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Kids Rock Summer Camp
Information Packet
1. Welcome Letter
2. General Camp Overview
3. Weekly Themes and Elective Class Schedule
4. Daily Schedule
5. Behavior Plan
6. Meet The Staff
7. Emergency Information
8. Waivers and Permission Forms
9. Kids Rock Referral Program
10. Kids Rock Sponsors
Website: www.KidsRockSummerCamp.com
Email: [email protected]
Kids Rock Zeeland: 616-644-4109
Kids Rock Grand Rapids: 616-666-1231
Camp Director (Ben Ashby) Direct Phone Number: 616-928-8320
Dear Kids Rock Parents,
Thank you for signing up your child for Kids Rock Summer Camp. The
camp staff and I are very excited about all of the fun activities that we have
planned for the summer. Our motto at Kids Rock is “committed to giving
campers the best summer of their lives.” We genuinely hope that your child’s
week at camp is one that will create a lifetime of memories.
The vision at Kids Rock is to provide a summer camp where all kids can
find activities that they love. We want to have an environment where campers
can learn new things, while feeling safe and successful. We have a wide variety
of programming happening this summer at Kids Rock ranging from: theme
activities, sports, elective classes, drama, singing, devotions, and arts and crafts.
As they run, laugh, smile, and play, it is our hope that campers will learn that
each moment in life is truly a gift from God.
Enclosed in this information packet you will find all of the necessary
information to ensure your child’s enjoyment and safety at camp. All permission
forms and waivers need to be filled out and either mailed or dropped off on the
first day of camp. If you have any questions about any of the contents of this
packet, do not hesitate to contact me.
The Kids Rock staff has a heart for God and a heart for kids. It is our
mission to serve you as best as we can. Please let us know if your family has
any special needs, or if there is anything that we can do to make this camp
experience the best that it can be for your kids. If you would like to sign up for
any extra weeks, we will be taking sign-ups all summer long if spots are
available. Thanks again for choosing Kids Rock to deliver an awesome camp
experience for you and your kids!
In Christ,
Ben Ashby
General Camp Overview
DROP OFF AND PICK UP TIMES: For a full day of camp, the recommended
drop off time is between 7:45-8:45 am and the recommended pick up time is
between 5:00-5:30pm. If you would like to drop your child off earlier than
7:45am, or pick them up later than 5:30pm, you will need to fill out an early drop
off/late pick up scheduling sheet. Otherwise, if you are late more than 5 minutes
in picking up your camper, you will be charged a $5 late fee. If you would like to
pick your child up early or drop them off late, we can be flexible with those
arrangements. Pick up and drop off this year will be at the back of the building at
Zeeland Christian and in the front parking lot of Legacy Christian Middle School.
EARLY DROP/LATE PICK UP SCHEDULING SHEET: If you need to drop your
camper off early, or pick them up late, you need to fill out and return the attached
Early Drop/Late Pick Up Scheduling Sheet. The cost is $5 per family for each
half hour. We need to have the sheets filled out and returned to us by the Friday
before each week so that we can schedule before and after camp supervision.
DROP OFF/PICK UP POLICY: We ask that you walk your camper inside each
morning to drop them off, and come inside to pick them up each afternoon.
Anyone picking up a camper other than a parent/guardian needs to be authorized
in writing ahead of time by the parent/guardian. Campers walking or biking to
and from camp need to have a signed permission slip from the parent or
guardian.
PAYMENT: Payment for each week is due before the first day of each camp
week. Failure to pay may result in the removal of the camper from camp.
EMERGENCY CARD/WAIVERS: Campers cannot attend camp until the
parent/guardians has filled out the attached emergency information, permission
slips, and liability waivers. These forms are included in the packet beginning on
page 12, and will also be available the first time you drop your camper off. You
may bring the forms to camp the first day, or mail them in ahead of time
AUTHORIZATION TO ADMINISTER PRESCRIPTION MEDICATION:
Medication can be administered only with written permission. All medical forms
must be filled out, before any medication can be administered. Contact Kids
Rock if you need a medication form.
WHAT TO BRING TO CAMP: Campers should bring sunscreen with their name
on it, clothes that may get wet/dirty, and athletic shoes. If the camper does not
have athletic shoes to wear they may not be able to enter the gymnasium area.
It is also recommended that campers bring with them a water bottle, snacks,
extra shoes/sandals and a change of clothes. Campers may bring with them
appropriate toys/games to play with during free time at the counselor’s discretion.
