Important Information

Congratulations! Your daughter/s is/are signed up for Lake Erie Nature & Science Center’s Back to Nature Day Camp, June 20 – 23, 2016. We look forward to having her attend camp. Camp hours are from 9a.m. - 3 p.m., Monday thru Thursday.

In this packet, you will find the Camper Registration Form, Health Release Form, Parent Release Form, Health and Safety Form, Medication Form, and all necessary information. Please make sure you have your forms turned in to CampCoordinator, Carole Lynn Stradtman at Lake ErieNature & ScienceCenterwithin TWO (2) WEEKS of your payment. Without these forms and payment, your daughter will be removed from the active list and dropped to the waiting list. Girls are moved back onto the active list on a first-come, first-served basis.

What is the camp fee?

The cost for Back to Nature Day Camp is $180/girl. Payment is required at time of registration. We accept Visa, Mastercard and Discover credit cards, cash or check (make check payable to LENSC). If for any reason your child in unable to attend camp, refunds must be requested on or before June 10, 2016. (Reduced fees may be available to campers with adult or older sibling who volunteer for camp – please speak directly to the CampCoordinator before registering for the camp.)

What should my camper wear?

Sturdy shoes, socks, long pants or shorts with knee socks (for hiking) and top.

NO sandals, platform shoes, jellies, sundresses, dresses, halter-tops or jewelry. If your child arrives at camp wearing these items you will be asked to take them home to change before returning to camp.

Girl Scout uniforms are not recommended since we spend most of our time outdoors and we want the girls to enjoy their activities without worrying about their clothing.

What does my camper need to bring?

Lunch in a lunch bag(please include an ice pack to keep items cold) and a drink in a non-breakable container. Any glass containers will be removed and replaced with a small bottle of water.

Two (2) water bottles filled with water. You might want to freeze one of the water bottles so that the water will still be cool in the afternoon.

A sit-upon. We use 5-gallon containers as sit-upons at the Center. You can use any 5-gallon container with lid (kitty litter, laundry soap, pickle barrel, etc). Please make sure the container is clean. Your daughter may decorate her sit-upon any way she likes. A carpet remnant cut to fit makes an excellent seat cushion.

  • Inside of her sit-upon should be rain gear, her lunch, rub-on insect repellent, rub-on sun block and any other NECESSARY item she may need during the day. Sit-upons are not toy boxes and such items should be left at home.

Sun Block is recommended. Sharing of sun block and insect repellent is not permitted except between sisters.

YOUR CHILD SHOULD NOT BRING: aerosol containers or sprays, toys, cell phones, electronic devices, etc. If these items are brought to camp, they will be confiscated and returned at the end of camp.

What if it rains?

We still have camp in the rain! In the event of rain, please send rain gear and follow regular drop-off procedures. In the event of a thunderstorm, campers will be taken into Lake ErieNature & ScienceCenter for all activities. Contingency plans are made daily for inclement weather.

What will my child do all day?

The girls will be placed in units or groups of campers of their own age. The units will have time together during the day but will also rotate around to activity areas. We have six (6) activity areas: Arts and Crafts; Games; Nature, Acting Out, GS Ways and This-n-That. The camp activities differ from year to year so if your daughter attended camp last year, she will still have a new experience this year.

Will my camper complete any Girl Scout Badges?

If your daughter is a Girl Scout, she will receive a sheet that details the Badge requirements that she completed during camp. It is the responsibility of the camper to take this sheet back to her troop leader to receive credit for these activities.

What if my daughter takes medication?

Please fill out the enclosed Medication form if your daughter needs to take medication at camp. This form needs to be returned with your other health release forms within two weeks.

If your daughter needs to carry an inhaler or bee sting kit, she still needs to have the medication form filled out and returned. If your child needs to have an Epi-Pen with her at all times due to allergies YOU must show the unit leader how to appropriately use the Epi-Pen on the first day of camp.

What about peanut allergies?

Because of the possibility of a child having an allergy to peanuts or peanut products, we ask that you NOT send any kind of peanut butter sandwiches, peanut butter snacks or nuts to camp. If a child comes with a peanut butter sandwich it will be confiscated and she will be sent to the pavilion to pick-up a lunchmeat or cheese sandwich.

How do I drop-off & pick-up my child?

Camper drop-off and pick-up will be done in the parking lot of the Wolf Picnic Area across from Lake ErieNature & ScienceCenter in Huntington Reservation. Cars will be asked to lineup entering the parking lot area. A CampStaff member will remove your camper from the car starting at 9 a.m. Do not let campers out of the car until a staff member is there. A staff person will tell you when it is safe for you to pull away. Our camp day ends at 3 p.m. Afternoon pickup will be in the same area as morning drop-off. YOU MUST HAVE A DRIVER PICK-UP CARD FOR EACH CHILD YOU WILL BE TAKING HOME. Two (2) pick-up cards will be sent with your confirmation packet. Your campers will be called and placed into your vehicle. Please do not pull away from the curb until a staff member has told you. These procedures take time but they are for your child’s safety.

