C h i l d r e n ’ s D i s c ov e ry M u s e u m o f t h e D e s e rt
Experience serious fun through art, science, stories, investigations and projects.
• Camp hours are 8:30 AM — 5:30 PM and camp is designed for children ages 5-9 only
• Morning sign-in is between 8:30-9:30 AM. Afternoon sign-out is between 4:30-5:30 PM
(Parents, because of camp days being a very busy 9 hours, please consider an early pick up for younger kids)
• Cost is $170 per week per child for CDMOD Members/$195 per week per child for Non-CDMOD Members
• Membership is $25.00 per individual per year—become a member today—applications available at the front desk!
• Full payment or $25.00 non-refundable deposit per week/per child and these completed forms are required for Registration.
lf you are using our deposit program, Camp Registration Balances are due two weeks prior to the registered camp week.
• Camp sessions fill up quickly — register early
• One Discovery Camp T-shirt per camper. Additional shirts may be purchased for $10.00
Registration Information: (One form per child is required)
Child’s Name ______________________________________________________________________________ Age________________________
DOB __________________________ Home Phone ___________________________ Parent Work/Cell _______________________________
Address___________________________________________________________________City_________________________________________
State___________ Zip Code________________ School to Attend in the Fall___________________________________________________
E-mail Address __________________________________________________________
Payment Information:
 Mastercard  Visa  Check  Cash
Member # _______________________ Non-Member______________________
Total Number of Camp Sessions________________________________ Paid in Full = $________________________________________
Card # _________________________________________________________ Expiration Date ________________________________________
Name on Card ___________________________________________ Signature____________________________________________________
Check Weekly Sessions your child wishes to attend camp:
Switching of Camp Sessions is not permitted
 Session 1: June 16-20 “Maker Lab”: Gadgets, gizmos and scribble machines for the inventor inside.
 Session 2: June 23-27 “Bon Appétit”: What’s on the menu? Pizza, Cakes and Gummy Bears to name a few!
 Session 3: June 30-July 3* “Moving and Grooving”: Make musical instruments, dance and explore sound waves.
 Session 4: July 7-11 “Ready, Set, GO!”: Cars, planes, boats and many more things that go, go, go!
 Session 5: July 14-18 “Bright Lights”: Bend light, make sun prints and create a kaleidoscope of colors.
 Session 6: July 21-25 “Design It, Create It”: Tall towers, strong bridges and egg drops.
 Session 7: July 28-August 1 “The Magic of Science”: Use science to make potions and wands.
 Session 8: August 4-8 “Movie Effects”: Let’s put on a show! Use costumes, special effects and zombie make-up.
 Session 9: August 11-15 “Creative Studio”: Create a mobile and make your own paints and puzzles.
*No camp on Friday, July 4th; weekly fee will be prorated.
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Please mail or fax:
Fax: 760.321.1605 or mail to Children’s Discovery Museum of the Desert, Attn: Elaine Behan
71701 Gerald Ford Drive, Rancho Mirage, CA 92270
C h i l d r e n ’ s D i s c ov e ry M u s e u m o f t h e D e s e rt
EMERGENCY AUTHORIZATION FORM
Please fill out, read and sign the next two pages
Mother’s Last Name_____________________________________ Mother’s First Name__________________________________________
Mother’s Address___________________________________________ City______________________ State_________ Zip________________
Mother’s Work Phone________________________________________________Alternative Phone__________________________________
Father’s Last Name______________________________________ Father’s First Name__________________________________________
Father’s Address___________________________________________ City______________________ State_________ Zip________________
Father’s Work Phone________________________________________________Alternative Phone__________________________________
Person Responsible for Child (Custodial Parent or Guardian):
Last Name_________________________________________________________First Name__________________________________________
Address____________________________________________________ City______________________ State_________ Zip________________
Daytime Phone_____________________________________________________________ Cell Phone__________________________________
Persons Authorized to Pick-Up Child from Facility:
Name / Address / Relationship / Home Phone / Alternate Phone
1. ______________________________________________________________________________________________________________________
2. ______________________________________________________________________________________________________________________
3. ______________________________________________________________________________________________________________________
4. ______________________________________________________________________________________________________________________
Any Special Medications / Allergies / Considerations ____________________________________________________________________
_____________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________
All medications must be prescribed and medically necessary. No over-the-counter remedies will be given. If your child has
symptoms of illness e.g. fever, runny nose, cough, or contagious/undefined rashes, please do not bring your child to the
program until the illness has passed. Children with these symptoms will be sent home.
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Please mail or fax:
Fax: 760.321.1605 or mail to Children’s Discovery Museum of the Desert, Attn: Elaine Behan
71701 Gerald Ford Drive, Rancho Mirage, CA 92270
C h i l d r e n ’ s D i s c ov e ry M u s e u m o f t h e D e s e rt
Parent Authorization / Agreement
As the parent, agency representative or legal guardian, I hereby give consent to the Children’s Discovery Museum to
provide all emergency medical and/or dental care prescribed by a duly licensed Physician (MD), or Dentist (DDS), for the
named child on reverse page. CDMOD will do its best to ensure a safe experience; however, I understand that certain
danger or accidents may occur. I hereby release CDMOD from any and all responsibility and liability of any nature,
including claims of injury, illness, death, loss or damage, resulting from my child’s participation in any program activities.
