the summer spot day camp -...

The Summer Spot Day Camp Located at: Rockland Country Day School, 34 Kings Highway Congers, NY

Mailing Address: P.O. Box 115, West Nyack, NY 10994 Phone: (845) 512-8270 FAX: (845) 577-6389 E-mail: [email protected] Max McClintock, Director

From the staff at The Summer Spot Day Camp, we hope you are having a

safe and wonderful year! As we enter our 16th

season, we are looking forward to

our fourth summer in our beautiful summer home, the campus of Rockland

Country Day School in Congers, NY and are expecting another safe, fun-filled,

memorable summer. Please know that our most important goals are:

The safety, emotional and physical well-being of every camper

The importance of all staff being positive role models

Campers making friends

Skill development

Our staff, returning and new, is looking forward to caring for your

children. Conflict resolution, creating positive verbal environments, giving logical

consequences for inappropriate behavior, having realistic, high expectations for

our campers and the importance of positive reinforcement is just part of what we

cover during our week long staff orientations.

Your children can look forward to sports, visual arts, performing arts,

cooking, science/nature, free swim, swim lessons, hobby time, trips, nutritious

snacks, organic juice, ices, outdoor games and play, special events such as color

games, Bill Robinson’s wildlife animals, Macaroni the Clown, overnight trip for

our oldest group, our Annual Family Dinner and Slide Show and more!

Furthermore, this summer we are adding Archery! Archery helps kids improve

focus, patience, self-confidence and is fun!

The following paperwork is enclosed in this enrollment packet:

application, financial agreement, medical consent, parent agreement and

Rockland Lake permission slip (required forms); tutoring, swimming lesson and

homework forms (optional); mailing address, open house and trip list letters.

of 2

Here are some specifics you need to know for the summer of 2015:

The enrollment deadline is Saturday, June 13th

, 2015. There is a

$30.00 per child non-refundable enrollment fee. The total fee from the

Financial Agreement is due in full by the enrollment deadline, June 13th

,

2015.

Lock into last year’s rates---Returning Families Only! To qualify for

our 2014 rates, a one-time payment in full is due by March 13th, 2015. (See page 1 of Financial Agreement for more details)

Early registration discount deadline is April 30th

, 2015. (See page 1 of the Financial Agreement for more details)

If you are registering more than one child, please deduct 10% from any

additional child’s tuition. (See page 3 of Financial Agreement for more details)

Enrollment checklist:

Enrollment packet (required forms)

25% minimum payment of total fee owed (required)

Medical and Immunizations (required by Health Department)

Rockland Lake Permission Slip (required by Health Department)

Sign-up forms (optional)

Important:

Please make sure that all forms and payments are mailed to P.O. Box 115,

West Nyack, NY 10994. Please do not mail to RCDS.

Enrollment packets and a secure space can only be processed when

accompanied with a payment. Payment must be a minimum of 25% of

total fee due.

After we receive a completed enrollment packet and payment, you will

receive a welcome letter and invoice via mail or e-mail within a week.

In order for your child(ren) to attend camp, the total fee due, medical,

immunizations and Rockland Lake Permission Slip must be received

by The Summer Spot Day Camp before the start of camp.

If you have any questions, please call (845) 512-8270, email us at

[email protected] or call our Camp Coordinator, Ashley at

(845) 598-9536. Please visit our website at www.thesummerspot.org and like us

on facebook!

We wish peace and happiness for the whole family!

mailto:[email protected]

http://www.thesummerspot.org/

The Summer Spot Day Camp Phone: (845) 512-8270 FAX: (845) 577-6389 E-mail: [email protected]

Max McClintock, Director

Page 1 of 3

Summer 2015 Application

(One enrollment packet per child, please print clearly)

Child’s Name Nickname Sex

Address Birth date

City State _____________ Zip

Age as of 6/29/15 Grade as of 9/15

Mother’s Name Home Phone: ____________ (Guardian’s)

Employer Work Phone:

Cell phone: ___________________ E-Mail Address: __________________________ (Please Print Clearly)

Father’s Name Home Phone: ____________ (Guardian’s)

Employer Work Phone:

Cell phone: ________________ E-Mail Address: __________________________ (Please Print Clearly)

T-shirt – please check appropriate size:

Youth Sizes: small___ medium___ large ___

Adult Sizes: small___ medium___ large___ XL___ XXL___

Are there other children in the family attending The Summer Spot?

