“I Survived...Day Camp” Osceola Day Camp Girls will get a chance to hike,do crafts, learn history, leather working, songs, flag etiquette, team-building, low-ropes*, archery*,and just have a LOT of fun! *age and training restrictions apply. When: Monday, July 27, – Friday, July 31, 2015 Where: Mon., Tues., Thurs., Fri. - Mary Ann Beebe Center, Harvard Illinois Wednesday – St. John's Lutheran Church for a fun Service Project Time: 8:00 A.M. – 5:15 P.M. All Week Cost: $125.00 registered Girl Scouts BEFORE JUNE 1. “Cookie Dough”/“S’More Dough” may be used. $140.00 new Girl Scouts (includes $15 Girl Scouts of the USA registration fee, valid through September 2015) $100.00 Cadette/Senior/Ambassador Girl Scout Volunteers Cost includes patch, T-shirt, crafts, snacks, and four lunches. BRING LUNCH ON WEDNESDAY. Make check payable to GSNI Osceola Service Unit Day Camp – NO REFUNDS ***Late Registration accepted until June 15. (Please add $25 Late Fee)*** Overnight: Open to all girls entering grade 4 and up on a first come basis – limited space. Date: Thursday, July 30, 2015 – Bring overnight gear Thurs. Morning Location: Mary Ann Beebe Center, Harvard, IL $10.00 additional fee for overnight - includes two meals and snacks. Transportation: Bus will be provided. Pick up & Drop off Location St. John's Lutheran Church 300 Jefferson St., Algonquin Pick up 8:00 A.M, SHARP Return 5:15 P.M. PLEASE ARRIVE 15 MINUTES EARLY TO BOARD BUS! The busses leave promptly at 8:00 A.M. every day except Wednesday, TBA Please be advised, in fairness to all campers, the busses will not wait for late arrivals. About Insurance at Day Camp…All Registered Girl Scouts (both girls and adults) attending day camp are covered by the limited accident insurance provided by their Girl Scouts of the USA membership dues. Non-member adults wishing to be covered by this insurance may register. Girl Scouts of Northern Illinois Registration Closes: June 1, 2015 Registration Information: Enrollment is limited and will be on a first-come, first-served basis. Registration begins March 11, 2015 and closes June 1, 2015 All registrations must be postmarked on or before the closing date. 1. Complete both sides of the registration form, filling in ALL of the blanks. 2. Mail form and payment to: Jenny Tackett-Irwin, 6 Kelsey Ct., Algonquin, IL 60102 (Bin also available on front porch for drop off) 3. Payment in full is due at the time of registration, unless applying for financial assistance. “Cookie Dough” or “S’More Dough” may be used for girl registrations. Financial Assistance: Financial assistance is available for a portion of the girls’ fees. 1. To apply for financial assistance call 847-741-5521 as soon as possible. A simple form will be mailed to you and must be completed and returned to the Girl Scout Center no later than June 1st. 2. Anyone applying for financial assistance must still fill out and return the registration form, along with “Cookie Dough” or “S’More Dough” and the amount you will be able to pay, to the name above by the close of registration. 3. Financial assistance will be forwarded to the day camp directly. Parents will receive a letter indicating the amount of assistance awarded. Any balance not covered by financial assistance must be paid in full before the start of camp. If further financial assistance is needed, it is the parent’s responsibility to call 847-741-5521 to request additional assistance. Refund Procedure: NO REFUNDS —NO confirmation of registration will be sent. Required C/S/A Volunteer Training: Sunday, July 12, 1-3 p.m., Lynn Konzen’s Home, 750 Pickwick Ct, Algonquin Required Parent Volunteer Training: Sunday, July 19, 1-3 p.m., Megan Petronella’s Home, 1235 Greenridge, Algonquin Parents/Guardians: Day camp is a volunteer-based program—there is no paid staff at camp. Safety guidelines require a 1:6 ratio of adults to children for the safe operation of our day camp. Adults are encouraged to volunteer in order for their camper to attend. If you cannot commit to volunteering at camp, we will also need volunteers for camp setup on Sunday, 7/26 and take down on Friday, 7/31. Please complete the attached application with your preferences. Volunteer services include both a toddlers’ unit and a boys’ unit. Drinks, snacks, lunch and crafts will be provided at the cost of $10 Tots and $15 Boys per day. We are not a peanut-free or any other allergen-free camp! Questions? Name: Megan Petronella Phone: 630.667.8875 Email: [email protected] OR Name: Gina Wynn Phone: 847.687.3988 Email: [email protected] Day camp offers girls of all ages the opportunity to discover the fun, friendship and power of girls together. Girls will be able to enjoy the outof-doors, while learning basic camping and outdoor skills. Would you like to make a difference in a young girl’s life? Day camp offers you that opportunity. Service unit day camp is powered by volunteers—some are Girl Scout leaders who have been serving troops throughout the year, while others are involved in Girl Scouting in other ways. Parents’ help is needed to ensure success of the camp. Come and share your knowledge and skills . . . try new things . . . spend time with your daughter. The Osceola Day Camp Committee has already done the planning for you—you can come and HAVE FUN. Training will be provided for you, and your younger children and boys are invited to join in the activities in their own special units. Please indicate your desire to join us on the back of the