CAMP WOODSY
2015 HWCC DAY CAMP
Tuesday/Wednesday/Thursday/Friday
(4-10 year olds)*
REGISTRATION FORM
Member Name: ________________________________________Member No.:________________
Name of Child:________________________________________Birth Date:___________________
Mailing Address:___________________________________________________________________
Home Phone:______________________________________________________________________
Mother’s First Name:________________________Mother’s Cell Phone:_____________________
Father’s First Name:_________________________Father’s Cell Phone:_____________________
In case of an emergency, who would you like us to contact if both parents are unavailable?
Name:____________________________________________________________________________
Relation:___________________________________ Phone:________________________________
Doctor Information:________________________________________________________________
Doctor’s Name: _____________________________ Phone:________________________________
Please list any health or special situations concerning your camper which Hawthorn Woods Country
Club should be aware of, such as Allergies, Injuries, Existing Illnesses:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Please remember to immediately notify Counselors if there are any changes in the above emergency
information!
FULL SIX-WEEK CAMP:
June 9 – July 24 (Tuesday through Friday)
No Camp June 30-July 4
Member
$1,320 ( )
Non-Member
$1,500 ( )
TWO-WEEK SESSIONS
(Tuesday through Friday)
No Camp June 30-July 4
WEEK 1:
JUNE 9 – JUNE 12
Member
$220 ( )
Non-Member $250 ( )
WEEK 4:
JULY 7 – JULY 10
Member
$220 ( )
Non-Member $250 ( )
WEEK 2:
JUNE 16 – JUNE 19
Member
$220 ( )
Non-Member $250 ( )
WEEK 5:
JULY 14 – JULY 17
Member
$220 ( )
Non-Member $250 ( )
WEEK 3:
JULY 23 – JULY 26
Member
$220 ( )
Non-Member $250 ( )
WEEK 6:
JULY 21 – JULY 24
Member
$220 ( )
Non-Member $250 ( )
What to Bring: Each day Camp Woodsy Campers should wear the Camp Woodsy T-Shirt, closed toe
gym shoes and are encouraged to bring a water bottle with their name on as well as a back pack or duffle
bag with sun screen, swim suit and towel. In addition, they are asked to bring the following on these
specified days:
Timely Tuesdays
Golf Clubs (If owned)
Thinking Thursdays
Tennis Racquet (If owned)
Wacky Wednesdays
A Wacky Show -n-Tell Item
Fun Fridays
A Large Blanket To Build A Fun Fort
Dress Code:
Please do not allow your child(ren) to wear jeans, or running shoes that have little traction on
them.
We encourage campers to wear comfortable clothes for outdoor play.
Please be conscious of weather conditions and bring a jacket, if necessary, as your child will
spend a considerable amount of time outdoors.
Please remember to apply sun block to your child every day before Camp. Counselors will reapply, as needed.
Camp Woodsy Rules / FAQ’s
What’s included: Included in your registration are 2 Camp Woodsy T-Shirts, Wake Up Snack
(each day), Fun Lunch (each day), all supervised Woodsy Camp activities and a ton of FUN!
Arrival/Pick UP: Drop off will be at the Paddle Hut each morning between 8:30am and 9:00am
and all children must be escorted into the Paddle Hut by a parent. Pickup will be at 4:00pm each
day. Children will not be released without a parent/guardian.
Lunches: We have tried to vary the lunch menu and choose things that the campers will like. If
your child does not care for anything on the lunch menu for a particular day, please pack them a
lunch. Menu options will be provided weekly for campers to enjoy. On Tuesdays we will ask the
Parent that is dropping off the child to pick that week’s food. If the parent is not present (friend
or nanny drop off child) – then we will ask the child for their choice unless you have granted
permission for the person dropping off to make the selections.
Menu options for your children include three of these each day.
Grilled Ham and Cheese – NEW
Mini Chef’s Salad – NEW
Grilled Chicken Wrap – NEW
Peanut Butter & Jelly
Grilled Cheese
Cheese Pizza
Mini Burger or Hot Dogs
Chicken Quesadillas
Each lunch will always include freshly sliced or cubed fresh seasonal fruit.
In addition, we will serve juices, water and lemonade with the meal.
Emergencies: In the case of an EMERGENCY, the emergency contact will be notified immediately.
Discipline: The Camp Woodsy staff will inform your child(ren) of the rules and will provide positive guidance
and re-direction, if needed. A brief time away from the group may be used as a disciplinary measure. Every
effort will be made by our staff to enlist the cooperation of your child and you to solve each problem. We are
dedicated to providing a fair and positive program.
