Camp Kindness Application 2015
Thank you for your interest in registering for the 5th Season of this unique educational program!
CAMP KINDNESS DETAILS
Our Camp Kindness week long program, is open to children aged 8-14, is enjoyed Monday – Friday and includes a vegan lunch and snack. We offer a standard and extended day option. The standard program runs from 9:00am-3:30pmand the tuition is $330 per child. Our extended day program runs from 9:00am-5:30pm and the tuition is $400 per child. Limited scholarships are available for families who would otherwise be unable to pay the Camp tuition. Applicant families must be able to demonstrate financial need. All inquiries and financial information will be kept strictly confidential.
All Camp applications and tuition fees are due upon registration.
If you are paying by check payment must be received within three weeks and your camp spot is not secured until payment is received. Upon review and acceptance of your application, we will email you to confirm your child’s registration.If the week you choose is full, we will contact you to discuss options for participation or a refund.
Refund Policy
Requests received prior to May 1st will be issued a full refund less a $20 processing fee.
Requests received between May1st and May 31st will be issued a 50% refund.
We do not issue any refunds for requests received after June 1st.
Scholarships
To apply for a scholarship please download the application on our webpage or contact our Programs Manager to have one mailed to you.
Please mail tuition along with completed and signed (in 3 places!) application(s) to:
Catskill Animal Sanctuary
Camp Kindness
Attn. Programs Manager
316 Old Stage Road, Saugerties, NY 12477
The Camp Kindness program includes age appropriate discussions and activities covering the plight of farmed animals and animal protection issues. Catskill Animal Sanctuary advocates a more just, humane world and works to inspire vegan choices. We encourage campers to think critically and to express themselves freely. We are dedicated to fostering a supportive, compassionate and completely
non-judgmental atmosphere for all.
For more information on Catskill Animal Sanctuary and/or Camp Kindness, please contact:
Kelly Mullins, Programs Manager
r call 845-336-8447 Ext. 200
CAMPER INFORMATION
Camper’s Name:______
Date of Birth: ______
Circle One: Female Male Gender Non-Conforming/Neutral
Age: ______Grade Completed by July 2015: ______
SESSION SELECTION
All sessions from Monday-Fridayand are open to children aged 8-14
Please check which session and day option you are interesting in attending.
_____ SESSION 1: July 20 - July 24th
_____ SESSION 2: July 27 - July 31st
_____ STANDARD DAY: Hours:9:00am–3:30pm
Drop off: 8:30am-9:00am
Pick up: By 3:30pm
Tuition:$330 per child
_____ EXTENDED DAY: Hours:9:00am–5:30pm
Drop off: 8:30am-9:00am
Pick up: After 3:30pm and no later than 5:30pm
Tuition:$400 per child
PARENT/GUARDIAN INFORMATION
Parent/Guardian Name(s) : ______
______
Street Address
______
City StateZip code
______
Home Phone Cell Phone Work Phone
Primary email______
EMERGENCY CONTACTS
Please provide two emergency contacts who will be available during camp hours:
Name: ______
Relationship to Child______
Primary Phone Number:______(cell, work, home - circle one)
Secondary Phone Number:______(cell, work, home - circle one)
Name: ______
Relationship to Child______
Primary Phone Number:______(cell, work, home - circle one)
Secondary Phone Number:______(cell, work, home - circle one)
GENERAL HEALTH INFORMATION
1.Has your child had any serious illness/injury/surgery in the past year? Circle one: YES or NO
If yes, please explain: ______
______
2. Does your child have any allergies or special dietary needs? Circle one: YES or NO
If yes, please explain: ______
* Please note: CAS welcomes all children, but due to the nature of the Camp program, it may be difficult to accommodate those with severe nut and wheat allergies.
3. Is your child currently taking any medications? Circle one: YES or NO
Please list medications______
4. Does your child have any special needs that we should be aware of? Circle one: YES or NO
If yes, please explain: ______
HEALTH CARE INFORMATION
Name of Child’s Doctor: ______Phone______
Health Insurance Carrier, if any: ______Phone______
Policy Number: ______
WAIVER FOR EMERGENCY TREATMENT:
In case of emergency, if parents/guardians are not available, I hereby authorize Catskill Animal Sanctuary to have my child______treated by a physician and/or admitted to the emergency room of a hospital. BY SIGNING HERE ON THIS WAIVER FOR EMERGENCY TREATMENT, I ALSO CERTIFY THAT I HAVE BEEN FORTHRIGHT IN INFORMING CATSKILL ANIMAL SANCTUARY AND ITS STAFF OF ANY ALLERGIES, ILLNESSES, FOOD SENSITIVITIES OR IMPORTANT HEALTH/WELL-BEING ISSUES MY ENROLLED CHILD HAS.
Signature: ______Date: ______
CAMP QUESTIONS FOR PARENT(S)
1. Has your child attended summer camp before? Circle one: YES or NO
If yes, what camp(s) were attended, and what was your child’s overall experience? ______
______
______
2. Why would you like your child to attend Camp Kindness? ______
______
______
3. How do you hope your child will benefit from Camp Kindness? ______
______
______
______
4. Is there anything else you would like us to know about your child? ______
______
______
______
PHOTO RELEASE FORM
As part of Camp, often the Humane Educators and campers take photos of the day’s activities and interactions - especially pictures of campers with the animal residents. Often these photos are so delightful, they end up in the CAS archive where they are used in various ways, from illustrating stories in our HERD email newsletter, to social media, to fundraising letters, etc. We have included this photo release. Please fill it out and include it with your application.
I (circle one) DO DO NOT authorize CAS and its affiliates to take photographs and videos of my child ______, during Camp Kindness session activities. I give permission and consent that any such photographs as taken, described herein, may be published and used by Catskill Animal Sanctuary.
Signature of Parent/Guardian(s): ______Date:______
CAMP PARTICIPATION WAIVER
Catskill Animal Sanctuary (CAS) acknowledges that your child has voluntarily enrolled in Camp Kindness at Catskill Animal Sanctuary. Property is located at 316 Old Stage Road, Saugerties, New York 12477 (the “Property”). CAS is a working farm. As such, heavy duty farming equipment, live animals, and other such hazards inherent to farming activities exist on the Property and may pose a danger to your child. You, by signing this Release and Waiver of Liability, on behalf of yourself and your child, hereby release and hold harmless CAS and its officers, directors, employees and volunteers from any and all liability resulting from any injury your child may sustain in connection with and arising out of such hazards, or in connection with your child’s participation in the Camp Kindness, or your child’s presence on the Property. You acknowledge that CAS is undertaking no duties with respect to you or your child.
Signature of Parent/Guardian(s): ______Date:______
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Catskill Animal Sanctuary 316 Old Stage Rd, Saugerties, NY 12477
Casanctuary.org 845-336-8447