Required Weekly Fee $40

Field Trips (Additional/optional Fee)

YOUTH SUMMER Week 1 ● JUNE 13-17

Total: _________

Date: _____/_____/2016 Entered By:___________ Cash Credit Card Check

Office Use Only

Parent/Guardian Signature ______________________________ By signing above, I agree that I have read this form in its entirety and agree to adhere to the rules set forth by BGCTM.

Tuesday Movies 11:00am-5:00pm Angry Birds—Time TBD

$8

Wednesday Fun Quest & Laser Tag 1:00pm-5:00pm

$10

One Sign Up Sheet Per Member

Member First and Last Name ___________________________________________

Current Phone Number ________________________________________________

Date of Birth _________________________________________________________

· In consideration of my child’s membership and participation in the activities, special programs and/or special events of the Boys & Girls Club, I hereby fully waive, release, and hold harmless the Boys & Girls Club, together with all its agents, employees, representatives, officers, and directors from any and all claims, causes of actions, damages, costs, expenses, and other liabilities in any way arising out of or resulting from such membership or participation, including, but not limited to, any personal injury, accident, illness, property damages or any loss, injury or harm of any nature whatsoever. · I attest and verify that I have full knowledge of any and all risk involved in such membership and participation, and that I will, on behalf of the named member(s), assume full responsibility for such risks and pay any and all medical, emergency, and other costs and expenses in the event of injury, accident, illness, casualty or other incapacity regardless of whether I have authorized such expenses. I acknowledge that my child is in good health, physically fit, and sufficiently trained to participate in membership and in programs, activities, and events of the Boys & Girls Club.

Thursday Coconut Bowling 1:00pm-5:00pm *Lemmon & Bresson sites only*

Socks required

Summer Break 2016

Program Reminders Hours of Operation: 7:00am-6:00pm. Children must be picked up by closing time. There is no grace period. Refunds or credits will not be issued for suspensions of any kind. All field trips fees must be paid by closing on the Friday prior to the trip. Weekly fee is required; field trips are optional. Field trip box on form must be marked for child to attend the field trip. Membership cards must be presented to attend field trips. Field trip shirts must be worn for designated outings. All field trips leave after lunch and return by 5:00pm unless stated otherwise.

$6

Monday Traner Pool 1:00pm-5:00pm Swimsuit, towel, sunscreen required

$3

Expedition

Africa

Week

On Friday,

Dress as your

favorite animal

or in safari gear.

Week 1 Specialty Camps

Robotics, Swim Lessons, and Junior Giants Baseball!

See your Membership Staff or Site Coordinator for more information and to sign up!

Bresson Avenue Facility ● 229-9538 Lemmon Valley Facility ● 622-0040

Neil Road Facility ● 229-9538

Thursday Nevada Bugs & Butterflies 1:00pm-5:00pm *Neil Road site only* First come, first served. 30 max.

$3

Required Weekly Fee $40

Field Trips (Additional/optional Fee)

YOUTH SUMM

ER Week 2 ● JUN

E 20-24

Total: _________

Date: _____/_____/2016 Entered By:___________ Cash Credit Card Check

Office Use Only

Parent/Guardian Signature ______________________________ By signing above, I agree that I have read this form in its entirety and agree to adhere to the rules set forth by BGCTM.

Tuesday Movies 11:00am-5:00pm Through the Looking Glass -Time TBD

$8

Wednesday Traner Pool 1:00pm-5:00pm Swimsuit, towel, sunscreen required

$3

One Sign Up Sheet Per Member

Member First and Last Name ___________________________________________

Current Phone Number ________________________________________________

Date of Birth _________________________________________________________

· In consideration of my child’s membership and participation in the activities, special programs and/or special events of the Boys & Girls Club, I hereby fully waive, release, and hold harmless the Boys & Girls Club, together with all its agents, employees, representatives, officers, and directors from any and all claims, causes of actions, damages, costs, expenses, and other liabilities in any way arising out of or resulting from such membership or participation, including, but not limited to, any personal injury, accident, illness, property damages or any loss, injury or harm of any nature whatsoever. · I attest and verify that I have full knowledge of any and all risk involved in such membership and participation, and that I will, on behalf of the named member(s), assume full responsibility for such risks and pay any and all medical, emergency, and other costs and expenses in the event of injury, accident, illness, casualty or other incapacity regardless of whether I have authorized such expenses. I acknowledge that my child is in good health, physically fit, and sufficiently trained to participate in membership and in programs, activities, and events of the Boys & Girls Club.

Thursday Roller Kingdom 1:00pm-5:00pm Socks required

Summer Break 2016

Program Reminders Hours of Operation: 7:00am-6:00pm. Children must be picked up by closing time. There is no grace period. Refunds or credits will not be issued for suspensions of any kind. All field trips fees must be paid by closing on the Friday prior to the trip. Weekly fee is required; field trips are optional. Field trip box on form must be marked for child to attend the field trip. Membership cards must be presented to attend field trips. Field trip shirts must be worn for designated outings. All field trips leave after lunch and return by 5:00pm unless stated otherwise.

$7

Monday Wild Waters- Ages 9-12 only 10:00am-5:00pm Swimsuit, towel, sunscreen required

$15

Week 2 Specialty Camps Rocket Build, Art Explorers, Science Camp, Cheerleading Camp, Swim Lessons, Pack Leaders Camp, and Junior Giants Baseball!

See your Membership Staff or Site Coordinator for more information and to sign up!

Keepin’ it Country Week

On Friday, Dress in your rodeo

gear.

Bresson Avenue Facility ● 229-9538 Lemmon Valley Facility ● 622-0040

Neil Road Facility ● 229-9538

$40

●

Total: _________

Date: _____/_____/2016 Entered By:___________ Cash Credit Card Check

Office Use Only

Parent/Guardian Signature ______________________________ By signing above, I agree that I have read this form in its entirety and agree to adhere to the rules set forth by BGCTM.

Tuesday Reno Aces Game 11:00am-5:00pm

$8

Wednesday Paradise Cove Fun Center 1:00pm-5:00pm

$14

Member First and Last Name ___________________________________________

Current Phone Number ________________________________________________

Date of Birth _________________________________________________________

· In consideration of my child’s membership and participation in the activities, special programs and/or special events of the Boys & Girls Club, I hereby fully waive, release, and hold harmless the Boys & Girls Club, together with all its agents, employees, representatives, officers, and directors from any and all claims, causes of actions, damages, costs, expenses, and other liabilities in any way arising out of or resulting from such membership or participation, including, but not limited to, any personal injury, accident, illness, property damages or any loss, injury or harm of any nature whatsoever. · I attest and verify that I have full knowledge of any and all risk involved in such membership and participation, and that I will, on behalf of the named member(s), assume full responsibility for such risks and pay any and all medical, emergency, and other costs and expenses in the event of injury, accident, illness, casualty or other incapacity regardless of whether I have authorized such expenses. I acknowledge that my child is in good health, physically fit, and sufficiently trained to participate in membership and in programs, activities, and events of the Boys & Girls Club.

Hours of Operation: 7:00am-6:00pm. Children must be picked up by closing time. There is no grace period. Refunds or credits will not be issued for suspensions of any kind. All field trips fees must be paid by closing on the Friday prior to the trip. Weekly fee is required; field trips are optional. Field trip box on form must be marked for child to attend the field trip. Membership cards must be presented to attend field trips. Field trip shirts must be worn for designated outings. All field trips leave after lunch and return by 5:00pm unless stated otherwise.

Monday Alf Sorenson Pool 1:00pm-5:00pm Swimsuit, towel, sunscreen required

$6

&Rocket Build, Art Explorers, Extreme Team Challenge, Junior Giants,

Club Kids College, Cheerleading Camp, and Swim Lessons! Family Night June 30!

See your Membership Staff or Site Coordinator for more information and to sign up!

Bresson Avenue Facility ● 229-9538 Lemmon Valley Facility ● 622-0040

Neil Road Facility ● 229-9538

Thursday Raceway & Mini Golf 1:00pm-5:00pm *Lemmon & Neil sites only* Socks required

$10

Thursday Nevada Bugs & Butterflies 1:00pm-5:00pm *Bresson site only* First come, first served. 30 max.

$3

Required Weekly Fee $32

Field Trips (Additional/Optional Fee)

Youth

Sum

mer W

eek 4 ●July 4-8

Total: _________

Date: _____/_____/2016 Entered By:___________ Cash Credit Card Check

Office Use Only

Parent/Guardian Signature ______________________________ By signing above, I agree that I have read this form in its entirety and agree to adhere to the rules set forth by BGCTM.

