekly fee. There will be NO refunds made 10 days
prior to the start of each weekly session. There will be NO partial week fees,
daily fees, or ½ day fees allowed.
CAMP WEEKS-Monday through Friday
Week 1 - June 1-5
Week 2: June 8-12
Week 3: June 15 -19
Week 4: June 22-26
DAILY ITINERARY:
8:00 am
8:30 am – 10:30 am
10:30 am – 11:00 am
11:00 am – 1:00 pm
1:00 pm – 3:00 pm
Registration & Sign In
Tennis & Golf Clinics
Snack
Pool Activities & Lunch
Park, Zoo, Science Center, Young
Rembrandts, Laser tag & Game trucks
3:00 pm
3:15 pm – 3:30 pm
Camper Pickup & Sign out
Late Pickup charge of $25.00 per child
*There are no exceptions to this policy.
CAMP ANCALA 2015
REGISTRATION FORM
Today’s Date: ________________
Ancala Country Club Member:
Ancala HOA: YES ____
YES ____
NO ____
NO ____
Child’s Full Name ____________________________ Name to be called
___________________
Age ______
Male _____
Female _____
Parent Name(s)
_____________________________________________________________________________
Mailing Address
_____________________________________________________________________________
Contact Phone Number
Home __________________________ Cell_________________________________________
Email ________________________________________________________________________
In Case of Emergency Contact, Provide Name & Number
______________________________________________________________________________
Please List the Name and Relationship of Authorized People to Pick Up Your Child:
_______________________________________________________________________________
If a Guest, provide Name of Sponsoring Member __________________________________
To reserve a space for my child, I understand full payment is required upon
registering and that if I cancel on or before May 25, 2015 I will forfeit a $50
non-refundable fee. I understand that there will be NO REFUNDS made 10
days prior to the start of each weekly session.
Parent’s Initials: _____________
I have read and signed ALL applicable forms including the Snack Bar consent
form, the Behavior Policy, the Parent Consent/Minor Liability release form,
and this Registration Form. I am aware of parking regulations when picking
up/dropping off my child. I am aware that gum is NOT allowed at camp.
Parent’s Initials: _____________
Member Total Fee plus tax (7.95%) _______________________
Guest Total Fee plus tax (7.95) ____________________________
Please check: Week 1 _____ Week 2 _____ Week 3 _____ Week 4 _____
Charge My Member Account #_________________
OR I have attached a check # __________________
OR Credit Card (Circle One): VISA/MC DISCOVER AMEX
Card Number: ____________________________________
Security Code (3-4 digits) _________
Exp ________
Name on Card: ______________________________________
STAFF INITIALS _______ Payment Received On ____________ Amount $__________
CAMP ANCALA 2015
SNACK BAR PARENTAL CONSENT FORMS
Campers have access to the Ancala Country Club Snack Bar each day
during the open swim. If you would like your child to have the ability
to charge items to your Member Account, please fill out and return the
Snack Bar Parental Consent Form. Campers may also purchase items with
cash. Unless we have a signed consent form on file, campers will not be
allowed to purchase items on member charge. If you are allowing other
children to purchase on your account, please list their names on your
consent form as well. If there are any restrictions for snack bar
purchases (i.e.: $5 per day, or no caffeinated beverages, etc.), you
must list those restrictions on the Snack Bar Consent Form as well.
DROP OFF/PICK UP RULES AND REGULATIONS
Please park your car in the Member-Only parking lot and escort your
child to the Ancala Ballroom for check-in each morning. Do not park in
front of the Clubhouse as it is imperative that the front circle remain clear
of all standing and parked vehicles. Please be prompt.
It is very important that your child is picked up on time.
There is a $25.00 late pick up fee that will be strictly enforced.
BEHAVIOR POLICY
Please read, sign, and return the Camp Ancala Behavior Policy.
We want all campers to have a safe and enjoyable time at Camp
Ancala; therefore, the Behavior Policy will be strictly enforced.
Any child who cannot comply with and abide by the rules and etiquette
of the sports and recreational activities or follow the guidelines set forth
by Camp instructors will be asked to leave Camp after three failed
attempts at corrective action. Questions regarding this Behavior
Policy may be directed to Club Management.
NO GUM AT CAMP!
Gum is not allowed at Camp Ancala. Please DO NOT send
your child to Camp with gum or candy containing gum.
ITEMS TO LEAVE AT HOME
Cell phones, iPods, iPads, hand-held gaming equipment, e-readers, etc.
Ancala Country Club is NOT responsible for lost or stolen items.
Please have your child leave these items at home during Camp hours.