Certain activities like some of the elective classes may require students to bring
additional items with them to camp and will be communicated to you on
Facebook, email, or a note home.
LUNCHES/SNACKS: Kids Rock does not provide lunch, and bringing a sack
lunch is recommended. However, we will have lunchables available for purchase
for $3, as well as Hungry Howies Pizza available for purchase on Fridays for
$1/slice. A pizza order slip will be available at the registration table. Campers will
have access to a refrigerator and microwave to heat their lunch if necessary.
Kids Rock will provide a snack for the campers each afternoon. We recommend
that you pack a snack for the campers to eat during our morning break time. Due
to some severe allergies at camp, Kids Rock is a peanut free zone.
FACILITIES: Kids Rock Zeeland is located at Zeeland Christian School, 334 W.
Central Ave, Zeeland, MI 49464. Tennis instruction will take place at Lawrence
Park. Kids Rock Grand Rapids is located at Legacy Christian School, 67 68th
Street SE, Grand Rapids, MI 49548. Kids Rock will have access to three
classrooms, the gymnasium, bathrooms, the playground, and athletic fields.
KIDS ROCK I & II: Campers entering grades 1-3 will be grouped together in Kids
Rock I. Campers entering grades 4-7 will be grouped together in Kids Rock II.
Each group will have their own home base, and age appropriate games and
activities available to them for free time. Kids Rock I & II will come together for
certain theme, class and sports activities when it is age and number appropriate.
CAMP LEADERSHIP: The camp leadership program is for grades 8 & 9. The
campers who sign-up for this program will be expected to be role models for the
younger campers. In addition, they will take on an expanded role with camp to
assist in games, activities, and other duties necessary to help the camp function.
It will be a way for these campers to gain valuable job and resume experience,
while having a great time participating in camp.
ADULT TO CAMPER RATIO: The adult to camper ratio will never be higher than
15 to 1. The ratio will frequently be 7 or 8 to 1.
ELECTIVE CLASSES: Kids Rock is offering unique elective classes for the
campers each week and will do its best to give each camper their first choice.
Campers will write down their first and second choices for elective classes on the
first day of each week. The elective class schedule on this packet is subject to
change based on interest and other determining factors.
CANCELLATION /REFUND POLICY: Kids Rock requires a two week notice on
any cancellations in order to receive a refund of payment. If payment has not yet
been received at the time of the late cancellation, the family will still be required
to pay for the registered weeks. This policy is to allow us adequate time to
contact families with campers on the waiting list, and make informed decisions
regarding weekly supplies and counselor work schedules. We can try to
accommodate families who would like to change their dates as long as there is
availability on the dates they would like to change in to.
June 17-21: Wet Wild N’ Wacky
Theme Description:
Campers will have a blast participating wet, wild, and wacky activities
like water fights, wacky hair day, water balloon toss, and the wet n’
wild carnival.
Sport of the Week:
Basketball
Mile Club
Do you like to run?
Log as many as
you can in this
class to receive
various rewards!
Baseball
Learn basic
baseball skills and
have a chance to
use them in game
situations!
Arts and Crafts
Campers will have a
blast making a new
craft each day!
Ooey Goey Science
Campers will have
fun learning about
science through
exciting experiments!
Special Instructions:
Campers should wear clothes that can get wet/dirty, and bring a swim
suit and change of clothes. Bring the whole family for the Kids Rock
Carnival! Kids Rock Zeeland’s carnival will be Friday at 4pm. Kids
Rock Grand Rapids’ carnival will be Thursday at 4pm.
June 24-28: Olympic Week
Theme Description:
Campers will compete in Olympic events like long jump shot put,
relay races and more! Join us at the end of the week for the closing
ceremony to see which country won the Olympic gold.
Sport of the Week:
Flag Football
Elective Classes:
Tennis
Games Games
Games!
Hockey
Campers will learn
basic tennis skills
and have a
chance to use
them in game-like
situations!
Campers will learn
how to play different
board games, and
have the chance to
design their own!
Campers will learn
basic hockey skills
and have a chance to
practice them in fun,
game-like settings!
Scrap
booking/card
making
Bring some
pictures of friends
and family at home
and learn some
scrap book and
card making
basics!
Special Instructions:
Parents are invited to attend our closing ceremony on Friday at
4:00pm!