Tuesday Movies 11:00am-5:00pm Finding Dory—Time TBD

$8

Wednesday High Ballocity 1:00pm-5:00pm Socks required

$6

One Sign Up Sheet Per Member

Member First and Last Name ___________________________________________

Current Phone Number ________________________________________________

Date of Birth _________________________________________________________

· In consideration of my child’s membership and participation in the activities, special programs and/or special events of the Boys & Girls Club, I hereby fully waive, release, and hold harmless the Boys & Girls Club, together with all its agents, employees, representatives, officers, and directors from any and all claims, causes of actions, damages, costs, expenses, and other liabilities in any way arising out of or resulting from such membership or participation, including, but not limited to, any personal injury, accident, illness, property damages or any loss, injury or harm of any nature whatsoever. · I attest and verify that I have full knowledge of any and all risk involved in such membership and participation, and that I will, on behalf of the named member(s), assume full responsibility for such risks and pay any and all medical, emergency, and other costs and expenses in the event of injury, accident, illness, casualty or other incapacity regardless of whether I have authorized such expenses. I acknowledge that my child is in good health, physically fit, and sufficiently trained to participate in membership and in programs, activities, and events of the Boys & Girls Club.

Thursday Fun Quest and Laser Tag 1:00pm-5:00pm

Summer Break 2016

Program Reminders Hours of Operation: 7:00am-6:00pm. Children must be picked up by closing time. There is no grace period. Refunds or credits will not be issued for suspensions of any kind. All field trips fees must be paid by closing on the Friday prior to the trip. Weekly fee is required; field trips are optional. Field trip box on form must be marked for child to attend the field trip. Membership cards must be presented to attend field trips. Field trip shirts must be worn for designated outings. All field trips leave after lunch and return by 5:00pm unless stated otherwise.

$10

Monday Closed Happy Independence Day

Week 4 Specialty Camps Swim Lessons

See your Membership Staff or Site Coordinator for more information and to sign up!

Party in the USA Week

On Friday, dress in red, white and blue.

Bresson Avenue Facility ● 229-9538 Lemmon Valley Facility ● 622-0040

Neil Road Facility ● 229-9538

Required Weekly Fee $40

Field Trips (Additional/optional Fee)

Youth Summer Week 5 ●July 11

15

Total: _________

Date: _____/_____/2016 Entered By:___________ Cash Credit Card Check

Office Use Only

Parent/Guardian Signature ______________________________ By signing above, I agree that I have read this form in its entirety and agree to adhere to the rules set forth by BGCTM.

Tuesday Movies 11:00am-5:00pm The BFG—Time TBD

$8

Wednesday Paradise Cove Fun Center 1:00pm-5:00pm

$14

One Sign Up Sheet Per Member

Member First and Last Name ___________________________________________

Current Phone Number ________________________________________________

Date of Birth _________________________________________________________

Program Reminders Hours of Operation: 7:00am-6:00pm. Children must be picked up by closing time. There is no grace period. Refunds or credits will not be issued for suspensions of any kind. All field trips fees must be paid by closing on the Friday prior to the trip. Weekly fee is required; field trips are optional. Field trip box on form must be marked for child to attend the field trip. Membership cards must be presented to attend field trips. Field trip shirts must be worn for designated outings. All field trips leave after lunch and return by 5:00pm unless stated otherwise.

Monday Wild Waters- Ages 9-12 only 10:00am-5:00pm Swimsuit, towel, sunscreen required

$15

Week 5 Specialty Camps & Info Robotics, Skate Camp, Equestrian (Horse Riding), Science Camp,

Tennis Camp, and Swim Lessons! Talent show July 15th!

See your Membership Staff or Site Coordinator for more information and to sign up!

Rollin’ Out the Red Carpet Week

Pajama day on

Friday!

· In consideration of my child’s membership and participation in the activities, special programs and/or special events of the Boys & Girls Club, I hereby fully waive, release, and hold harmless the Boys & Girls Club, together with all its agents, employees, representatives, officers, and directors from any and all claims, causes of actions, damages, costs, expenses, and other liabilities in any way arising out of or resulting from such membership or participation, including, but not limited to, any personal injury, accident, illness, property damages or any loss, injury or harm of any nature whatsoever. · I attest and verify that I have full knowledge of any and all risk involved in such membership and participation, and that I will, on behalf of the named member(s), assume full responsibility for such risks and pay any and all medical, emergency, and other costs and expenses in the event of injury, accident, illness, casualty or other incapacity regardless of whether I have authorized such expenses. I acknowledge that my child is in good health, physically fit, and sufficiently trained to participate in membership and in programs, activities, and events of the Boys & Girls Club.

