Awesome Summer Adventure 2015 From the Directors Welcome! We are looking forward to a great summer, packed full of action, adventure, hilarious laughter, crazy Summer Staff friends and meaningful encounters with God, for your child and friends. Situated in a spacious grove of fir and cedar trees, Fircreek and ASA provide a great environment for having fun, making new friends, cultivating new interests and just being kids! ASA and Fircreek are working together to provide your child with the perfect summer-time experience for children going into 1st - 6th grades. This broad age range is divided into two groups - grades 1-3 and 4-6, specifically addressing the needs of each group. ASA provides care for children who are approved for DSHS and need to attend a licensed childcare program approved by the state. Children who are part of the Awesome Summer Adventure program will join Fircreek for a wide variety of outdoor activities. What could be better - having more childcare options available to parents, while your child gets to participate in our popular Fircreek Day Camp?! Your child is our #1 priority at Fircreek and ASA, as we offer a safe, exciting and caring environment for children to grow and experience new challenges. We warmly invite children of any ethnic or religious background to “choose your adventure” at Awesome Summer Adventure and Fircreek Day Camp this summer. We look forward to meeting you! Stacy Smith ASA Director Darell Smith Fircreek Director Weekly Themes Wk. 1 June 23-26 Who Wants to be a Minion-aire? Wk. 2 June 29-July 3 President Business as Usual Wk. 3 July 6-10 The Adventures of Sherlock Gnomes Wk. 4 July 13-17 Fir Creekcelot & the Sword in the Stump Wk. 5 July 20-24 It’s a Wonderful Creek Wk. 6 July 27-31 Smurfin’ Safari Wk. 7 Aug 3-7 Oregon Trail: How to Train Your Wagon Wk. 8 Aug. 10-14 Gotta Catch ‘Em, Y’all Wk. 9 Aug. 17-21 School of Rocks Family Fun Nights For weeks 6 and 9, Fircreek will be hosting a Family Fun night on the Thursday of that week. Your entire family is invited to enjoy a BBQ dinner and some fun entertainment from 5:30-7:30pm with the Fircreek and ASA staff. Sign-up will be available that week. Cost: Sample Schedule 6:45am Doors Open for ASA 6:45-9:00 Arrival &Open Play Time 9:00-9:30 Kick-Off (songs, skits, & story) 9:40-11:20 Adventure Zone Activity (see below) 11:30-12:15pmLunch 12:20-2:45 Adventure Zone Activity 3:00-3:30 Bible Study 3:30-4:30 All-Camp Game & Activity 4:30-4:45 Wrap-Up 4:45-5:15 Pick-Up Adventure Zones (chosen by ASA counselor) Woodz Zone - tree houses, giant swing, archery, fort building Sportz Zone - basketball court, badminton,& a sports field Artz Zone - pottery & clay sculpting, drawing, crafts, etc. Wet Zone - ski boats, tubing, water trampoline, kayaks, swimming DSHS families: the copay amount is determined by DSHS & due at the beginning of each month To register your child for summer ASA, please submit your completed forms to The Firs Registration Office or mail to: ASA Registrar - 4605 Cable St. - Bellingham, WA 98229 (A registration confirmation will be sent to you) Awesome Summer Adventure 2015 Registration Camper Information First Name Last Name Birth Date Grade in 2015-2016 Gender Residing Parent/Guardian Information Name(s) Email Address Phone #1 City Home Cell Work State Phone #2 Home Zip Cell Work Health History Doctor Please answer each of the following: Had any recent injury, illness, or infectious disease? ........ y Wear glasses, contacts, or protective eyewear? ............... y Have an orthodontic appliance being brought to camp? ... y Have diabetes? ............................................................. y Have asthma? ...............................................................y Other: (Please state tendencies towards bed wetting, eating Phone n Had Tuberculosis? ......................................... y n Allergic to bee stings? .................................. y n Are immunizations current? ............................ y n Had tetanus shot in last 5 years? date_____ ... y Any diet restrictions? ..................................... y n disorders, or behaviors we should be aware of.) Please give an explanation for any questions answered “Yes”: Please list any general health concerns: List any allergies to food, medication, or the environment: Does your child take any medications: No If yes, please list: Yes At home n n n n n At camp **Additional information may be requested. Medical Insurance Company Policy Number I give The Firs ASA program permission to use photographs of my child for display/program purposes I give The Firs ASA program permission to transport my child on field trips (walking or by Firs van) My child needs a booster/car seat when transported (must be 8 or older and at least 80lbs to be exempt) In an emergency, after every effort is made to reach me, I give The Firs permission to seek medical attention for my child y y y n n n y n Emergency Contact In case of emergency, please list someone to be contacted if parents are unable to be reached. Name Relationship to Camper Phone Please list any people authorized to pick up your camper from ASA. (Anyone not listed will not be granted permission to pick up your camper.) Name Relationship to Camper Phone Name Relationship to Camper Phone Name Relationship to Camper Phone Schedule & Attendance Due to very limited space in the Awesome Summer Adventure program, the attendance schedule you provide will not be flexible for payment. You will be responsible for payment of all days registered for, regardless of attendance. Additional days may be requested through the summer, and attendance will be granted as space is available. Please indicate which days your child will attend ASA, each month, on the appropriate calendar(s) below. June 23 29 24 July 25 30 26 August 1 2 3 3 4 5 6 7 10 10 11 12 13 14 17 18 19 20 21 6 7 8 9 13 14 15 16 17 20 21 22 23 24 27 28 29 30 31 Billing You will be billed monthly on the first business day of the month. All DSHS copays are due by the 10th of each month. Failure to pay by the 15th may result in a $25 late fee. Payment Details: DSHS: Please provide your case number to verify approval: You must report a change in provider and/or schedule to DSHS 30 days prior to the start of Awesome Summer Adventure. DSHS Client Line: 1-877-501-2233 ASA Provider #: 257320 Parent/Guardian Signature: Date: