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Prince of Peace Catholic Community
Summer Camp 2015
The summer program is open to all school aged children that are ages 5-12 years by the first
day of camp or entering kindergarten through sixth/seventh grade (or 12 years of age) for the
2015-2016 school year.
Prince of Peace Catholic Community Summer Program provides the children an enriching and
Christian environment through activities which will invoke imagination, creativity, and
excitement in your child.
Camp is in session for 8 weeks (Monday through Friday) from June 8th- July 31st. Camp is open
daily from 7:45am to 6:00pm.
The summer camp is located at 5100 Plano Parkway West, Plano 75093. Additionally, we will
venture on daily field trips every morning or afternoon in the Dallas area with the exception of
an occasional on campus “field trip”.
Camp Director, Kri McGinnis 972-380-2100 ext 172 [email protected]
www.popschool.net or www.popplano.org
Step 1. Print, read, sign, complete Admission
Forms and signature pages.
Step 2. Return signed admission forms and
signature pages to Director Kri McGinnis via
email, fax, snail mail, or deliver to POP
school/pastoral office.
Step 3. Pay Registration Fee online at
www.popplano.org click on WeShare. Campers
are not confirmed without payment of
Registration.
Step 4. Pay tuition for selected weeks/days
online (as indicated above). Campers are not
confirmed without payment of tuition. Pay in
full or weekly, if attending more than one week.
Monday
Tuesday
Wednesday
Thursday
Friday
8
9
10
11
12
THEME: Art
Makes You Smart
National
Scouting
Museum
pm
15
THEME: The
Blue Planet
North Texas
Municipal
Water plant
pm
22
THEME: Play
Ball!
Dallas Museum of
Arts
Kimbell Art
Museum
(picnic at Klyde
Warren Park)
Am/all day
Am/all day
16
17
Celebration
Park
Ft. Worth
Museum of
Science and
History
Am/all day
pm
23
24
Globe Life Park
(Ballpark in
Arlington)
Interskate
Roller Rink
American
Airlines Center
pm
Am/all day
29
See July
30
See July
9:00 am mass
Pm pool
Tom
Muhlenbeck
Center
18
9:00 am mass
Pm pool
Tom
Muhlenbeck
Center
25
9:00 am mass
Pm pool
Tom
Muhlenbeck
Center
African
American
Museum
pm
19
Texas
Discovery
Gardens
pm
26
Strikz Bowling
pm
*Field trips subject to change due to unforeseen circumstances
Monday
June
Tuesday
June
Wednesday
Thursday
Friday
29
30
1
2
Dallas
Children’s
Theater
“Flat Stanley”
pm
Bureau of
Engraving and
Printing
9:00 am mass
Pm pool
Tom Muhlenbeck
Center
3
POP Summer
Camp CLOSED
in observance of
Independence
Day
7
Fritz Park
Petting zoo
8
Log Cabin
Village
9
10
Dallas Zoo
pm
Am/all day
9:00 am mass
Pm pool
Tom Muhlenbeck
Center
14
15
16
17
Perot Museum
Klyde Warren
Park
9:00 am mass
Pm pool
Tom Muhlenbeck
Center
Sharkarosa
THEME: GOD
Bless America!
George Bush
Presidential
Library
pm
6
THEME: The
GREAT Outdoors
Dallas
Arboretum
pm
13
THEME:
Weird Science
Scit-Tech
Discovery
Center
pm
20
THEME: Just
For Fun!
pm
Am/all day
Am/all day
Am/all day
Picnic and FUN!
Am/all day
21
22
23
24
Interskate
9:00 am mass
Pm pool
Tom Muhlenbeck
Center
Home Depot
Workshop
Going Bonkers!
pm
Movie theather
(movie and
location TBD)
pm
27
28
29
30
Celebration
Park
Meadows
Museum
9:00 am mass
Pm pool
Tom Muhlenbeck
Center
pm
pm
THEME: Guess
What WE Did
today?
Dallas Star
Center
pm
pm
pm
31
The Canyons
Rock Climbing
Center
Ice cream party
End of summer
celebration!
pm
Location of movies TBA
*Field
trips subject to
change.
ADMISSION INFORMATION
Return this form!
Operation Name
Director’s Name
Prince of Peace Catholic Community Summer Camp
Kri McGinnis
Child’s Full Name
Child’s Date of Birth/age/grade
Child’s Home Telephone No.
Child’s Home Address
Date of Admission
Date of Withdrawal
Email address (es) **Required
Parent’s or Guardian’s Name
Address (if different from child’s address)
List telephone numbers below where parents/guardian may be reached while child will be in care:
Mother’s Telephone No.
Father’s Telephone No.
Guardian’s Telephone No.
Cell Phone No
Give the name, address and phone number of person to call in case of an emergency if parents / guardian cannot be reached:
Relationship
I hereby authorize the childcare operation to allow my child to leave the childcare operation ONLY with the following persons. Please list name &
telephone number for each. Children will only be released to a parent or a person designated by the parent/guardian after verification of ID.
 consent for my child to be transported and supervised by the
operation’s employees:
CHECK ALL THAT APPLY:
1.
TRANSPORTATION:
Walk home
I hereby
2.
FIELD TRIPS:
I hereby
give
do not give
 my consent for my child to participate in Field Trips:
3.
WATER ACTIVITIES:
I hereby
give
do not give
 my consent for my child to participate in Water Activities:
give
do not give
for emergency care
sprinkler play
on field trips
splashing/wading pools
swimming pools
4.
RECEIPT OF WRITTEN OPERATIONAL POLICIES:
I acknowledge receipt of the facility’s operational policies including those for discipline and guidance.
5. I UNDERSTAND THAT THE FOLLOWING MEALS WILL BE SERVED TO MY CHILD WHILE IN CARE:
Lunch
PM Snack
(lunch brought from home. Snacks may be brought from home or purchased at camp.)
AUTHORIZATION FOR EMERGENCY MEDICAL ATTENTION:
In the event I cannot be reached to make arrangements for emergency medical care, I authorize the person in charge to take my child to:
Name of Physician:
Address:
Ph.#:
Name of Emergency Medical Care Facility:
Address:
Ph.#:
I give consent for the facility to secure any and all
necessary emergency medical care for my child.
Signature - Parent or Legal Guardian
List any special problems that your child may have, such as allergies, existing illness, previous serious illness, injuries a nd hospitalizations during
the past 12 months, any medication prescribed for long -term continuous use, and any other information which caregiver’s should be aware of:
Child daycare operations are public accommodations under the Americans with Disabilities Act (ADA), Title III. If you believe that such an operation
may be practicing discrimination in violation of Title III, you may call the ADA Information Line at (800) 514-0301 (voice) or (800)-514-0383 (TTY).
Signature – Parent or Legal Guardian
Date
Return this form!
My child attends the following school:
Name of school and Address
School Ph #
CHECK ALL THAT APPLY:
His / her immunization record is on file at the school and all
required immunizations and/or tuberculosis test are current.
Vision and Hearing screening records are also on file.
My child has permission to:
be released to the care of his/her
sibling(s) under 18 years old.
Name of sibling(s):
IMMUNIZATION RECORD:
I have provided the childcare operation with a copy of my child’s most current immunization record.
ADMISSION REQUIREMENT: If your child does not attend pre-kindergarten or school away from the child-care operation, one of the
following must be presented when your child is admitted to the child -care operation or within one week of admission.
Please check only one option:
1.
HEALTH-CARE PROFESSIONAL’S STATEMENT: I have examined the above named child within the past year and find that he / she is
able to take part in the day care program.
2.
Health Care Professional's Signature
A signed and dated copy of a health care professional’s statement is attached.
Date
3.