Name ______________________________________ Age Grade

Name ______________________________________ Age Grade

Name ______________________________________ Age Grade

of 3

Please check the appropriate block of time that your child will be attending

The Summer Spot Day Camp:

Basic Day: (8:30AM– 4:00 PM)

6 weeks: June 29th

– August 7th

____

5 weeks: -OR- 4 weeks:

(You may choose any 5 weeks) (You may choose any 4 weeks)

______ June 29 - July 3

______ June 29 - July 3

______ July 6 - July 10 ______ July 6 - July 10



______ July 27 - July 31 ______ July 27 – July 31

______ Aug. 3 - Aug. 7 ______ Aug. 3 - Aug. 7

If you choose to send your child(ren) to The Summer Spot’s Breakfast Program and/or

After Care Program, in addition to the basic day, please check the weeks that your child

will need this extended time:

*Please note, enrolling in either program requires you to drop off and/or pickup by car*

Breakfast Program After Care Program

(7:30 – 8:30 am) (4:00 – 6:30 pm)

______ June 29 - July 3

______ June 29 - July 3




______ July 27 - July 31 ______ July 27 – July 31

______ Aug. 3 - Aug. 7 ______ Aug. 3 - Aug. 7

How did you hear of The Summer Spot Day Camp?

________________________________________________________________________

________________________________________________________________________

of 3

Is there anything about your child’s health that the staff should know (medications needed,

allergies, insect bite sensitivity, special needs, limitations on activities, etc.)?

Is there anything about your child’s emotional/social life that you think would help us in

getting to know and understand her/him?

________________________________________________________________________

________________________________________________________________________

Please tell us any special interests that your child has.

_______________________________________________________________________

________________________________________________________________________

Do we have your permission to use your child’s photograph in publicity for The Spot?

Yes, with name ______ Yes, without name _______ No _______

Parent Signature: ____________________________________ Date: _______________



Page 1 of 1

2015 Parent Consent for Medical Treatment

I/We, ____________________________________and______________________________

(Mother/guardian signature) (Father/guardian signature)

give permission for our child ________________________________________________ to have

emergency treatment or other treatment deemed necessary at Nyack or Good Samaritan Hospital

or other medical facility.

Please print:

Name of Parent(s):

________________________________________________________________________

Mother’s home phone: _______________________ Work phone: ____________________

Cell Phone: _____________________

Father’s home phone: ________________________ Work phone: _____________________

Cell phone: _____________________

Emergency Contacts (in addition to parent/guardian)

Name ________________________________________ Home phone: ______________

Work phone: _________________ Cell: ____________ Relationship to child: ____________

Name ________________________________________ Home phone ______________

Work phone: _________________ Cell: ____________ Relationship to child: _____________

Child’s Physician ________________________________ Phone: ___________________

Child’s Dentist __________________________________ Phone: ___________________

Allergies to drugs, other medical conditions that affect treatment:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

The Summer Spot Day Camp Phone: (845) 512-8270 FAX: (845) 577-6389 E-mail:[email protected]


Rockland Lake Permission Slip

(Please sign and return with enrollment packet)

I, ___________________________________________ give my child(ren)

__________________________________________________________________

permission to swim with The Summer Spot Day Camp at Rockland Lake South

Pool in 2015 on the following days: 6/30, 7/2. 7/7, 7/9, 7/17, 7/21, 7/24, 7/28,

7/30, 8/5, 8/6.

On each of the above mentioned dates, campers and staff will be leaving Rockland

Country Day School at approximately 10:00AM and returning by approximately

3:00PM.

We will be transported to and from the pool by bus (Student Bus Company).

Signature:_________________________________ Date:__________________



Page 1 of 4

2015 FINANCIAL AGREEMENT (This form must be filled out and signed for each child enrolling)

Child’s Name ________________________________________________________

Parent’s (Guardian’s) Name______________________________________________

Enrollment Fee: $30 non-refundable per child enrollment fee.

Lock into last year’s rates---Returning Families Only!

To qualify for our 2014 rates, a one-time payment in full is due by March 13th

, 2015.

The Summer Spot’s 2014 Fees:

For the Basic Day ONLY (8:30am – 4:00pm) I agree to pay:

6 weeks $1,350 ________ 5 weeks $1,175 ________ $4 weeks $980 ________

Breakfast Program (7:30am – 8:30am) I agree to pay:

6 weeks $120 ________ 5 weeks $100________ 4 weeks $80 _________

Aftercare Program (4:00pm – 6:30pm) I agree to pay:

6 weeks $240 ________ 5 weeks $200 ________ 4 weeks $160 _________

**Early Enrollment Discount**

If you pay in full by April 30th

2015, deduct the following amount per child:

6 weeks $50_____ 5 weeks $40 _____4 weeks $30 _____

(If The Summer Spot does not receive the completed enrollment forms and total amount due by April 30th 2015, the

discount will not be applied and any balance resulting must be paid by the enrollment deadline.)

