CAMP CALABASAS TEEN PROGRAM SUMMER 2012 REGISTRATION FORMS

Teen _____________________________________________Age_______ Date of Birth________________ Sex______ Father First Name__________________________________ Last Name______________________________ Mother First Name_________________________________ Last Name_______________________________ Home Phone__________________________________ Mother Work___________________________ Mother Cell___________________ Father Work___________________________________ Father Cell ____________________________Alt Number_ ___________________ E-Mail____________________________________________________________________________________________________ Address_________________________________________________ City______________________________ Zip_____________ School Camper Attends____________________________________ Grade of Camper (Starting in September)_______________

Please make your checks out to: LITTLE LEARNERS Method of Payment: Check_____ Cash_____ Credit Card______ Amount Enclosed $____________________________

FOR CREDIT CARDS (VISA or MASTERCARD) PLEASE FILL OUT THE ATTACHED AUTHORIZATION FORM

Check in the box of the date your teen will attend camp. FULL PAYMENT or $100 DEPOSIT required and will be credited to the first days of attendance. FULL WEEKLY PAYMENT DUE UPON ARRIVAL FOR ADDITIONAL DAYS MARKED IN THE BOXES BELOW. ADDITIONAL DAYS CAN BE ADDED IF AVAILABLE. FIVE DAYS WRITTEN NOTICE IS REQUIRED FOR ANY CHANGE IN ATTENDANCE. IF YOU EMAIL YOUR NOTICE YOU MUST GET A REPLY FROM CAMP ACKNOWLEDGING THE NOTICE/IF CALLING YOU MUST SPEAK TO A CAMP DIRECTOR TO MAKE CHANGES Make up days not permitted PLEASE INITIAL HERE THAT YOU UNDERSTAND THE ABOVE INFORMATION______________
JUNE
Mon Tue Wed Thu Fri Mon Tue

JULY
Wed Thu Fri Mon Tue

AUGUST
Wed Thu Fri

18 $75

19$50

20$50 21 $50 22$50

2 $75 3 $50

4 closed 5 $50 11 $50 18 $50 12 $75 19 $50 26 $75

6 $50 13 $50

30 $75 31 $50 1 $50 6 $50 7 $50 8 $50

2 $75 9 $50

3 $50 10 $50

25 $75 26$50 27$50 28 $75 29 $50 9 $85 10 $50 16 $75 17 $50

20 $50 13 $75 14 $50 15 $85 16 $75 17 $50 27 $50

23 $75 24 $50 25 $50

DAILY PRICES ARE ALSO LISTED ON THE TRIP CALENDAR PAGE

FOR MORE INFORMATION OR TO REGISTER PLEASE CONTACT US AT 818-878-0162 FAX 818-878-0195, www.campcalabasas.org OR EMAIL US AT campcalabasas@aol.com

Camp Calabasas Teen Camp 2012 Trip Calendar

Week Mondays Times Vary
June 18 Universal Studios 9am-6:30pm $75.00 June 25 Knotts Berry Farm 8:30am-6:30pm $75.00 July 2 Soak City 9:30am-6:30pm $75.00 July 9 Disneyland 7:00am-6:30pm July 16 Knott's Berry Farm 8:30am-6:30pm $75.00 23 Universal Studios 9:00am-6:30pm $75.00 30 California Adventure 8:30am-6:30pm $75.00 Aug 6 Guinness Book & Wax Museums 9am-5pm $50.00 Aug 13 Magic Mountain 9am-6:30pm $75.00

Tuesdays 9am-5pm
June 19 Movie & Starbucks 9am-5pm $50.00 June 26 Bowling & Lazer Tag 9am-5pm $50.00 July 3 Mountasia 9am-5pm $50.00 July 10 Movie & Menchies 9am-5pm July 17 Mini Golf & Bowling 9am-5pm $50.00 24 Pacific Park 9am-5pm $50.00 31 Zuma Beach 9am-5pm $50.00

Wednesdays Times Vary

June 20 Magic Mountain 9:30am-6:30pm $50.00 June 27 Santa Barbara Zoo 9am-5:00pm $50.00 July 4

Thursdays Times Vary

June 21 Zuma Beach 9am-5pm $50.00 June 28 Hurricane Harbor 9:30am-5:30pm $75.00 July 5 Zuma Beach 9am-5pm $50.00 July 12 Magic Mountain 8am-8pm July 19 Zuma Beach 9am-5pm $50.00

Fridays Times Vary

June 22 Medieval Times 9am-5pm $50.00 June 29 Movie & Starbucks 9am-5pm $50.00 July 6 Movie & Lunch 9am-5pm $50.00 July 13 Zuma 9am-5pm July 20 Movie & Lunch 9am-5pm $50.00 27 Zuma Beach 9am-5pm $50.00 3 Movie & Crumbs 9am-5pm $50.00 Aug 10 Movie & Menchies 9am-5pm $50.00 Aug 17 Movie & Lunch 9am-5pm $50.00