July 1,2,3,5: Game Shows Galore
Theme Description:
Family Feud, Jeopardy, The Amazing Race, Who wants to be a
Millionaire, Wheel of Fortune, American Gladiator! Kids Rock will
bring these hit TV game shows to life for this fun-filled week.
Sport of the Week:
Volleyball
Elective Classes:
D.E.A.R
Drop everything
and read! Bring a
book, and cool
down and relax
for some nice
summer reading!
Soccer
Campers will learn
the basic skills of
football and have a
chance to practice
them in fun, gamelike settings!
Chess
Campers will learn
the basic rules and
strategies of chess
and then have fun
competing against
their friends!
Flag Football
Campers will learn the
basic skills of football
and have a chance to
practice them in fun,
game-like settings!
Special Instructions:
Campers should bring a tennis racket with them if possible for the
sport of the week.
.
July 8-12: Hollywood Magic
Theme Description:
Kids Rock idol, the camper talent show, and the Kids Rock play are
all part of this fun-filled week that focuses on having fun with the fine
arts.
Sport of the Week:
Baseball
Elective Classes:
Acting
Learn basic acting
skills in fun settings
like improvisation,
reader’s theatre, and
short skits!
Dance
Learn a dance to
perform at our
talent show!
Golf
Students will learn
how to drive, chip,
and putt and then
put those skills in to
practice with our
own Kids Rock golf
course!
Volleyball
Learn basic volley
skills and have a
chance to use them
in game-like
settings!
Special Instructions:
Parents are invited to our talent show/Kids Rock play on Friday at
4:00pm. Bring a baseball glove if you are able!
July 15-19: Splish Splash N’ Sports
Theme Description:
This week combines the campers favorite sports activities with wet n'
wild fun! Sprinkler soccer, water balloon volleyball, and much more!
Bring your bathing suits and your athletic gear for a splish splashin'
good time! Parents are invited to join us at the end of the week for our
Kids Rock track meet and ribbon ceremony
Sport of the Week:
Track and Field
Elective Classes:
Arts and Crafts
Campers will have
a blast making a
new craft each day!
Basketball
Campers will learn
basic basketball
skills and have a
chance to practice
them in game like
settings!
Frisbee Golf
Jewelry Making
Campers will learn the
Learn how to
basic rules of frisbee
make and create
golf and have a chance your own jewelry!
to play our Kids Rock
Frisbee golf course!
Special Instructions:
Join us at 4:00 on Friday for our Kids Rock track meet and medal
ceremony
July 22-26: Survivor
Theme Description:
Join us for Kids Rock Survivor week. Campers with their tribes will
compete in obstacle courses, scavenger hunts, and other reward
challenges similar to those seen on the hit TV show “Survivor”. Don’t
worry, campers will not be voted off the island.
Sport of the Week:
Soccer
Elective Classes:
Exercise Science
Yoga, Tai Bo,
Aerobics, Dance,
Zumba are part of
this fun filled
exercise class!
Card Games
Badminton
Painting
Campers will learn a
new card game each
day!
Campers will learn basic
badminton skills and
have a chance to use
them in fun, game-like
settings!
Bring from home:
Campers will have fun
painting with different
mediums each day.
Please bring a paint
shirt for this class!
July 29-August 2: It’s Showtime!
Theme Description:
Bring your acting, singing, dancing, videotaping, editing, writing and
computer skills to Kids Rock Studios this summer to help us film our
first ever Kids Rock movie! Campers will have the opportunity to be a
part of each aspect of movie production during this fun-filled
week! Parents are invited to join us on Friday for a popcorn movie
premiere party!
Sport of the Week:
Tennis
Elective Classes:
Music
Dance
Photography Fun
Campers will have a
Campers will have a
Campers will learn
chance to learn about blast learning dance
some basic
different styles of music routine that is sure to
photography skills
and instruments.
find its appearance and use their photos
Students will enjoy
somewhere in our
for a fun project!
listening, playing, and
Kids Rock Movie!
Must bring a camera
singing in this music
from home.
appreciation class!
Basketball
Campers will
learn some
basic basketball
skills and have
the chance to
use them in a
game setting!
Special Instructions:
Campers should bring a tennis racket with them if possible for the sport of
the week. Join us Friday at 4:00 for our Kids Rock Movie premiere!
August 5-9: Field Trip Frenzy
Theme Description:
Each day, we will travel by bus for fun at a new location! The kids will
enjoy fun field trips like Crazy Bounce, roller-skating, Craig’s
Cruisers, The Critter Barn, bowling, the movie theatre, timber town,
and more! All bussing and entry fees are included in the price!