Medical diagnosis and treatment conflict with the tenets and practices of a recognized religious organization, which I adhere to or am a
member of; I have attached a signed and dated affidavit stating this.
4.
My child has been examined within the past year by a health care professional and is able to participate in the day care prog ram.
Within 12 months of admission, I will obtain a health care professional’s signed statement and will submit it to the child -care operation.
Name and address of health care professional :
Signature - Parent or Legal Guardian
VISION
R 20/ ________
L 20/ ________
1000 Hz
PASS
FAIL
DATE _____________________________________
SIGNATURE ____________________________________________
HEARING
Date
2000 Hz
R
L
4000 Hz
PASS
SIGNATURE ___________________________________________
Signature – Parent or Legal Guardian
DATE ______________________________________
Date
FAIL
Summer Camp Enrollment Request
Return this page
Please indicate child's name, dates needed, and t-shirt size for each child you are enrolling and return this
request with registration forms. Check the appropriate weeks/days needed. One free t- shirt per child. If you
would like extra t-shirts, please indicate the number you would like to order and pay online at WeShare for the
additional shirts ($12 each). Use this worksheet to assist with online payment. Please note - NO CHANGES to
days selected for "By the Day" enrollment. No exceptions.
Sample
Date
Mon
Tues
Wed
Thur
Fri
June 8-12
x
x
x
x
x
Date
Mon
Tues
Wed
Thur
Fri
June 8-12
x
Child #1
Child #2
x
Date
Tues
Wed
Thur
Fri
Jun 15-19
Jun 22-26
July 6-10
Jul 13-17
Jul 20-24
Jul 27-31
Weekly
$235
each
No camp
Weekly
$235
each
# of
Days
$55 each
3
# of
Days
$55 each
Total Amt
Due for
Week
$235.00
# of Shirts:
Jun 8-12
Jun 29-Jul 3
1
Tee Shirt Size:
Grade
entering:
Mon
# of
Days
$55 each
x
Child #1 Name:
Age:
Weekly
$235
each
Total
Amt Due
for Week
Total Amt
Due for
Week
$165.00
Summer Camp Enrollment Request
Multiple Children
Return this page
Child #2 Name:
Grade
entering:
Age:
Date
Tee Shirt Size:
Mon
Tues
# of Shirts:
Wed
Thur
Fri
Weekly
$235
each
# of
Days
$55 each
Total
Amt Due
for Week
Jun 8-12
Jun 15-19
Jun 22-26
Jun 29-Jul 3
No camp
July 6-10
Jul 13-17
Jul 20-24
Jul 27-31
Child #3 Name:
Grade
entering:
Age:
Date
Tee Shirt Size:
Mon
Tues
# of Shirts:
Wed
Thur
Fri
Jun 8-12
Jun 15-19
Jun 22-26
Jun 29-Jul 3
July 6-10
Jul 13-17
Jul 20-24
Jul 27-31
No camp
Weekly
$235
each
# of
Days
$55 each
Total
Amt Due
for Week
HEALTH REQUIREMENTS
Name of Child:
Age ►
Vaccine ▼
Date of Birth:
Birth
1 mos
2 mos
4 mos
6 mos
12 mos
15 mos
18 mos
19-23
Mos
2-3 Yrs
4-6 Yrs
Hepatitis B
Rotavirus
Diphtheria, Tetanus,
Pertussis
Haemophilus
influenzae type b
Pneumococccal
Inactivated Poliovirus
Influenza
Measles, Mumps,
Rubella
Varicella
Hepatitis A
Meningococcal
TB TEST (if required)
Positive
Date:
Negative
Signature or stamp of a physician or public health
personnel verifying immunization information above.
Signature
Date
Varicella (chickenpox) vaccine is not required if your child has had chickenpox disease. If your child has had chickenpox, please complete the
statement: My child had varicella disease (chickenpox) on or about (date)
and does not need varicella vaccine.