Late drop-off

If your child arrives at camp late, the parent/guardian must escort their child to the pavilion. You will then have to sign your camper in with either the First Aid staffer or the CampCoordinator. We will make sure your camper gets to her unit.

Early pick-up

During morning drop-off, please notify camp staff that you will need to make an early pick-up of your child. Upon returning, come to the pavilion and notify the First Aid staffer or the CampCoordinator that you have arrived. You will have to present your drivers pick-up card and a photo ID. This will be checked against their parent release form. At this time, you can sign your camper out while a staff member collects your daughter from her unit.

If you try to pick your daughter up from her unit or from an activity, the unit leader will escort you to the pavilion. DO NOT ask your daughter to meet you at a specified area. Campers will not be permitted to leave their unit until picked up by a staff member.

When will I receive my driver pick-up cards?

You will receive a confirmation packet approximately two weeks before camp begins. In the confirmation packet will be two (2) driver pick-up cards and a letter with any last minute reminders or information. If you need more driver pick-up cards please call to request extra.

Can I request for my camper to be placed with another camper?

Campers are placed in groups called units. Each unit has between 20 – 25 campers. The units are grouped by age and scouting level (if applicable). This year we are again allowing campers to request to be placed with a buddy. Please indicate the buddy names on the camper application. Each buddy pair must be the same age level. But, remember that day camp is a great place to meet new friends from the communities within our area. Last year we had campers from Bay Village, Westlake, North Olmsted, Rocky River, Avon, AvonLake, Cleveland and other cities.

Any questions about the above conditions can be directed to Camp Coordinator Carole Lynn Stradtman at 440-871-2900, Ext. 211.

Remember -- The forms that need to be returned within two weeks are:

Form A: Camper Registration Form

Form B: Health Release Form

Form C: Parent Release

Form D: Bottom Half Only of Health and Safety Form

Form E: Medication Form

The highest priority of Lake ErieNature & ScienceCenter Day Camp Staff is to make sure your camper(s) is safe and happy. Thank you in advance for your understanding and patience.

Form A:Camper Registration Form

General Information

Camper Name ______

Parent Name ______

Address ______

City ______ State ______Zip ______

Home Phone (_____) ______-______Work Phone (_____) ______-______

Cell Phone(_____) ______-______Preferred PhoneHomeWorkCell

Current Grade (School Year 2015-16) ______Age______

Birthdate______Girl Scout Level (if applicable): Daisy Brownie Junior

Please buddy me with ______

______

I have read the information in this package and have completed and returned the following items:

Form A: Registration______

Form B: Health Release______

Form C: Parent Release______

Form D: Health and Safety______

Form E: Medication Form______

Paid On-Line or Payment Enclosed (Circle)

Completed registration materials should be returned to:

Lake Erie Nature & Science Center | 28728 Wolf Road | Bay Village, OH 44140

440-871-2900 |

Or email to

Form B: Health Release Form

Child’s Name: ______ Date of Birth: ______/______/______

IN CASE OF EMERGENCY, PLEASE NOTIFY:

PARENT/GUARDIAN:

1. NAME: ______PHONE ( C ): ______

EMAIL: ______PHONE ( H ): ______

2. NAME: ______PHONE: ______

IF PARENT CANNOT BE REACHED, NOTIFY:

1. NAME: ______PHONE: ______

2. NAME: ______PHONE: ______

Does your child have any specific health issues (e.g. drug or food allergies, poison ivy, etc.)?

NO YES

If yes, please provide full details as well as any other information that will enable us to help your child succeed in our programs.

______

Parent Authorization– In the event that I cannot be reached in an emergency, I hereby give permission to Lake ErieNature & ScienceCenter to secure NECESSARY emergency transportation to and treatment at the nearest hospital (St. JohnMedicalCenter), unless otherwise noted by me. (Additional emergency authorization forms are available at each individual hospital should you wish to take further precaution.)

Date______Signature: ______

Participant / Parent / Guardian (please circle one)

Participant Waiver of LIABILITY – For and in consideration of permitting the person or persons indicated above to enrollin and participate in Lake Erie Nature & Science Center programs indicated above, and any and all subsequent Center programs in which they participate, I hereby voluntarily release, discharge and relinquish any and all actions, causes of action and claims for personal injury, property damage or any other damages occurring to them arising out of, or in any way related to their participation in, and I represent that I understand that this release is intended to, and does, discharge in advance Lake Erie Nature & Science Center, any and all of its officers, directors, agents, volunteers, servants and employees from any and all liability, actions and causes of action even though that liability may arise out of the negligence and/or carelessness of Lake Erie Nature & Science Center.