-over-

of 4

The Summer Spot’s 2015 Fees:

For the Basic Day ONLY (8:30am – 4:00pm) I agree to pay:

6 weeks $1,400 ________ 5 weeks $1,225 ________ $4 weeks $1030 ________

Breakfast Program (7:30am – 8:30am) I agree to pay:

6 weeks $150 ________ 5 weeks $125________ 4 weeks $100 _________

Aftercare Program (4:00pm – 6:30pm) I agree to pay:

6 weeks $270 ________ 5 weeks $225 ________ 4 weeks $180 _________

Bus Service (Please contact The Summer Spot to see if bus service is available in your area)

*Please remember you must drop off/pick up by car if signing up for the Breakfast and/or After

Care Programs.*

Bus service IS available if you are…

o Enrolling for our Basic day only (AM and PM bus service offered)

o Enrolling for the Basic day and the Breakfast program (PM bus service offered)

o Enrolling for the Basic day and the Aftercare program (AM bus service offered)

Bus (please check one):

AM and PM bus service: 6 weeks $270 ____ 5 weeks $225 ____ 4 weeks $ 180____

AM bus service only: 6 weeks $150 ____ 5 weeks $125 ____ 4 weeks $100 ____

PM bus service only: 6 weeks $150 ____ 5 weeks $125 ____ 4 weeks $100 ____

*If this application is for an additional child, apply a 50% discount to above fees*

Please total all financial agreement fees/discounts for total amount due

Enrollment fee ($30): $____________

Basic Day: $____________ (2014 rate) $____________ (2015 rate)

Breakfast Program: $____________ (2014 rate) $____________ (2015 rate) (please leave blank if n/a)

Aftercare: $____________ (2014 rate) $____________ (2015 rate) (please leave blank if n/a)

Homework Time: $ ____________ (please leave blank if n/a)

Tutoring: $ ____________ (please leave blank if n/a)

Bus fee: $____________ (please leave blank if n/a)

April 30th

Early

Enrollment Discount: $ ____________ (please leave blank if n/a)

Sibling Discount (10%):$ ____________ (please leave blank if n/a)

Total Fee Due: $ _____________

of 4

I understand that:

The enrollment deadline is June 13h, 2015.

The total fee is due by June 13th

, 2015.

The total fee must be paid in full by the enrollment deadline in order for my child

to attend The Summer Spot Day Camp.

The Summer Spot must receive my child’s medical form and immunizations

before his or hers first day of camp in order to attend.

Written notification of withdrawal must be received at The Summer Spot’s

mailing address on or before the dates listed below in order for me to be

given a refund:

100% refund if written notification is received on or before June 13th

, 2015.

50% refund if written notification is received between June 14th

, 2015 and

June 21st, 2015.

25% refund if written notification is received between June 22nd

, 2015 and

June 28th

, 2015.

No refunds for withdrawal/change after June 29th

, 2015. If I withdraw my

child(ren) on or after June 29th

, 2015 because of a medical emergency, I will

receive a pro-rated refund. The Summer Spot must receive an official letter from

a physician explaining my child’s medical condition within 7 days of my child’s

withdrawal in order for me to receive the refund.

The Summer Spot charges $35 for checks returned by the bank for insufficient

funds.

There is no refund/credit for absences.

There is a 10% sibling discount. The discount is to be taken on each additional

child’s fee, not the combine total of all fees. Discount to be applied to the lesser of

any sibling fees, if applicable and does not include the enrollment fee.

Any outstanding account, after verbal and written attempts by the The Summer

Spot Day Camp to receive payment owed, will be forwarded to a collection

agency. Any costs that The Summer Spot Day Camp incurs as a result will be

added to the outstanding balance which in total is owed by the undersigned.

Parent Signature ____________________________ Date _______________________

of 4

The Summer Spot Day Camp 2015 Payment Agreement Form

(Please fill out this form)

Mailing Address: _____________________________________________________________

_____________________________________________________________

Phone: ( ) _____________________________________________________________

I understand that my child’s spot in camp will be secured upon The Summer Spot Day

Camp receiving a minimum payment of 25% of the total fee due. Total enrollment fee

must be paid in full by the enrollment deadline Saturday, June 13th

, 2015.