CAMP ANCALA BEHAVIOR POLICY
We aim for all campers to have a safe and enjoyable time at
Camp Ancala. Therefore, the Behavior Policy will be strictly
enforced. Any child who cannot comply with and abide by the
rules and etiquette of the sports and recreational activities or
follow guidelines set forth by Camp instructors will be subject to
dismissal from Camp after three (3) failed attempts at corrective
action. If your child requires corrective action at Camp, you will be
contacted that day by Club Management to discuss an action plan.
You will be contacted by Club Management if all corrective action
attempts have failed and dismissal is necessary.
If you have any questions or concerns, please contact the GENERAL
MANAGER, Patrick O’Brien at 480-391-1000 ext 220.
I, ____________________________, have read the above Behavior
Policy and agree to the terms contained within it. I understand
and agree that if my child requires corrective action at any point
during Camp Ancala, I will be contacted to discuss an action plan.
Sign _______________________________________
Date _____________
Member Number ___________
CAMP ANCALA PARKING REGULATIONS
As there are many campers participating in Camp Ancala this year,
it is imperative that the front circle at the entrance of the
Clubhouse is clear of all standing and parked vehicles.
When dropping off or picking up your camper, please be courteous
to others and park in the Member parking section. This is not only a
courtesy to other Members and guests, but a safety precaution for
all of the children here at Camp.
If you have any questions or concerns, please contact the GENERAL
MANAGER, Patrick O’Brien at 480-391-1000 ext 220.
CAMP ANCALA FOOD AND BEVERAGE
The snack and lunch menus for Camp Ancala have been specially
prepared by our Chef to provide both healthy and delicious
nourishment for your child.
If your child has special dietary needs, you must contact Club
Reception. A food and beverage liability waiver must be complete
if outside items are brought to Camp.
If you have any questions or concerns, please contact Club
Reception 480.391.1000 x 210.
PERSONAL ITEMS
We strongly recommend that you LABEL ALL ITEMS with your
child’s name—including golf and tennis equipment. Ancala Country
Club is NOT responsible for lost or stolen items and recommends
that each camper have a backpack or bag for personal items and a
golf bag for club storage. These are to be taken home each night.
CAMPER’S SNACK BAR PARENTAL CONSENT FORM
MEMBER CHARGES / MEMBER NUMBER #___________
I, ________________________, give my
child_________________________, permission to charge my
Member Account for items purchased at the Ancala Country Club
Snack Bar for Week(s)
1___________2____________3_____________4____________
Sign ______________________________ Date ______________
Food/Beverage Allergies
____________________________________________
Food/Beverage Restrictions
___________________________________________________
CAMPER’S SNACK BAR PARENTAL CONSENT FORM
CREDIT CARD CHARGES
I, ________________________, give my
child_________________________, permission to charge my
credit card listed below for items purchased at the Ancala Country
Club Snack Bar for Week(s)
1________2_________3__________4_________
Credit Card (circle one) VISA/MC
DISCOVER
AMEX
Card Number _______________________ Exp._____________
Name on Card ______________________ Sec. Code _________
Food/Beverage Allergies
_______________________________________________________
_______________________________________________________
Food/Beverage Restrictions
Please List Additional Campers who May Charge Items
_______________________________________________________
_______________________________________________________
Sign __________________________________ Date ____________
Exhibit A
EMERGENCY MEDICAL TREATMENT
FULL NAME OF CHILD:
_______________________________________________________
NAME TO BE CALLED:
_______________________________________________________
ALLERGIES:
_______________________________________________________
_______________________________________________________
IMMUNIZATIONS:
_______________________________________________________
_______________________________________________________
MEDICAL HISTORY:
HOSPITAL:
Family Physician:
_______________________________________________________
Phone Number:
_______________________________________________________
Insurance Company:
_______________________________________________________
Phone Number:
_______________________________________________________
Other relatives in this area, list relationship:
Name:
_______________________________________________________
Phone Number (Home and/or Cell):
_______________________________________________________
Name:
_______________________________________________________
Phone Number (Home and/or Cell):
_______________________________________________________
EMERGENCY CONTACT(S):
Name:
_______________________________________________________
Phone Number (Home and/or Cell):
_______________________________________________________
Name:
_______________________________________________________
Phone Number (Home and/or Cell):
_______________________________________________________
CAMP CHECKLIST
____
Tennis Racket
____
Junior Golf Clubs & Golf Bag—Iron, Driver, Putter
____
Bathing Suit & Towel
____
Water Bottle
____
Waterproof Sunscreen *SPRAY BOTTLES PREFERRED*
____
Hat
____
____
Backpack or Bag for Misc. Items
Medication in Appropriately Labeled Bottles
(PLEASE NOTE: Children must be able to administer their own medication.
**PARENTS PLEASE KEEP THIS LIST**