Special Instructions:
Additional information such as specific field trip times and details will
be posted on our Facebook page and our website when a complete
schedule is available. We will eat lunch each day at the school’s
location.
Daily Schedule
*This schedule is subject to change based on daily and weekly activities.
7:45-8:45: Arrival/free time
8:45-9:00: Devotions
9:00-9:45: Group games/Activities
9:45-10:015: Activity of the day
Monday-Gym Games
Tuesday-Arts and crafts
Wednesday- Wacky sport Wednesday
Thursday- Arts and crafts
Friday- Singing
10:15-11:00: Weekly sport activity
11:00-11:15: Snack (provided from home)
11:15-12:00: Weekly theme activity
12:00-12:45: Lunch
12:45-1:30: Free time
1:30-2:15: Camper elective classes (change weekly)
2:15-3:00: Weekly sport activity
3:00-3:15: Snack (provided by camp)
3:15-4:00: Weekly theme activity
4:00-4:30: Group games
4:30-5:00: Gym Games
5:00-5:30: Camper pick-up/free time
***Early drop-off and late pick-up plans available.
***We have late drop off and early pick flexibility.
Kids Rock Behavior Plan
Although Kids Rock is a fantastic option for parents looking for a positive experience for their
children all summer long, our program is also designed to give a unique camp experience each
week. Although our counselor to camper ratio is 15 to 1 or lower, we do not have the capability
to provide an aide for any camper due to behavior or health concerns. We provide highly
structured activities with very limited free time. This is different from a traditional day care
setting, and may not be a fit for every camper.
We have two basic expectations for all campers:
1.
Treat others the way you want to be treated.
Examples of not meeting this expectation: Arguing with campers or counselors, name
calling, teasing, disrupting camp activities, damaging school property, talking while
counselors are talking, fighting, bullying, threatening others, stealing, etc.
2.
Participate and always have a good attitude.
Examples of not meeting this expectation: Poor sportsmanship, not following activity
directions, playing fair during games and free time, etc.
Daily Behavior Management System: Minor infractions such as general camp disruptions will be
handled using a daily stoplight system with the following consequences:
First offense: Verbal warning
Second offense: Removal from activity for 10 minutes
Third offense: Removal from an entire camp activity, and written violation slip will be filled out
Fourth offense: Camper will be sent home for the day, and a written violation slip will be filled
out
Written Violation Slips: Violation slips are a means of documenting camp behavior infractions.
A written violation slip can be given for repeated basic infractions, or for more serious offenses
such as bullying, swearing, stealing, threats to a camper or counselor, physical harm to another
child or staff member, etc.
1 Violation Slip: Removal from an entire camp activity
2 Violation Slips: Removal from an entire camp activity
3 Violation Slips: One day suspension out of the program
4 Violation Slips: Dismissal from the program
*Kids Rock Summer Camp reserves the right to dismiss students from the program for severe
infractions without going through all of the steps mentioned above.
Meet The Zeeland Staff
Ben Ashby, Camp Director- Ben Ashby is a middle school Spanish teacher at Zeeland Public
Schools. He also taught elementary Spanish for 6 years. He attended South Christian High
School in Grand Rapids, MI and is a graduate of Calvin College. In his experience working as
a teacher, coach, and camp counselor, he has worked with children of all ages. Ben is
excited about sharing the love of God with the campers this summer through all of the fun
activities that Kids Rock has planned. His wife Sarah was a 2nd grade teacher at Holland
Christian for four years. They live in Zeeland, MI with their 4 year old Eli, and their 2
year old, Isaac.
Sarah Ashby, Camp Administration-Sarah Ashby taught second grade at Holland Christian
for four years at South Side Elementary. She was also the director of a summer camp in her
home town in New Jersey. Sarah stays extremely busy as a stay at home mom, and enjoys
walking, gardening, being active, and spending time with friends and family. Sarah is
involved with camp planning, organization, registration, and paperwork. She is also often a
frequent camp visitor!
Jonathan Van Eck, Zeeland Site Director- Jonathan Van Eck is the director of vocal music at
the high school level for Zeeland Public Schools. He graduated from Grand Rapids Christian
High School and went on to study vocal music education at Calvin College. Jonathan has
been a camp counselor for Kids Rock Summer Camp for two summers, and this year he will
serve as the camp director of the Zeeland location. He is always full of energy and
enthusiasm for students of all ages, and is looking forward to another great summer with
KRSC!