Parent’s signature
Date
I am excluding my child from the immunization requirements for reasons of conscience, including a religious belief. I have attached an official
notarized affidavit form developed and issued by the Department of State Health Services. I understand this affidavit is valid for 2 years.
For additional information regarding immunizations contact the Department of State Health Services at
www.dshs.state.tx.us/immunize/public.shtm
Signature – Parent or Legal Guardian
Return this form!
Date
Illness and Exclusion from Summer Camp please refer to the following guidelines listed below:
Guides for Excluding Students from
Return to Summer Camp Guidelines
Summer Camp
Exclusion Guidelines
Oral Temperature of 100 degrees or
Fever free for 24 hours
above
Vomiting
Symptom free for 24 hours
Nausea, or severe abdominal pain
Symptom free
Marked drowsiness or malaise
Symptom free
Sore throat, acute cold, or persistent
Symptom free
cough
Red, inflamed, or discharging eyes
Written physician release
Exclusion Guidelines
Return to School Guidelines
Acute skin rashes or eruptions
Written physician release
Swollen glands around jaws, ears, and Written physician release
neck
Suspected scabies or impetigo
Written physician release
Earache
Symptom free
Pediculosis (head lice)
Nit free
Other symptoms suggestive of acute
Written physician release
illness
A student must be free of symptoms or illnesses for 24 hours prior to returning to camp. Any student
exhibiting such symptoms will be sent home.
Prince of Peace Summer Camp General Information
SAMPLE DAILY SCHEDULE
Monday-Fridays: Field trips will vary between morning and afternoon departure times.
7:45-9:00
Free play
9:00-10:00
Clean up, morning prayer (Thursday mass), attendance, etc
10:00-12:00
Small group activities, such as gym games, crafts, or computer time/Field trip
12:00-12:30
Lunch
12:30-3:00
Field Trip/small group activities
3:15-3:45
Quiet time
3:45-4:15
Snack time
4:15-6:00
Free time to play in St. James Hall or Gym
Absences
If your child is going to be absent, please let us know before 8:30 am by leaving camp director a voice mail or
email. Camp director is Kri McGinnis and may be reached at 972-380-2100 ext 172 or
[email protected]
Camp T-shirts/Attire
Camp tee shirts will be available to pick up the first week of camp, are to be worn on all field trips except pool
days.
Campers must wear tennis shoes each day (flip flops/swim shoes for pool days) and comfortable play clothes.
A change of clothes is recommended for all campers. Please send a complete change of clothes including
socks, underwear, top, shorts, and shoes (flip flops) in a clear Ziploc bag labeled with your child’s name. We
will return it on last day child attends camp.
Contact information
Parents may review and discuss questions or concerns regarding the camp policies and operational procedures
with the camp director by contacting Kri McGinnis, Summer Camp director at 972-380-2100 ext 172 or
[email protected].
Discipline and Rules for Summer camp
POP Summer Camp follows the same rules that apply to Prince of Peace Catholic School regarding discipline
and policies pertaining to Off-Campus Conduct, Behavior at School Functions Outside the School Day(Summer
camp hours), School Property, Alcohol, Tobacco, and Illegal Drugs, Blogs, Bullying and Cyber bullying,
Harassment, Weapons and Firearms .
This information can be found at www.popschool.net under “About Us” and “Handbook” pp21-23.
Drop Off and Pick up of campers
Parents may drop off and pick up campers at St. James Hall entrance only (near Bell Tower). Parents or
authorized persons to pick up must come inside to sign in/out the child. Authorized persons to pick up
child(ren) must be prepared to present a photo ID such as driver’s license or State issued ID card. No other
persons will be allowed to pick up a child without written notification from parent(s).
Electronics/Toys
Campers are not to bring any toys from home unless they are told to bring in an item for a specific activity.
This includes all electronic devices, trading cards (Pokemon, baseball cards, kooky pens, etc). Camp staff is not
responsible for campers’ personal belongings.