Bresson Avenue Facility ● 229-9538 Lemmon Valley Facility ● 622-0040

Neil Road Facility ● 229-9538

Summer Break 2016

Thursday Discovery Museum 1:00pm-5:00pm *Bresson & Neil sites only* Socks required

$8

Thursday Nevada Bugs & Butterflies 1:00pm-5:00pm *Lemmon Valley site only* First come, first served. 30 max.

$3

Required Weekly Fee $40

Field Trips (Additional/Optional Fee)

Youth

Summer W

eek 6

●Ju

ly 18-

22

Total: _________

Date: _____/_____/2016 Entered By:___________ Cash Credit Card Check

Office Use Only

Parent/Guardian Signature ______________________________ By signing above, I agree that I have read this form in its entirety and agree to adhere to the rules set forth by BGCTM.

Tuesday Roller Kingdom 1:00pm-5:00pm Socks required

$7

Wednesday Alice in Wonderland 11:00am-5:00pm Play for Artown First come, first served. 45 max.

$8

One Sign Up Sheet Per Member

Member First and Last Name ___________________________________________

Current Phone Number ________________________________________________

Date of Birth _________________________________________________________

Thursday Bowling @ GSR 1:00pm-5:00pm Socks required

Summer Break 2016

Program Reminders Hours of Operation: 7:00am-6:00pm. Children must be picked up by closing time. There is no grace period. Refunds or credits will not be issued for suspensions of any kind. All field trips fees must be paid by closing on the Friday prior to the trip. Weekly fee is required; field trips are optional. Field trip box on form must be marked for child to attend the field trip. Membership cards must be presented to attend field trips. Field trip shirts must be worn for designated outings. All field trips leave after lunch and return by 5:00pm unless stated otherwise.

$6

Monday Traner Pool 1:00pm-5:00pm Swimsuit, towel, sunscreen required

$3

Week 6 Specialty Camps Club Kids College, Tennis Camp and Swim Lessons!

See your Membership Staff or Site Coordinator for more information and to sign up!

Nautical by Nature Week On Friday, wear

your flip-flops and

shorts.

· In consideration of my child’s membership and participation in the activities, special programs and/or special events of the Boys & Girls Club, I hereby fully waive, release, and hold harmless the Boys & Girls Club, together with all its agents, employees, representatives, officers, and directors from any and all claims, causes of actions, damages, costs, expenses, and other liabilities in any way arising out of or resulting from such membership or participation, including, but not limited to, any personal injury, accident, illness, property damages or any loss, injury or harm of any nature whatsoever. · I attest and verify that I have full knowledge of any and all risk involved in such membership and participation, and that I will, on behalf of the named member(s), assume full responsibility for such risks and pay any and all medical, emergency, and other costs and expenses in the event of injury, accident, illness, casualty or other incapacity regardless of whether I have authorized such expenses. I acknowledge that my child is in good health, physically fit, and sufficiently trained to participate in membership and in programs, activities, and events of the Boys & Girls Club.

Bresson Avenue Facility ● 229-9538 Lemmon Valley Facility ● 622-0040

Neil Road Facility ● 229-9538

Required Weekly Fee $40

Field Trips (Additional/optional Fee)

Yo

ut

h S

um

me

r W

ee

k 7 ●

Ju

ly

25-

29

Total: _________

Date: _____/_____/2016 Entered By:___________ Cash Credit Card Check

Office Use Only

Parent/Guardian Signature ______________________________ By signing above, I agree that I have read this form in its entirety and agree to adhere to the rules set forth by BGCTM.

Tuesday Movies 11:00am-5:00pm Secret Life of Pets—Time TBD

$8

Wednesday Raceway & Mini Golf 1:00pm-5:00pm

$10

One Sign Up Sheet Per Member

Member First and Last Name ___________________________________________

Current Phone Number ________________________________________________

Date of Birth _________________________________________________________

Thursday High Ballocity 1:00pm-5:00pm Socks required

Summer Break 2016

Program Reminders Hours of Operation: 7:00am-6:00pm. Children must be picked up by closing time. There is no grace period. Refunds or credits will not be issued for suspensions of any kind. All field trips fees must be paid by closing on the Friday prior to the trip. Weekly fee is required; field trips are optional. Field trip box on form must be marked for child to attend the field trip. Membership cards must be presented to attend field trips. Field trip shirts must be worn for designated outings. All field trips leave after lunch and return by 5:00pm unless stated otherwise.