1 2

CLOSED
July 11 Soak City 9am-6pm July 18 Dodgers vs. Phillies 10am-6:30pm $50.00

25 26 Scooters Jungle/Arcade Hurricane Harbor 10am-5:00pm 9:30am-5:30pm $50.00 $75.00 August 1 Hurricane Harbor 9:30am-5:30pm $50.00 2 Soak City 8am-6pm $75.00 Aug 9 Mountasia 9am-5pm $50.00 Aug 16 Hurricane Harbor 9:30am-5:30pm $75.00

Aug 7 Aug 8 Pirate Adventure Show Knott's Berry Farm 9am-5pm Leave-7am-6:30pm $50.00 $50.00 Aug 14 Zuma Beach 9am-5pm $50.00 Aug 15 Disneyland $85.00 7am-6:30pm

PLEASE ARRIVE AT CAMP 15-30 MINUTES BEFORE THE DEPARTURE TIME LISTED ON THE CALENDAR TO ENSURE A SPOT FOR THE DAY, TO REGISTER and GET READY FOR THE DAY.

CAMP CALABASAS 818-878-0162/De Anza Park 818-880-6457/Fax 818-878-0195 ~ email: campcalabasas@aol.com ~ www.campcalabasas.org ~

SUMMER CAMP CALABASAS 2012

CAMP AGREEMENT

Campers Name LITTLE LEARNERS, LLC RELEASE, ASSUMPTION OF RISK, AND INDEMNITY RELEASE: The undersigned is the parent or legal guardian of the minor camper, identified above. In consideration
for Little Learners providing to the camper identified above a camp Experience at Camp Calabasas, I HEREBY, ON MY OWN BEHALF AND ON BEHALF OF THE CAMPER, RELEASE AND DISCHARGE LITTLE LEARNERS, LLC, THE OWNER AND OPERATOR OF CAMP, AND THE CITY OF CALABASAS AND BOTH OF THEIR OFFICERS, DIRECTORS, EMPLOYEES, VOLUNTEERS AND AGENTS (called herein the Releasees) FOR AND FROM ANY AND ALL CLAIMS ARISING OUT OF THE CAMPERS PARTICIPATION IN THE CAMP, INCLUDING CLAIMS ARISING OUT OF THE NEGLIGENCE OF THE RELEASEES OR ANY OTHER CAMPER THAT CAUSES, OR IS CLAIMED TO CAUSE, INJURY OR DEATH TO THE CAMPER IDENTIFIED ABOVE, PROPERTY DAMAGE, OR OTHER DAMAGES. I ALSO PROMISE NOT TO SUE ANY OF THE RELEASEES FOR ANY OF THE CLAIMS BEING RELEASED. ASSUMPTION OF RISK: I understand and acknowledge that participation in camp activities involves risk of injury. I fully appreciate the risks involved in my campers participation in these activities and voluntarily assume, on the campers behalf, those risks. PROMISE TO DEFEND, IDEMNIFY, AND HOLD HARMLESS: In consideration of the above camper being permitted to participate in Little Learners camp, I agree to defend, indemnify, and hold harmless the Releasees from and against all claims arising out of the campers participation in the camp. EMERGENCY TREATMENT: I hereby consent to allowing emergency medical personnel to be summoned for the camper if needed and consent to emergency treatment of the camper as may be required as the result of accidental injury or otherwise. I further agree to pay any and all costs incurred for such treatment. PHOTOGRAPHS: I agree to allow the camper to be photographed while participating in camp activities and understand that Little Learners and the City retain the right to use any photographs taken during camp activities for promotional and other purposes. I HAVE READ THIS AGREEMENT AND UNDERSTAND IT INCLUDES A RELEASE OF ALL CLAIMS, VOLUNTARY ASSUMPTION OF ALL RISKS INVOLVED IN CAMP ATTENDANCE AND AN AGREEMENT TO DEFEND, INDEMNIFY AND HOLD HARMLESS THE RELEASEES. BY SIGNING THIS AGREEMENT I VOLUNTARILLY ACCEPT ALL OF THE TERMS AND CONDITIONS OF THIS AGREEMENT.

PARENT OR LEGAL GUARDIANS SIGNATURE

PARENT OR LEGAL GUARDIANS PRINTED NAME

RELATIONSHIP TO CAMPER

DATE

Camp Calabasas Teen Camp 2012 Water Waiver/Permission Form

The Teen Program will be going to the beach and swimming every Tuesday and Thursday along with taking trips to water parks on specific trip days. Transportation will be provided by the Cities of Agoura and Calabasas. I understand that there will be a lifeguard on duty at all times and thereby give permission for my child to swim and participate in water activities. I also understand that if I wish for my child not to swim that I will verbally notify the staff in charge. If I wish for my child to participate I understand that they will need to bring their own swimsuit, towel, and sunscreen. Lunch can be purchased or a sack lunch can be brought to any of these excursions. I also understand that all participants will leave the campsite between the hours listed on the trip calendar.