Emergency Preparedness Plan
POP Summer camp practices emergency procedures for inclement or dangerous weather, fire drill, and lock
down drill.
In the event of an emergency where the children must be removed from campus to a separate location, all
campers will be relocated to the Primacare Medical Center located just across the street from Prince of Peace.
The address is 5076 W. Plano Pkwy, Plano TX 75093. A member of our staff will call all parents to retrieve
campers from this location. A copy of POP Summer Camp Emergency Preparedness Plan is available on
request.
Field Trips
A signed permission slip must be on file for all field trips in order for campers to participate. A permission slip
will emailed weekly as well as a hard copy available at the sign in desk at drop off.
Campers must remain with group at all times except when given permission from their counselor.
Campers must respect one another and the counselors.
Continued misbehavior on field trips may result in disciplinary action and possible dismissal from camp. More
information regarding behavior expectations and discipline policy may be found at www.popschool.net under
“About Us” and “Handbook” pp21-23.
Hours of Operation
Summer Camp is open from 7:45-6:00. Children must be picked up by 6:00pm. A charge of $1.00 per minute
per child will be assessed and is payable to the counselor waiting with your child.
Illness and Exclusion from Summer Camp please refer to the guidelines listed in the admissions packet.
Important Information and Phone numbers
Local Licensing office phone/address 550 E. 15th Street Ste 120, Plano, TX 76209 469-229-6900. DFPS Child
Abuse Hotline 1-800-252-5400 or secure website https://www.txabusehotline.org
www.dfps.tx.state.us
Parents may also find this information posted on the Summer Camp information board.
Lunch and Snack
Please send a lunch and beverage each day with your camper. It is also encouraged to bring an additional water
bottle (labeled).
If your child is without a lunch and the POP staff has to provide one, a fee of $5.00 PLUS the cost of the lunch
will be charged to you. This is payable in cash at pickup on the same day. This is for emergencies only (i.e.
forgotten lunch).
One day per week a pizza lunch will be offered as an option. $3.00 includes one slice of pizza, drink and fruit
cup/fruit. Additional slices of pizza are $2.00 each. Cash only please paid when you order at drop off in the
morning.
One day per week a Chick Fila lunch will be offered (provided we are not on an all-day field trip). The charge
is $5.00 for a choice of chick fila sandwich or 8 nuggets, chips, and a drink. Cash only please paid when you
order at drop off in the morning.
Snack time is daily at approximately 4:00 pm. Your child may either bring a snack from home or we will have
a concession area with snacks that range in price from $.50-$1.00. A drink will be provided free of charge to
each camper.
Medical Emergencies
In the event of illness or injury to a child during while at Summer Camp, the parent of the injured child will be
notified by phone. If parents are unable to be reached, the emergency contact will be notified by phone. In the
event of extreme illness or injury, 911 will be called and then a phone call will go to the parents. An
accident/illness report will be completed and signed by appropriate summer camp staff and parents.
Medication
If your child needs to take any medication, it must be in original container with a note from the doctor given to
the camp director. A medication form MUST be submitted with all medication.
Minimum Standards for School Age Programs
Parents may review a copy of the minimum standards for school age programs online at www.dfps.tx.state.us or
a hard copy is located at the camp at the sign in desk for your convenience.
Parent visitation/participation
Parents are welcome to visit and participate in activities at any time while camp is in session and we are on site.
Parental Notifications
Parents will be notified of any changes to planned activities or field trips, change in policies, or any other
pertinent information by email, posted in St. James Hall, and hardcopy of notification at the sign in /out desk.
Please keep a current email address and phone number on file with camp director at all times.
Pool Days
Each Thursday we will be going to the Tom Muhlenbeck Center to swim. On these days the campers may wear
a bathing suit under their clothes and bring sandals or water shoes. **Please note that all campers age 7 and
under are required to wear a life jacket. Life jackets are available at the Muhlenbeck Center.