Counselor to Camper Ratio: Camp Woodsy has 1 Counselor to every 8 campers
Bathroom Breaks: Counselors are never alone with your child for bathroom breaks. At least 2 campers go with
1 counselor
Potty Training: To attend Camp Woodsy your child must be out of diapers and fully potty trained.
Member Guest’s Participation: Member’s guest’s children may attend Camp Woodsy. The guest’s child or
children must attend the same sessions as the member’s child or children attend. The member guest rate applies
and a minimum of 3 three sessions must be attended.
Missed Days: Refunds and/or credits will not be given for missed days
Camp Woodsy Parent Agreement
_____I hereby give my consent and authorization for Hawthorn Woods Country Club, in the event of a medical
emergency, sudden illness, or accident, to take whatever emergency medical measure may be deemed necessary for the
care and protection of my child, whether it be to administer first aid or to call 911 if emergency room medical care is
necessary.
_____I give permission for any treatment, including first aid, x-rays, anesthetics, surgery, and/or hospitalization.
_____I agree to bear the cost of all emergency care in addition to the fees which I pay at Hawthorn Woods Country Club.
_____I hereby give my consent and authorization for Hawthorn Woods Country Club staff to take pictures, movies, and
videos of my child for use and reasonable advertising, promotion and educational activities without compensation.
_____I hereby give my consent and authorization for Hawthorn Woods Country Club to take my child on walks,
excursions, and field trips. I also give permission for my child to ride as a passenger in any vehicle owned, leased or
authorized by Hawthorn Woods Country Club.
_____I hereby give consent and authorization for Hawthorn Woods Country Club to apply lotion to my child during
camp.
_____I am aware that my child must follow the Behavior Expectations that are listed below:
Participants shall:
-Show respect to all campers and staff
-Avoid using obscene or offensive language
- Refrain from striking or causing bodily harm to others
-Show respect for equipment, supplies, facilities, and camp counselors
Breach of the behavior expectations will result in the following:
1.
The first incident, a warning will be given.
2.
The second incident, a time out will be given. This means that game time, swim time, or fun activities will be
taken away.
3.
The third incident, a conference will be held with the Director, the parents, and the camper.
4.
The fourth incident will result in removal from camp. NO REFUND WILL BE ISSUED.
__________________________________________________________________________________________________
Parent Signature
Date
Hawthorn Woods Country Club Camp Woodsy
Waiver of Liability, Release and hold harmless agreement for Hawthorn Woods Country Club
THIS WAIVER MUST BE READ CAREFULLY AND SIGNED.
Please read this form carefully and be aware that in signing up for, and participating in, Camp Woodsy, you release all
claims for injuries arising out of this program, which you or the other named participants might sustain. The terms “I,”
“me” and “my” also refer to parents or guardians, as well as participants in program. In registering for this program, you
are agreeing as follows:
As a participant in this program, I recognize and acknowledge that there are certain risks of physical injury, and I agree to
assume the full risk of any damages of loss which I may sustain as a result of participating, in any manner, in any and all
activities connected with or associated with such program.
I agree to waive and relinquish any and all claims I may have as a result of participating in this program against Hawthorn
Woods Country Club, any and all independent contractors, officers, agents, servants, partners, and employees, and any
and all other persons and entities of whatever nature, that might be directly or indirectly liable for any injuries that might
be sustained as a result of particpating in this program. (The parties described in the preceding sentence are referred to as
“release parties” in the remainder of the agreement.)
I do hereby fully release and discharge Hawthorn Woods Country Club and all release parties from any and all claims
from injuries, damage or loss which I may have or which may accrue to me on account of my particpation in this program.
I further agree to indemnify, hold harmless and defend Hawthorn Woods Country Club and any and all other related
parties, from any and all claims resulting from injuries, damanges and losses sustained by anyone, and arising out of,
connected with, or in any association with my conduct and the activites of this program.
I further understand and agree that the terms such as “participation,” “programs,” and “activities” referred to in this
agreement, include all exercises and physical movements of any nature while I am participating in these programs and
further include the provision of, or failure to, provide proper instructions or supervision, the use and adjustment of any
and all machinery, equipment, and apparatus, and anything related to the use of the services, facilities, or premises
involved in this program, and transportation to and from any events.
I understand the nature of this program for which I am registering, and have read and fully understand this waiver, release
and hold harmless agreement. I further understand that any advisements or warnings of the particular risks of this program
that I subsequently receive will be incorporated by reference into, and become a part of, this agreement.
__________________________________________________________________________________________________
Parent Signature
Date