Thank you for choosing Bruster’s Real Ice Cream of Ingomar’s
Summer Day Camp! Below, you will find the itinerary of all the fun and educational activities we plan to do with your child! These will be lead by Pennsylvania Certified Teacher and/or experiencedCampCounselors and Directors!
Day 1
- CampCounselor will await your arrival at the entrance of the Bruster’s of Ingomar front door in order to facilitate accurate and convenient sign-in procedures for your kids to ensure their safe arrival.
- While we await the arrival of others, Kids will enjoy ice-cream-themed activity pages from the Bruster’s Real Ice Cream webpage activity section. They will also do a small craft.
- Ice cream making activity: Your kids will learn and help to make Birthday Cake Ice Cream, and Cotton Candy Explosion! They will then get to enjoy a kids’ sized sundae with the flavors they made, and get to choose toppings to go with them! Please facilitate this activity for your child by pulling back any long hair and having them wear high-traction, closed-toed shoes and short-sleeved shirts. Your child will be given a Bruster’s official tee to wear and keep!
- These indoor activities will be followed by burning some energy in the sun, as the kids will enjoy jump-roping, hoola-hooping, sidewalk chalk drawing, Bruster’s corn hole, hackie sack tic tac toe, and more (Oldest age group will play dodge ball)!
- Back inside to start our Measurement Robot made of our cups, pints, quarts, and half gallon containers! We’ll learn measurement conversions – THE FUN ICE CREAM WAY!
- CampCounselor will await your arrival at the entrance of the Bruster’s of ingomar front door with your child in order to facilitate accurate and convenient sign-out procedures to ensure safe departure.
Day 2
- CampCounselor will await your arrival at the entrance of the Bruster’s of Ingomar front door in order to facilitate accurate and convenient sign-in procedures for your kids to ensure their safe arrival.
- While we await the arrival of others, Kids will enjoy ice-cream-themed activity pages from the Bruster’s Real Ice Cream webpage activity section. They will also do a small craft.
- Waffle cone and waffle bowl making activity: Your kids will learn and help to make Bruster’s waffle cones and waffle bowls. They will then get to enjoy their waffle bowl with a kid-sized portion of vanilla ice cream and sprinkles. Please facilitate this activity for your child by pulling back any long hair and having them wear high-traction closed-toed shoes and short-sleeved shirts.
- These indoor activities will be followed by burning some energy in the sun, as the kids will enjoy blowing bubbles and guided chalk drawing activities (Oldest age group will enjoy Football Obstacle course sponsored by Pittsburgh Passion).
- Back inside to continue our Measurement Robot made of our cups, pints, quarts, and half gallon containers! We’ll learn measurement conversions – THE FUN ICE CREAM WAY!
- CampCounselor will await your arrival at the entrance of the Bruster’s of ingomar front door with your child in order to facilitate accurate and convenient sign-out procedures to ensure safe departure, and send your kids off with a smile!
Day 3
- CampCounselor will await your arrival at the entrance of the Bruster’s of Ingomar front door in order to facilitate accurate and convenient sign-in procedures for your kids to ensure their safe arrival.
- While we await the arrival of others, Kids will enjoy ice-cream-themed activity pages from the Bruster’s Real Ice Cream webpage activity section. They will also do a small craft.
- Cake making and decorating activity: Your kids will learn and to make their very own Bruster’s Birthday Ice Creammini cakes, and they will help to decorate one, and get to eat it, too! Please facilitate this activity for your child by pulling back any long hair and having them wear high-traction closed-toed shoes and short-sleeved shirts.
- These indoor activities will be followed by burning some energy in the sun, as the kids enjoy playing water balloon games. Please have your child wear a bathing suit underneath their clothes that day, and also bring a towel(Oldest age group will do Zumba with D-Fit by Deawna)!
- Your kids will receive their official “I Helped to Make Bruster’s Real Ice Cream” badge stickers! They will finish they Measuremnts Robot and place it outside for customers to vote on. (Announced within a week) The winning camp session will get free cone cards.
- CampCounselor will await your arrival at the entrance of the Bruster’s of ingomar front door with your child in order to facilitate accurate and convenient sign-out procedures to ensure safe departure, and send your kids off with a smile!