Brad Lemmen, Camp Counselor- Brad is currently a 7th grade teacher at East Arbor Charter
Academy in Ypsilanti, Michigan. He previously taught 4th grade and student taught in a 2nd
grade classroom. He graduated from Western Michigan University in 2011 with a degree in
elementary education, after graduating from Zeeland West High School in 2007. In addition
to camp, Brad will be getting married this summer. This will be Brad’s 5th summer at Kids
Rock Summer Camp! He enjoys playing golf and softball during the summer and loves sports
of all kinds. Brad is excited to be back at camp this year for another great summer!
Lillea Prins, Camp Counselor- Lillea is a 2010 graduate of Holland Christian and will be a
senior at Calvin College in the fall. She is studying elementary education and hopes to be a
teacher one day. In high school, Lillea participated in cross country, Dutch dance, and art
club. At Calvin she is a part of the Student Activities board, planning events and activities for
the on campus students. She also volunteers at the Cook Library Center helping students
with their homework. Lillea enjoys spending time with kids of all ages, and loves biking,
baking, going to the beach, and spending time with family and friends. This will be Lillea’s
second summer at Kids Rock Summer Camp and she is very excited about building new
relationships and sharing God’s love with the students at the camp!
Carly Van Eck, Camp Counselor- Carly Van Eck just finished her Master's degree in social
work at GVSU and hopes to work in the mental health field as a therapist or case manager.
Carly grew up in Allendale and graduated from Allendale High School. She has experience
teaching dance, mentoring adolescents, and camp counseling. Carly is looking forward to
her fourth summer at Kids Rock Summer Camp!
Emily McKenzie, Camp Counselor- Emily will be a senior at the University of Michigan in the
fall studying nursing and is anxiously awaiting graduation in May 2014. She hopes to work as
a pediatric or mental health nurse practitioner someday. She grew up in Kentwood and
graduated from East Kentwood in 2010. In high school she was involved in band and played
softball, volleyball and track and field. In her free time she enjoys reading, baking, traveling,
hiking, backpacking and spending time with her amazing family. Emily has always loved
working with kids and has many years of experience as a babysitter. She is extremely
excited that she is able to say that this will be her 3rd summer at camp!
Jenna Jongekrijg, Camp Counselor – Jenna is a 2012 graduate of Holland Christian and will
be a sophomore at Calvin College in the fall. She is studying elementary education. In high
school she participated in basketball her freshmen and sophomore years, and softball all
four years. She enjoys sports, traveling, snowmobiling, and being out in nature. She has
experience mentoring and volunteering in children programs. She is extremely excited to be
a camp counselor and cannot wait to see what God has in store this summer!
Evan Finch, Camp Counselor- Evan just finished his junior year at Hope College and he is
majoring in physical education with a health minor. He has been on the Hope College
Varsity Football and Track teams for all of his three years in college. Evan also has
experience working with kids from field placements, mission trips, Special Olympics and
coaching. He was born in North Carolina but grew up in Ann Arbor and graduated from Ann
Arbor Pioneer in 2010. This is only Evan's first year at Kids Rock Summer Camp but he looks
forward to this awesome new experience!
Lindsay Sanders, Camp Counselor- Lindsay will be a sophomore this fall at Cedarville
University in Ohio. She is majoring in Early Childhood Education with a Bible minor. She is a
2012 graduate of Zeeland East High School where she participated in Dutch Dance, student
senate, and four years in the Dance program. At Cedarville she is involved with an after
school Bible club at the local elementary school, a Discipleship group, and various Cedarville
hosted children’s events. She has experience teaching, babysitting, mentoring, and
volunteering at church, camp, and several elementary schools. She always enjoys spending
time with her family, watching movies, playing board games or cards, hanging out at the
beach with friends, ice skating, reading, and doing crafts. Lindsay has wanted to be a
teacher since first grade and can’t imagine a better way to spend her summer than being a
camp counselor at Kids Rock Camp!
Austin Ball, Camp Counselor- Austin is a 2011 graduate of Hudsonville High School in
Hudsonville, Michigan. He is planning on attending Western Michigan University to pursue
a degree in Business with a Marketing focus. He is currently an Intern for Zox Straps, an
elastic wristband company that was born right here in West Michigan. He has enjoyed
ministering to youth year round for the past 3 years, ranging in ages Kindergarten through
8th grade. His favorite hobbies are video games, singing, sports, and writing. Austin is
thrilled to be returning for his 3rd year at Kids Rock Summer Camp!