registration form. Day camp planning starts in September! You are not required to be a troop leader to be on the committee! Are you interested in being a part of the planning committee for next year? YES ___ NO ___ MAYBE ___ Please include e-mail address: _________________________________________________ Registration Closes: June 1, 2015 REGISTRATION FORM Please complete both sides and mail to: Jenny Tackett-Irwin 6 Kelsey Ct., Algonquin, IL 60102 Please Print Girl Scouts of Northern Illinois Office Use – Fees Cash ______________________________________ Check ______________________________________ “Cookie Dough”/“S’More Dough” _________________ GSUSA Reg. ________________________________ FA _________________________________________ Overnight ___________________________________ Total Camper’s Full Name Age ________ Address Home Phone ( ) Daytime Phone ( ) City and Zip Code Parent’s/Guardian’s Name Parent/Guardian E-Mail Grade entering in fall New Girl Scout? [ ] check if yes She is (Check all that apply): She is Hispanic or Latina: ___American Indian or Alaskan Native ___Asian ___Black or African American ___Other ___Hawaiian or Pacific Islander ___Yes ___No __White ___I choose not to share ___I choose not to share Media Permission: When participating in Girl Scout activities I (or the person that I am registering) give consent to be interviewed, photographed, videotaped, or electronically imaged for the purposes of promotional materials, news releases, or other published formats for either the local Girl Scout Councils or Girl Scouts of the USA. The images will be the sole property of the local Girl Scout Council or Girl Scouts of the USA,. I hereby release and hold harmless the local Girl Scout Council and Girl Scouts of the USA from any claim arising from the use of these images. _____ I wish to opt out of the media permission at this time. [ ] My daughter will be riding the bus [ ] My daughter will NOT be riding the bus Comments: Camper Fees Camp Fee $125 Camper’s Name Camper’s T-Shirt size: Youth: [ ] M [ ] L Volunteer Fees Name New Scout GSUSA Fee $15 Overnight Fee $10 Total A T-Shirt Cost $10 Subtotal Adult: [ ] S [ ] M [ ] L [ ] XL Day Camp Patch $2 Number of Days Attending (1 – 5) Fees Boy: $15/Day Toddler: $10/Day Adult: Adult’s T-Shirt size: Adult: [ ] S [ ] M [ ] L [ ] XL [ ] XXL [ ] XXXL Boy: Boy’s T-Shirt size: Youth: [ ] M [ ] L Adult: [ ] S [ ] M [ ] L [ ] XL Toddler: Toddler’s T-Shirt size: Youth: [ ] S [ ] M [ ] L Please complete the other Total B side of this registration form. Total Fees Enclosed (Total A + Total B) Camper’s Medical Information: This camper,______________________________________________________ is in good physical condition and can take part in usual outdoor activities. Special health considerations (allergies, diabetes, dietary restrictions, etc.), include instructions for medication sent to camp with camper: ______________________________________ _______________________________________________________________________________________ Print name of parent/guardian _______________________________________________________________ I can be reached during camp at (_____) _____________________cell or pager ( ____ ) _______________ Date of last tetanus shot ___________________________________________________________________ Please list two (2) emergency contacts in case you cannot be reached. Emergency contact #1 name ______________________ relationship _________ Emergency contact #2 name ______________________ relationship _________ Child’s physician __________________________________________________ Name of family insurance carrier _____________________________________ phone ( _____ ) __________ phone ( _____ ) __________ phone ( _____ ) __________ phone ( _____ ) __________ The bearer of this letter has my permission as a parent or legal guardian to act on my behalf in any emergency dealing with the health and welfare of my daughter and to obtain emergency treatment for her by a licensed physician. [ ]This girl is not currently registered with Girl Scouts of the USA, and I am willing to have her become a Girl Scout. _____________________________________________ (signature of parent/guardian) _______________________________ (date) Day Camp Volunteer Help Information: I would love to help! Dads, grandparents, aunts and uncles at least age 18 are welcome. An Application for Volunteer Position and CBC Authorization Form (Criminal Background Check) must be completed by all volunteers. Forms can be found at www.girlscoutsni.org. Name address phone ( )________________ I prefer to work with (check all that apply): [ ] GS Daisy [ ] GS Brownie [ ] GS Junior [ ] GS Cadette [ ] overnight [ ] first aid/CPR* [ ] with my camper [ ] not with my camper [ ] crafts [ ] archery* [ ] toddlers [ ] boys [ ] not in a unit *requires specialized training I can volunteer: [ ] for all five days [ ] for only the following days. Circle all that apply: Monday Tuesday Wednesday Thursday Friday [ ] for Camp Set-Up on Sunday, July 26 [ ] for Camp Take-Down on Friday, July 31 [ ] I (and my boys/toddlers) will NOT be riding the bus [ ] I (and my boys/toddlers) will be riding the bus Comments: _____________________________________________________________________________ Volunteer and Sibling Medical Information: Name Age as of 6/1 Doctor’s Name and Phone # Special Health Considerations Adult Sibling Sibling Sibling Please complete the other side of this registration form.
© Copyright 2024