Bruster’s Real Ice Cream of Ingomar
Summer Day Camp
REGISTRATION FORM
Child’s name: ______
Today’s Date ______
Birth date: ______Grade: ______School: ______
Address: ______
City: ______State ______Zip: ______Phone: ______
PARENT INFORMATION:
?Father �Male Guardian If Guardian, relationship to child: ______
Name: ______
Address: ______Email______
Home Phone ______Work Phone ______
?Mother �Female Guardian If Guardian, relationship to ______
Name: ______
Address:______
Home Phone ______Work Phone ______
With whom does the child live? ______
Child may be taken home by: ______
Names of Individuals who may take child home besides Parent or Guardian ______
?Child may walk home: ______
Parent or Guardian’s Signature
To what address should information be mailed? ______
HEALTH RECORD
Date of last tetanus shot: ______Any active reaction? ______
Check if child has had the following and give details below:
?Heart Trouble �Epilepsy �Asthma �Diabetes �Allergies �Rheumatic Fever
Details: ______
Child’s Name: ______
EMERGENCY NUMBERS (If we are unable to reach a parent or legal guardian, we will call one of these numbers.)
1. Name: ______Phone: ______
2. Name: ______Phone: ______
GENERAL SUMMER CAMP WAIVER
I, the under signed parent/guardian of______do hereby consent to his/her participation in Bruster’s Real Ice Cream Summer Camp.
I acknowledge that participation in this camp may expose the above named camper to the possibility of injury. I grant Bruster’s Real Ice Cream of Ingomar’s Summer Camp Staff the authority to obtain emergency medical treatment as necessary to ensure that the above named camper is safe from further injury.
In consideration of Bruster’s Real Ice Cream of Ingomar (Legal Name: Creamery Management or Don’s Creamery), I agree to waive and release Bruster’s Real Ice Cream of Ingomar (Legal Name: Creamery Management or Don’s Creamery) from all claims for damages that may arise, other than by negligence of Bruster’s Real Ice Cream of Ingomar Summer Camp, its employees and agents, as a result of my child’s participation in its Summer Camp.
MEDIA WAIVER
I am aware that the above named camper may appear in a photograph or video taken by camp staff or local media and that photograph or video may appear in a variety of media sources on behalf of Bruster’s Real Ice Cream. Bruster’s Real ice Cream will not divulge your camper’s name without written permission.
I acknowledge and confirm that I have read this entire document prior to signing below.
______
Parent/ Guardian (Please Print)Signature of Parent/ Guardian
______
DateSignature of Witness
Bruster’s Real Ice Cream of Ingomar
Summer Day Camp
- Camp hours are as follows. Please check your desired session:
July 16, 17 and 18 – Ages 4 to 6 – 9:00 a.m. to 11:30 a.m.______
July 16, 17 and 18 – Ages 7 to 9 – 1:00 p.m. to 3:30 p.m.______
July16, 17 and 18 – Ages 10 & up – 4:00 p.m. to 6:30 p.m.______
August 6, 7 and 8 – Ages 4 to 6 – 9:30 a.m. to 11:30 a.m.______
August 6, 7 and 8 – Ages 7 to 9 – 1:00 p.m. to 3:30 p.m.______
August 6, 7 and 8 – Ages 10 & up – 4:00 p.m. to 6:30 p.m.______
- Tuition is due two weeks prior to the beginning of your summer camp session by check, cash, or credit.
Because supplies are purchased in advance based on registration numbers, refunds are not available.
Tuition information: Early bird special - attendants who e-mailed or called for an application packet before May 2nd secured a low-cost tuition of just $75 per child!
Other applicants get to attend the camp for $160 per child, but applying the Val Pak or Living Social specials brings down the price to just $80.00!
Families with multiple children get a discount of $5 off tuition fee per extra child. Unfortunately, this discount is not available through Living Social.
PARENTS: Please pay directly to a staff member. It is better not to give the money to your child to hand us.
3.We will follow the North Allegheny County School System’s decision on closings due to inclement weather.
4. A two week notice needs to be given if you plan on removing your child from our program. That gives us time to fill the spot. We run our budget based on the number of children we have. There are no refunds given for missed days, special occasions, or sickness.
5. No child will be allowed to leave the camp with anyone other than his/her parent/guardian without advanced written permission from parent/guardian.
6. We strongly discourage a child bringing money. We will not be responsible for lost money, games or other personal items brought to after school.
7. Staff is not allowed to dispense any medication to children except basic first aid. The child is responsible for taking his/her own medicine. Parent/guardian must notify Bruster’s Real Ice Cream of Ingomar of child taking medicine. Medicine must be labeled clearly with child’s name, name of medication and dosage level.
8. We cannot tolerate unruly or disruptive behavior from any of the children. If any child becomes a discipline problem, he/she may be subject to dismissal from our program. Parents/guardians are expected to work with the staff in the discipline of their children. Depending on the severity of the incident, a child can (a) be given a verbal warning, (b) be placed in time-out, (c) have an activity taken away, (d) be dismissed from the program.
9.A short list of disciplinary problems would be, cursing, theft, defacing property, fighting, disrespect of volunteers and staff, inappropriate contact between boys and girls, aggressive behavior and leaving the property or group without permission.