Be sure to apply sunscreen on your child in the morning before camp. Counselors are not allowed to apply
sunscreen. You may send extra sunscreen for your child to reapply.
Please be sure your child has a labeled towel, labeled dry clothing (including underwear) and labeled water
bottle.
REGISTRATION and TUITION/FEE INFORMATION
Return this form!
Registration:
The attached enrollment/admissions forms and non-refundable registration fee of $ must be submitted to
the camp director, Kri McGinnis by May 22, 2015, as well as, on line payment of first week’s tuition. There are
three options for submitting registration forms/signature pages.
1. You may submit forms via email to [email protected] and pay online for weekly tuition.
2. Return all admission forms and signature pages directly to the school or pastoral office at Prince of
Peace Catholic Community.
3. Mail all forms to the school office ATTN Kri McGinnis: 5100 Plano Parkway West, Plano, TX 75093.
Tuition:
$235 per week (except the week of June 29-July 3-$205) or $55 per day.
Tuition is due at the time of registration/two weeks prior to the first day of the week for each week
registered. You may register one week at a time and pay as you go. Registrations and payments will not be
accepted within 14 days of the week needed. Please note, in the event that your child becomes ill or absent due
to vacation, you will not be reimbursed for tuition. No changes allowed for days selected on “By the day”
registrations. Absolutely no exceptions!
Withdrawal from/Cancelation of enrolled dates:
We must have at least two weeks advance notice of cancelation of a scheduled enrollment date to avoid
penalty. You are responsible for tuition if cancelation is not received in writing at least two weeks in advance.
For example, if your child is enrolled for an entire week but only attends 3 days you are still responsible for the
entire week’s tuition.
“By the Day” enrollment selected days are final. No changes will be honored.
Please understand there are many factors that are considered when planning summer camp that includes but it
not limited to pre-paid field trips, scheduled buses, scheduled staff, supplies, etc. TWO WEEKS ADVANCE
NOTICE including payment is required for attendance at camp. Drop-ins are not allowed according to the state
licensing regulations.
PLEASE PRINT AND RETURN THIS SIGNATURE PAGE WITH REGISTRATION/ADMISSION FORMS.
I have read the General Information and Tuition/Fee information for Prince of Peace Catholic Community
Summer Camp and agree to abide by the rules, regulation, and guidelines set forth within the General
Information and Tuition/Fee Information.
Signature – Parent or Legal Guardian
Date
RELEASE AGREEMENT
Return this form!
The UNDERSIGNED gives to Prince of Peace Catholic Community (the Parish)
and The Catholic Diocese of Dallas, its legal representatives, successors, and all persons
or corporations acting with their permission, unrestricted permission to videotape,
copyright and/or use, and/or publish photographic portraits or pictures of me, and the
negatives, transparencies, prints, or digital information pertaining to them, in still, single,
multiple, moving or video format, or in which I may be included in whole or in part, or
composite, or distorted in form, or reproductions thereof, in color or otherwise, made
through any or otherwise make reproductions of images of the UNDERSIGNED, to use
my name and make recordings of my voice for the purposes of creating videos and other
media used in the development of newsletters, bulletins or publicity materials for Prince
of Peace Catholic Community.
I hereby waive any right that I may have to inspect and approve the finished
product or copy that may be used in connection with an image that the Parish or Diocese
has taken of me, or the use to which it may be applied. I further acknowledge that I will
not be compensated for these uses, and that the Parish exclusively owns all rights to the
images.
The UNDERSIGNED releases Prince of Peace Catholic Community and The
Catholic Diocese of Dallas, its successors, assigns, employees, and agents from any and
all claims for compensation, damages or rights to monies arising out of the use by the
Parish or third parties.
Date this ________Day of _______________________
Print Name______________________________________
_______________________________________________
Parent or Guardian on behalf of minor