Meet the Grand Rapids Staff
Ben Ashby, Camp Director- Ben Ashby is a middle school Spanish teacher at Zeeland Public
Schools. He also taught elementary Spanish for 6 years. He attended South Christian High
School in Grand Rapids, MI and is a graduate of Calvin College. In his experience working as
a teacher, coach, and camp counselor, he has worked with children of all ages. Ben is
excited about sharing the love of God with the campers this summer through all of the fun
activities that Kids Rock has planned. His wife Sarah was a 2nd grade teacher at Holland
Christian for four years. They live in Zeeland, MI with their 4 year old Eli, and their 2
year old, Isaac.
Sarah Ashby, Camp Administration-Sarah Ashby taught second grade at Holland Christian
for four years at South Side Elementary. She was also the director of a summer camp in her
home town in New Jersey. Sarah stays extremely busy as a stay at home mom, and enjoys
walking, gardening, being active, and spending time with friends and family. Sarah is
involved with camp planning, organization, registration, and paperwork. She is also often a
frequent camp visitor!
Audrey Slotsema Grand Rapids Site Director- Audrey is a student at Calvin College and will
graduate this coming fall with a degree in Elementary Education and Spanish. While
at Calvin she planned activities for her residence hall, was an Orientation Leader
for incoming students, and worked at the Admissions Office. Audrey loves to travel, spend
time at the beach, and read. She has spent much time with children and is so excited for her
first summer at Kids Rock Summer Camp!
Tom Snikkers, Camp Counselor/Sports Director – Tom Snikkers is a 2013 graduate of Calvin
College with a degree in Sports Management. Prior to his 4 years at Calvin, he attended
Unity Christian High School in Hudsonville, Michigan. Tom is looking to pursue a career as a
Professional Basketball player this coming fall. Upon finishing his basketball career overseas,
he plans to attend graduate school in route of becoming an Athletic Director at the
collegiate level. He has played many sports at various levels, including four years as a starter
on the Calvin College varsity basketball team. Tom looks forward to sharing his passion for
sport combined with his love for Christ. This will be his first season serving as the Kids Rock
Camp Sports Director, and he is excited to be a part of the Kids Rock Summer Program.
Kimbra Filippini, Camp Counselor- Kimbra is a 2010 graduate of Holland Christian and will
graduate from Calvin College at the end of this coming fall. She is pursuing a degree in
Elementary Education with minors in Mathematics and Language arts and is incredibly
excited to begin student teaching in September. Kimbra has spent a lot of her spare time
working on the leadership team for SPEC, Calvin’s club for Education majors, coordinating
and participating in a variety of educationally focused volunteer opportunities, and working
for Calvin’s Education Program office. The past two summers, Kimbra has enjoyed working
at the Play & Learn Summer Program which is a day camp sponsored by the City of
Wyoming’s Parks and Recreation Department. Kimbra enjoys spending time with her
family, working with children, hanging out with her friends, and dance. She was involved in
ballet for nine years, and still enjoys recreational dancing through Calvin’s Dance Guild.
Kimbra has a passion for working with and sharing the love of the Lord with children of all
ages. This will be Kimbra’s first summer at Kid’s Rock and she couldn’t be more excited to be
a part of this incredible program!
Kendra Tameling, Camp Counselor- Kendra is a 2010 graduate of South Christian High
School and will be a junior at Calvin College in the fall. At Calvin, she is studying therapeutic
recreation and minoring in psychology and dance. She hopes to be a Therapeutic Recreation
Specialist someday and work in a rehabilitation setting with the disabled. In high school she
participated in cross-country, track, and took many dance classes in hip-hop and ballet. At
Calvin, she helps run a program called “Horizons” for the mentally disabled by planning and
leading events for them, and is very active in Dance Guild. She enjoys running, dancing,
listening to music, spending time with family and friends, and being active and
adventuresome outdoors. This will be her first summer at Kids Rock Summer Camp, and she
is thrilled to be working at a camp where she grew up going to school. She is looking
forward to meeting all the kids and having a blast with them this summer.