10.Proper attire must be worn. Please have long hair pulled up into a pony tail. We will provide a an official Bruster’s tee shirt that can be worn so that your child’s regular clothing does not get stained from the ice cream activities. Please also have your child wear closed-toed shoes with good traction, such as sneakers or tennis shoes.
11.As a food establishment, we are required to abide by health department standards and cannot allow children with head lice, fever, vomiting, diarrhea pink eye, or obvious signs of sickness to attend the program until symptoms and, or evidence of problematic conditions are abated.
12.Unfortunately, if a child is picked up late, a charge of $10.00 per child is assessed and must be paid by the end of camp.
15. Returned checks have a $37.00 service charge. After the 1st NSF check has been received, only cash will be accepted.
16.Please notify Bruster’s of Ingomar if your child will not be attending the day’s summer camp, so that your child can be accounted for.
17.Attendance is kept and checked daily. If there is an unexplained absence, a staff member will call the parent.
18.The summer camp is open to ALL children who may benefit from our type of program regardless of race, creed, sex, religion, or nationality. We guarantee placements in our program only if we have your child’s registration form, health information, emergency information, conduct agreement and registration fee. The above applies as long as there are openings available. If there are no spaces available, a child may be put on the waiting list.
I, ______have read the above Rules and Regulations and agree to have my child(ren) abide by them.
______
Parent/Guardian Signature Date
Bruster’s Real Ice Cream of Ingomar
9600 Perry Highway
Pittsburgh, PA15237
_____Initials 1. General Release of Liability:
(Application is not considered complete unless signed below and each point initialed) In consideration of being allowed to participate in any way in Bruster’s Real Ice Cream of Ingomar Summer Camp, and related events, the undersigned agrees to:
I acknowledge and fully understand that each participant will be engaging in activities that may involve risk or serious injury, including permanent disability and severe social and economic losses, which might result not only from their actions, inactions or negligence, but the actions, inactions or negligence of others, the rules of play, or the condition of the premises, or of any equipment used. Further, that there may be risks not known to us or not reasonably foreseeable at this time. To the best of my knowledge, my daughter/son is physically fit to engage in the summer camp activities. Bruster’s Real Ice Cream of Ingomar and their employees and agents will exercise reasonable care while my daughter/son is in their custody and care engaging in activities. Bruster’s Real Ice Cream of Ingomar and their employees and agents are held harmless from any and all liability, which may arise while exercising their duty of care, relating to my daughter/son for personal injury or illness that may be suffered or any loss of property that may occur to my daughter/son while participating in the Program.
_____Initials 2. Authorization for Emergency care:
In case of accidental injury or serious illness, and Bruster’s is unable to reach me, The Carpenter’s Shop may make whatever arrangements necessary to provide medical care and treatment for my child.
_____Initials 3. Photo/Media Release:
I acknowledge and understand that publicity activities such as interviews, photos and videotaping may occur. I consent and permit my child, as a participant in Bruster’s Programs and events to be photographed, videotaped, and/or interviewed for publicity activities.
I have read, understand and consent to the above 5 release statements.
______
Youth’s Name (Print Full Name)
______
Parent/Guardian Name (Print) Signature Date
MEDICAL RELEASE Parent’s or Guardian’s Authorization for adult in charge to consent to
medical or dental treatment of minor child.
The undersigned ______(Parent or Guardian) who resides at ______, city of ______, state of ______, and who is a parent or legal guardian of ______, a minor, age ______, born ______, who resides at ______,
city of ______, state of ______herein authorizes the adult sponsor of Bruster’s Real Ice Cream of Ingomar to consent to any x-ray, examination, anesthetic, medical or surgical supervision and on the advice of any physician or surgeon licensed to practice in the state ofPennsylvania, when the need for such treatment is immediate, and when efforts to contact meare unsuccessful.
Dated this ______day of ______, Year ______
______
Signature of Parent or Guardian
Family physician’s name, address, and phone: ______
Is there any further information that might help us better care for your child?
______
Bruster’s Real Ice Cream of Ingomar
Summer Day Camp
Pickup Policy:
When it's time to go homeour number one concern is the safety of your child. We ask that you understand that the staff should not have to stay late waiting for a child to be picked up after the program.
1. Person picking up a student must be at least 18 years old, show identification and their name MUST BE on the authorized pick-up list. (We will not let a child leave with any person whose name is not on the list.)
2. All youth will be signed out on the sign-out sheet
______
Parent SignatureBruster’s Real Ice Cream Camp Director
Date: ______Date: ______
Adults eligible to pick up your child
1)
2)
3)