All photos that are taken of my child may be used for promotional purposes. This form may be copied for use away
from the main program site. I further authorize the CDMOD staff to apply sunscreen to exposed areas on my child as
needed. We recognize that our child must follow safety instructions, remain in areas designated by staff and refrain from
behavior that is harmful to oneself or others. Failure to adhere to program policies will cause dismissal without refund of
program fees. I understand that my child will not be released from the program site unless the signature below matches
written permission from parents/guardian or the person picking up my child is named above.
Credit Statement
A refund is only given when the Children’s Discovery Museum of the Desert cancels the activity or program.
The museum reserves the right to cancel / reschedule programs. Credits are not given for absences.
There are NO REFUNDS for switching camp sessions.
Other Camp Policies
In the event that my child is not picked up by 5:30pm, I will be charged a late fee of $10 per child, per occurrence.
Authorized persons must show I.D. daily at time of pick-up.
Limited Financial Assistance is available to those who qualify, ask a staff person for assistance.
If my child/children are showing any signs of illness e.g. fever, runny nose, cough, or contagious/undefined rashes,
I will not bring my child to camp.
y child’s age is within the Museum camp registration policy of a minimum of 5 years of age up to a maximum of 9
M
years of age at the time of registration - children who do not meet or exceed the age registration policy are not eligible
for the camp program.
Your signature permits CDMOD to use photographs and / or video of all programs for promotional purposes. Denial of
this agreement must be submitted in writing, prior to the first class / workshop / day attended.
I have read the entire Summer Discovery Camp Registration Packet and understand it completely, including the above
Parental Authorization / Agreement & Letter to the Parents. I have informed the Camp Director of my child’s special
needs and considerations. All of the information given is true to the best of my knowledge.
SIGNATURE OF PARENT_____________________________________________________________________ DATE ______/______/______
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Please mail or fax:
Fax: 760.321.1605 or mail to Children’s Discovery Museum of the Desert, Attn: Elaine Behan
71701 Gerald Ford Drive, Rancho Mirage, CA 92270
C h i l d r e n ’ s D i s c ov e ry M u s e u m o f t h e D e s e rt
Letter to Parents / Guardians - Children’s Discovery Museum of the Desert Camp information Sheet
Each week at camp is an imaginative and fun experience filled with art and science activities, group games, explorations
and a unique educational theme! This camp experience brings kids together through discovery of the world we share.
Summer Discovery Camp at the Children’s Discovery Museum of the Desert is serious fun! Space is limited.
Pre-registration advised.
Registration:
Full payment or $25.00 non—refundable deposit per week/per child and these completed forms are required for Registration.
If you are using our deposit program, Camp Registration Balances are due two weeks prior to the registered camp week.
Parents, keep this form for your own records.
 1: June 16-20
“Maker Lab”
 2: June 23-27
“Bon Appétit”
 3: June 30-July 3* “Moving and Grooving”
 4: July 7-11
“Ready, Set, GO!”
 5: July 14-18
“Bright Lights”
 6: July 21-25
“Design It, Create It”
 7: July 28-August 1 “The Magic of Science”
 8: August 4-8
“Movie Effects”
 9: August 11-15
“Creative Studio”
* No camp on Friday, July 4th; weekly fee will be prorated.
For assistance or questions please call:
Phone: (760) 321-0602
Fax: (760) 321-1605
www.cdmod.org
(This form is downloadable on our website.)
Elaine Behan, Camp Enrollment ext.117
[email protected]
Drop-off, Pick-Up and Late Fees: (the camp day is 8:30am — 5:30pm)
• Pre-Registered Discovery Camp drop off/sign-in is between 8:30- 9:30am in the Main Lobby. If you arrive after 9:30am
you will need to bring your child directly to the Multipurpose Building (camp facility). Children must be picked up prior to 5:30pm.
• Children remaining in our care after 5:30pm will be charged the late fee of $ 10.00 per child, per occurrence.
• No child should be instructed to “wait” at the entrance of the building or parking lot. We believe in safety first!
Sign-in/Sign-out: All campers must be signed in and out of camp each day by a parent or guardian who is listed on the
Emergency Authorization Form. Any person NOT on this form is NOT authorized to pick-up your child from CDMOD Camp.
The Camp Director/Assistants will ask for picture ID [driver’s license] to ensure safety.
To make changes to this form, contact the Camp Director as soon as possible.
A Discovery Camp T-shirt: The T-shirt your child receives is necessary as it provides immediate visual recognition of your child
among our other museum patrons. We encourage all children to wear their camp shirt and tennis or other comfortable shoes each
day — no open-toed sandals.
Each day camp begins with special, campers-only time to explore the museum before it opens to the general public. From there,
we move on to a varied schedule of crafts, songs, games, stories, enrichment lessons, snacks, and time to play (both inside and outside). Ask your child to show you their crafts, tell you about the games, stories, guests and lessons they experienced each day.
All children must be signed in and out of the camp program each day. Please be prepared to show your identification daily.
Personal Items: All campers’ personal items must be labeled with first and last name. CDMOD will keep a lost and found for your access,
and at the last day of camp all leftover things will go to charity. CDMOD is not responsible for any lost/stolen/left—behind property.
We’II see you at Discovery Camp!
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Please mail or fax:
Fax: 760.321.1605 or mail to Children’s Discovery Museum of the Desert, Attn: Elaine Behan
71701 Gerald Ford Drive, Rancho Mirage, CA 92270