Jeff VanderMolen, Camp Counselor- Jeff is a 2010 graduate of Unity Christian High School
and will be a senior at Dordt College in the fall. He is studying Elementary and Middle School
Education with an endorsement in coaching. In high school, Jeff participated in football,
cross country, and track. He was also part of the spiritual leadership team at Unity during his
senior year. At Dordt, he has worked in the admissions office, is a teacher assistant for a
college math class, serves as a student coach for cross country, and participates in track and
field. Jeff also volunteers at HUGS ranch in Byron Center, MI. Jeff enjoys spending time with
kids of all ages and loves sports, spending time with family, hanging out with friends, and
simply spending time outdoors. This will be Jeff’s first summer at Kids Rock Summer Camp!
He looks forward to being a Christian role model in the lives of the students at camp.
Diane Arthur, Camp Counselor- Diane is a 2013 graduate of East Kentwood High School
where she participated in volleyball, soccer, track, study abroad, and theater programs. She
has been a counselor at Camp Crystal in Frankfort, Michigan, is a frequent babysitter, and
volunteers in her church nursery. Although her college location is undecided, she intends to
pursue a degree in Christian ministries and/or global studies. Diane is ecstatic to spend this
summer at Kids Rock sharing Christ's love with the children!
Kids Rock Emergency Card
Child’s name: ___________________
Address: _________________________
Birth Date: ________________________
Home Phone:________________________
Mother’s Name: ____________________ Father’s Name: ______________________
Employer: _________________________ Employer: ___________________________
Work Phone: ______________________ Work Phone: _________________________
Cell Phone: ________________________ Cell Phone: __________________________
Describe any physical condition requiring special attention by camp staff. (Surgeries,
Illnesses, Allergies, Chronic Health Problems, etc.)
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Individuals Other Than Parent/Guardian Authorization
ONLY these individuals have my authorization to care for my child in the event of an
emergency and/or for drop-off and pick-up. * Please advise these individuals that they are
authorized and will need to present identification to staff.
Parent/Guardians Initial:______
Name/Relation: ____________________ Phone Number:______________________
Address:________________________________________________________________
________________________________________________________________________
Name/Relation: _________________ Phone Number:_________________________
Address:________________________________________________________________
________________________________________________________________________
Name/Relation: _________________ Phone Number:_________________________
Address:________________________________________________________________
________________________________________________________________________
Authorization for Emergency Medical Care
I hereby give my permission to Kids Rock Summer Camp to call a doctor or emergency
medical service and for the doctor, hospital or medical service to provide emergency medical
or surgical care for my child ______________________________________ should an
emergency arise. It is understood that the Kids Rock Summer Camp staff will make a
conscientious effort to locate the parent/guardian or the emergency contact listed on the
registration document before any action will be taken. If it is not possible to locate the
emergency contact listed, I will accept the expense of emergency medical or surgical
treatment.
_______________________
_____________________
Signature of parent/guardian
Date
Authorization to Administer Over the Counter Medication
Kids Rock Summer Camp staff cannot supply your child with any over the counter
medication unless we have a permission slip on file. If your child has needs beyond over
the counter medication, please contact the camp director to make those arrangements.
Please fill out this permission slip if you would like your child to be able to receive over
the counter medication at the camp director’s discretion. I hereby give my permission to
Kids Rock Summer Camp to administer the following to my child in the manner
described on the packaging:
 Bug spray
 Antiseptic cream
 Tylenol
______________________________
Child’s name
______________________________
Signature of parent/legal guardian
___________________
Date
Lost or Stolen Items
I understand that the Kids Rock Summer Camp is NOT responsible for personal property
lost or stolen on the Camp facilities or on the camp premises.
______________________________
Signature of parent/legal guardian
___________________
Date
Liability Waiver For Participant
I, as parent or legal guardians of __________________________ approve and give my
permission for him/her to participate in any class or program offered by Kids Rock
Summer Camp. By registering for youth programs through Kids Rock Summer Camp,
registrant acknowledges that the activities carried on in the program carry certain risks
for the participant. Registrant has independently reviewed and evaluated the risks and
determined to engage in the program with full knowledge and acceptance of the risk. The
registrants agrees to and hereby releases and forever discharge the Kids Rock LLC, their
officers, employees, agents, Zeeland Christian School, Legacy Christian School and
volunteers from any and all liability for damages, loss or personal injury arising out of or
related to registrant’s participation in youth recreational programs.