Date______Signature: ______

Participant / Parent / Guardian (please circle one)

PLEASE NOTE:This health release form will be kept on file until the conclusion of Back to Nature Day Camp, through 6/30/2016. It is the parent’s responsibility to notify the Center of any changes to contact details or your child's health situation (e.g. drug or food allergies, etc) during that time period. Please call us at 440-871-2900, Ext. 211 to notify us as soon as any changes occur.

Lake Erie Nature & Science Center • 28728 Wolf Road • Bay Village • Ohio • 44140 • 440-871-2900 •

Form C:Parent Release Form

Driver Release

I, ______give permission for my child, ______to

(Parent/Guardian) (Camper’s Name)

leave the Lake Erie Nature & Science Center’s BacktoNature Day Camp 2016 at the end of the camp day or during the camp day if necessary with the following adult drivers:

______

(Print Parent/Guardian’s name) (Print Parent/Guardian’s name)

My daughter may also be released to the following adults:

______

(Print full name)(Relation to camper)

______

(Print full name)(Relation to camper)

______

(Print full name)(Relation to camper)

I understand that my daughter will not be released to anyone other than the persons named above. I understand that the above adults will have to show the driver pick-up card and possibly photo identification. All persons not having a driver pick-up card will be asked for photo identification and if necessary photo identification is not shown my child will not be released until an approved adult with the necessary photo identification arrives. I understand that this is for the protection of my child.

Under NO circumstances should my child be released to:

______

(Print full name)(Relation to camper)

Signature: ______Date: ______

General Photo Release

I hereby give consent to and grant Lake Erie Nature & Science Center permission to use for publication, advertising and exhibition, either using or not using my name or the name of my child, the photographs of me or my child taken at the Back to Nature Day Camp at Lake Erie Nature & Science Center on June 20 - June 23, 2016. Refraining from signing this release does not remove your child from any group souvenir photos (if applicable) given only to the girls to take home.

Signature: ______Date: ______

Form D: Health and Safety Form

For the health and safety of ALL campers and staff at Lake ErieNature & ScienceCenter,please do not send your child to camp if they are showing signs of the following medical conditions. Your child will be sent home if they are showing signs of any of the following:

Diarrhea

Vomiting or nausea

Severe sunburn

Fever

Discharge form eyes

Rash or hives

Any communicable disease

Refusing to participate in camp activities or asking to go home

Behavioral problems requiring additional supervision

The CampCoordinator or First Aid staff member will contact you by phone if your child is exhibiting any of these conditions. Your child must be picked up immediately. We have no facilities for long-term health care. In the event of an emergency, your child will be transported by EMS to the nearest hospital and you will be notified to meet them there.

If you know the night before camp that your child will not be attending due to illness, please call 440-871-2900 Ext. 211 and leave a message that your child will not be attending.

Refunds due to illness will be given up to 14 days before the start of camp. Children who miss part or all of camp due to illness or lack of participation will not be given a refund.

(Please return the bottom portion of this form ONLY

and keep the top portion for your reference)

 ------ ------

I have read the above health and safety notice and understand that if my child exhibits any of the above conditions I must pick them up IMMEDIATELY from camp. If I am unreachable at the time of contact, camp staff will begin contacting all of the listed emergency contacts until one is able to pick up my child and bring them home. I understand that refunds are not given for missed time at camp.

Parent signature______Date ______

Form E: Medication Form

Parent Consent and Instructions for Administration

THIS FORM MUST BE RETURNED WHETHER YOUR CHILD IS TAKING MEDICATION OR NOT

My Child IS NOT taking any medication at this time. (Please disregard the following questions, sign the bottom of this form and return)

My Child IS taking medication at this time. (Please complete the remainder of this form, sign the bottom of this form and return)

Parent/Guardian Consent:

I request and give permission to the CampCoordinator and the First Aid staffer to give my daughter, ______, the following medications during camp:

Medication name: ______

Condition that requires medication: ______

Physician prescribing medication: ______

Physician phone: ______

**This medication is for a life threatening illness (bee sting, peanut allergy, asthma, etc.) and I request that my child be allowed to carry this medication with her in her sit-upon or other carrying case during the duration of camp.

Administration Instructions:

Medication name: ______

Dosage: ______to be given by the CampCoordinator or First Aid staffer during the day at the following times:

Time 1: ______Time 2: ______Time 3: ______

Side effects to look for? ______

Special Instructions? ______

Has the child ever taken this medication before? (please circle one) YesNo

Medication being sent to camp must be in its original container with the original label attached. Please send medication in a ziplock bag labeled with your camper’s name on the bag.

Parent/Guardian signature: ______Date: ______

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