*Reminder*

1. The first payment must be at least 25% of the total fee owed.

2. If you choose to create a payment plan, please include all checks, post-dated and make sure

the dates on checks coincide with the date to be deposited listed below.

3. To qualify for our 2014 rates, a one-time payment in full is due by March 13, 2015.

4. To qualify for our Early Enrollment Discount, the total fee is due by April 30th, 2015.

Total Fee Due $___________________

Check here to make a one-time payment (paying in full only):

Check/Cashier’s Check/MO # _____________________________________

(We accept credit cards. Please fill out Credit Card Authorization Agreement form.)

Check here to create a payment schedule:

(Checks must be paper clipped to this form. All payments are due by the enrollment deadline,

June 13th, 2015).

Date to be deposited ___/ ___/ ____ Amount: $____________ Check #: _______________



____________________________________ __________________________

SIGNATURE DATE

The Summer Spot Day Camp PH: (845) 512-8270 Mailing Address: P.O. Box 115, West Nyack, NY 10994

FAX: (845) 577-6389 E-mail: [email protected] Max McClintock, Director

***If you have any changes to your credit card account, i.e. expired date, new account number, etc., please

notify The Summer Spot Day Camp immediately. Page 1 of 1

Summer 2015 Credit Card Authorization Agreement (To pay with your credit card, please complete and submit this form with your enrollment packet.)

Camper Name(s): ____________________________________________________________________

CREDIT CARD TYPE: ___Visa ___Master Card ___Discover ___American Express

CREDIT CARD NUMBER: ____________________________________________________________

CARD CV2 #/AUTHORIZATION CODE: ___________________ (Last 3 digits in the signature box on

the back of your Visa, MasterCard or Discover. American Express puts the 4 digit number on the front of the card

above the credit card account number.)

EXPIRATION DATE: ____________________

NAME ON CARD (As it appears on card):

___________________________________________________________

BILLING ADDRESS: _____________________________________________________________________________________________

_____________________________________________________________________________________________

E-MAIL ADDRESS: __________________________________________ PHONE NUMBER: ___________

Total Enrollment Fee Owed: $___________________

Total Credit Card Fee Owed (2.75% per swipe or 3.15% plus 15 cents if manually entered of

total enrollment fee. Please call us at 845-598-9536 if you would like to swipe your card):

$______________

Check here to make a one-time payment and have The Summer Spot Day Camp charge

your credit card upon receipt of enrollment packet.

Check here to make a one-time payment:

Date to be charged ___/ ___/ ____ (No later than 6/13/2015)

I authorize The Summer Spot Day Camp to charge my credit card as listed above for the amount

shown.

SIGNATURE ______________________________________ DATE ___________________



2015 Summer Spot Day Camp Parent Agreement

I will be picking up my child from The Summer Spot Day Camp or designated bus stop and

assume full responsibility for his/her transportation at that time. The following people, other

than the parents/legal guardians, have permission to pick up my child:

Name & Relation ______________________________________________________________

Cell #___________________ Home # ________________ Work # ________________

Name & Relation ______________________________________________________________

Cell #___________________ Home # ________________ Work # ________________

Name & Relation ______________________________________________________________

Cell #___________________ Home # ________________ Work # ________________

I understand that:

Children must function consistently within our basic guidelines for behavior.

The Summer Spot’s Bottom Line Rules are: to respect the school, The Summer Spot’s

and other people’s bodies and possessions, stay within the areas designated for them, zero

tolerance for teasing, keep hands and feet to themselves-no fighting and cooperate with

the staff’s instructions. Please understand that children must be able to adhere to The

Summer Spot’s Bottom Line Rules in order to participate in the camp.

I am responsible for the total enrollment fee.

I will notify the staff at The Summer Spot whenever my child will be absent (you can call

845-200-0918 or 845-598-9536).

I understand that if my child is NOT enrolled in The Summer Spot’s Breakfast

Program and/or After Care Program, and is not registered for bus service, I must

drop off my child at The Summer Spot no earlier than 8:30am and pick up my child

no later than 4:00pm.

Late fines will be: (for pick-up at camp or the bus more than five minutes late) $5.00 for

the first ten minutes and $5.00 for each ten minutes thereafter. Fines are to be paid

in cash directly to the staff person who waited with your child on the day of the

lateness.

Please know, parents are encouraged to visit The Summer Spot Day Camp at any

time.

Date: ________________ Parent Signature: _______________________________________

the summer spot day camp -...

Documents