______________________________
___________________
Signature of parent/guardian
Date
Sunscreen Permission Form
Children will apply sunscreen to themselves under the direct supervision of a day camp
staff member at least once a day. Sunscreen will not be applied to any broken skin or if a
skin reaction has been observed. Any skin reaction observed by staff will be reported
promptly to parent/ guardian. It is the parent’s responsibility to provide and apply
sunscreen before camp with a specific amount of SPF they wish their child to have.
Please have your child’s first and last name clearly labeled on the sunscreen bottle. By
signing below, I agree to provide sunscreen, apply it before camp and allow staff and/or
other campers to assist in applying sunscreen as necessary throughout the day.
______________________________
Child’s name
______________________________
___________________
Signature of parent/legal guardian
Date
PG Movie Permission Form
During lunch, children will occasionally be offered an option to watch part of a movie. We
try to show G movies when at all possible, but some of our movies are age appropriate PG.
Please sign this section if you would like to allow your child to watch a PG family/children’s
film. Movie titles are available from the Summer Camp Director if you would like to review
our selections.
______________________________
Child’s name
______________________________
Signature of parent/legal guardian
___________________
Date
Bike/Walk To &/Or From Camp Permission Form
My child _____________________________ has my permission to bike or walk to and from
camp and be released on his/her own. He/she will be responsible for signing him/herself into
and/or out of camp each day. I agree that Kids Rock Summer Camp and employees will not
be responsible for the welfare of my child before camp and once released to go home.
____________________________________
_________________
Signature of parent/legal guardian
Date
Walking/Biking Field Trip Permission Form
We will be leaving the camp facilities occasionally to play tennis at the park, for biking
class, or nearby service project opportunity. Please fill out the following form to give
your child permission to do those activities. My child_________________ has my
permission leave camp under counselor supervision for walking and/or biking field trips.
____________________________________
_________________
Signature of parent/legal guardian
Date
Field Trip Frenzy Field Trip Permission Form
My child, ______________________________, participating in Kids Rock Summer Camp, has
my permission to participate in all field trips during Field Trip Frenzy Week. I am aware that
these field trips may include swimming at the beach. We understand that these field trips may
include walking, riding with a licensed bus driver on a school bus, a privately owned transportation
company, or a city bus. We as parents/guardians agree to hold harmless Kids RockSummer Camp
and any employees or volunteers thereof, for any accident, injury or occurrence arising out of, or in
connection with the field trips during field trip week. If I am late and the busses have already left, I
understand that I am still charged for that day.
____________________________________
Signature of parent/legal guardian
_________________
Date
Cancellation/Refund Policy
I have read and agree to Kids Rock Summer Camp’s two week notice cancellation and
refund policy.
____________________________________
_________________
Signature of parent/legal guardian
Date
Photo Release
My child_______________ has the permission to be photographed, for publication.
____________________________________
_________________
Signature of parent/legal guardian
Date
Kids Rock Camper Profile
Camper name:_________________________ ________________________________
Last
First
1. Does your child have any dietary restrictions or concerns?
2. Does your child have any allergies? If yes, please elaborate.
3. What is your child’s interests/favorite activities at school and at home?
4. What social goals do you have for your child while at camp?
5. Does your child have any characteristics that require special attention?
6. Does your child have any limitations or restrictions on camp activities? If yes, please
explain.
7. Do you have any behavior management suggestions for your child?
8. What types of things can easily upset your child/cause them anxiety?
9. Do you have any other suggestions for how camp can provide the best experience
possible for your child?
Kids Rock Referral Program
What is it? The Kids Rock referral program is a way for you to save
money on your registration cost, and a way for Kids Rock to spread
the word about the exciting programming happening at Kids Rock this
summer.
How much money can I save? For each camper that comes to Kids
Rock because they heard about it through your family, you will
receive $20 off your registration cost. If you have already paid, Kids
Rock will reimburse you for the amount owed. If you refer 5 different
campers, you would receive a check for $100.
How does Kids Rock keep track of the referrals? On each
registration form, there is a spot that asks, how did you hear about
Kids Rock? For each camper that writes your family’s name in that
blank, you will receive $20 off your registration cost.
Telling your friends about the fabulous programming this summer is
the highest form of compliment that we can receive. This referral
program will run all summer long as long as we still have spots
available. Thank you for helping us spread the word!
A Special Thanks to our
Sponsors
Ridge Point Community Church
Hudsonville Expressway Self Storage
Hungry Howie’s Pizza in Zeeland, MI
Zeeland Christian School
Legacy Christian School
The Zeeland Print Shop