$6

Monday Wild Waters- Ages 9-12 only 10:00am-5:00pm Swimsuit, towel, sunscreen required

$15

Week 7 Specialty Camps Streams & Trails, SMART Girls Camp, and Swim Lessons!

See your Membership Staff or Site Coordinator for more information and to sign up!

Rev Your Engine Week

Crazy hair day on

Friday!

· In consideration of my child’s membership and participation in the activities, special programs and/or special events of the Boys & Girls Club, I hereby fully waive, release, and hold harmless the Boys & Girls Club, together with all its agents, employees, representatives, officers, and directors from any and all claims, causes of actions, damages, costs, expenses, and other liabilities in any way arising out of or resulting from such membership or participation, including, but not limited to, any personal injury, accident, illness, property damages or any loss, injury or harm of any nature whatsoever. · I attest and verify that I have full knowledge of any and all risk involved in such membership and participation, and that I will, on behalf of the named member(s), assume full responsibility for such risks and pay any and all medical, emergency, and other costs and expenses in the event of injury, accident, illness, casualty or other incapacity regardless of whether I have authorized such expenses. I acknowledge that my child is in good health, physically fit, and sufficiently trained to participate in membership and in programs, activities, and events of the Boys & Girls Club.

Bresson Avenue Facility ● 229-9538 Lemmon Valley Facility ● 622-0040

Neil Road Facility ● 229-9538

Required Weekly Fee $40

Field Trips (Additional/Optional Fee)

Youth Sum

mer W

eek 8 ●A

ugust 1-5

Total: _________

Date: _____/_____/2016 Entered By:___________ Cash Credit Card Check

Office Use Only

Parent/Guardian Signature ______________________________ By signing above, I agree that I have read this form in its entirety and agree to adhere to the rules set forth by BGCTM.

Tuesday Movies 11:00am-5:00pm Ice Age: Collison Course—Time TBD

$8

Wednesday Coconut Bowling 1:00pm-5:00pm Socks required

$6

One Sign Up Sheet Per Member

Member First and Last Name ___________________________________________

Current Phone Number ________________________________________________

Date of Birth _________________________________________________________

Thursday Discovery Museum 1:00pm-5:00pm

Summer Break 2016

Program Reminders Hours of Operation: 7:00am-6:00pm. Children must be picked up by closing time. There is no grace period. Refunds or credits will not be issued for suspensions of any kind. All field trips fees must be paid by closing on the Friday prior to the trip. Weekly fee is required; field trips are optional. Field trip box on form must be marked for child to attend the field trip. Membership cards must be presented to attend field trips. Field trip shirts must be worn for designated outings. All field trips leave after lunch and return by 5:00pm unless stated otherwise.

$8

Monday Traner Pool 1:00pm-5:00pm Swimsuit, towel, sunscreen required

$3

Week 8 Specialty Camps Swim Lessons

See your Membership Staff or Site Coordinator for more information and to sign up!

Let the Games Begin...Rio 2016 On Friday, represent your

favorite Olympic country.

· In consideration of my child’s membership and participation in the activities, special programs and/or special events of the Boys & Girls Club, I hereby fully waive, release, and hold harmless the Boys & Girls Club, together with all its agents, employees, representatives, officers, and directors from any and all claims, causes of actions, damages, costs, expenses, and other liabilities in any way arising out of or resulting from such membership or participation, including, but not limited to, any personal injury, accident, illness, property damages or any loss, injury or harm of any nature whatsoever. · I attest and verify that I have full knowledge of any and all risk involved in such membership and participation, and that I will, on behalf of the named member(s), assume full responsibility for such risks and pay any and all medical, emergency, and other costs and expenses in the event of injury, accident, illness, casualty or other incapacity regardless of whether I have authorized such expenses. I acknowledge that my child is in good health, physically fit, and sufficiently trained to participate in membership and in programs, activities, and events of the Boys & Girls Club.

Bresson Avenue Facility ● 229-9538 Lemmon Valley Facility ● 622-0040

Neil Road Facility ● 229-9538