1. ____________________________________________ Teens Name

___________ Age

Knows how to swim? Y N

2. ____________________________________________ Teens Name

___________ Age

Knows how to swim? Y N

3. ____________________________________________ Teens Name

___________ Age

Knows how to swim? Y N

The undersigned hereby agrees to defend, indemnify, and hold harmless the City of Calabasas and its officers, employees and agents against any loss, liability charges and expenses (including attorneys fees) and costs which may arise by reason of participation in any program. (The City does not provide accidents, medical, liability, workers compensation insurance for program participants). As parent/guardian, I hereby consent to emergency treatment of my minor child as a result of accident or injury. I further agree to pay any and all costs incurred as a result of said treatment. I agree to carefully inspect and satisfy for me that the facilities provided are reasonably safe for their use. Once having conducted the inspection, I agree to expressly assume the risk of participating at the premises. I understand the City retains the right to use photos taken during activities for public purposes.

Parent Signature:_________________________________________ Date:_____________

TEEN CAMP 2012 ADMISSION AGREEMENT AND IMPORTANT INFORMATION Registration: There are three easy ways to register. You can mail-in, walk-in or fax-in the registration forms. Payments are to be made out to LITTLE LEARNERS Fees - Includes field trips admission, transportation, and activities listed on the calendar. Lunch is not provided unless stated on the calendar. If going to a shopping center teens may bring money to shop. DEPOSIT: Full payment or $100 which will be credited to your childs days of attendance. Payments: All payments to Little Learners must be made by credit card: Visa or Master Card, or by check: pay able to Little Learners, money order or cash. Checks returned to us for NSF or any other reason will be required to replaced with cash or a credit card. If there are any problems collecting the owed money for returned checks the information will be turned over to the District Attorneys Check Restitution program. A fee of $25 will also be charged for any returned check. Camp Times: Teen Camp times are listed on the calendar. They will be departing very close to the time listed. (Parents running late will be charged $1.00/minute and it must be paid to the supervising counselor, for every minute that you are late. What to Bring: Teens may bring a sack lunch with a drink each day they attend camp unless they plan on purchasing lunch at their specific destination. We recommend bringing sunscreen on a daily basis.. Info: All refunds and cancellations of days must have FIVE BUSINESS DAYS NOTICE prior to the sessions start date. Excessive changes will result in an administrative fee of $10.00. There will be no refunds and transfers due to illness, or non-attendance for registered days. You are financially responsible for all days registered unless we are notified via email or in writing about such changes. If you email us we will respond letting you know we re received your notice. For those who do not register in advance please be advised that we might not have spots for all of the drop-ins. If you know your child wants to attend a specific trip you must pre-pay to hold your spot. Due to the nature of our reservations and only being able to take a certain number of campers Making-up or transferring missing days is not permitted regardless of the circumstances. Discipline: We strive to provide a well-rounded and safe program for all participants. Discipline will be handled in the following manner and depending on the infraction: (1) Child will be spoken to and will be given a warning. (2) Child will be suspended from the program. Children will three warnings will be asked to leave the program.

Dismissal Policy: Expulsion from the Camp Calabasas and Little Learners Program results from one or more of the following situations: (1) Physically or verbally abusing another participant (USING FOUL INNAPROPRIATE LANGUGE) (2) Refusal to correct documented problematic behavior (3) Theft (4) Parent Payment Negligence (5) Disturbing drivers of busses by not following rules set by driver and bus company
Sign In/Out: Teens arriving and departing camp must be signed in and out on a daily basis **************************************************************************************************** TEEN CAMP 2010 ADMISSION AGREEMENT PLEASE RETURN THIS PORTION TO CAMP CALABASAS I HAVE READ AND AGREE TO ABIDE BY THE ADMISSION AGREEMENT POLICIES STATED ABOVE AND OTHER PROCEDURES SET FORTH BY THE CITY OF CALABASAS AND LITTLE LEARNERS AND UNDERSTAND THE PAYMENT/CANCELLATION POLICIES.

Childs Name:_______________________________________________________________________

Parents Signature :___________________________________________________________________Date:_______________

LITTLE LEARNERS/CAMP CALABASAS SUMMER CAMP 2012 CREDIT CARD FORM

I, _____________________________________________, hereby authorize Little Learners to automatically charge my Credit Card for Summer Camp fees. Participants Name:___________________________________ Fees: (Please circle one) $________________ (one time use) OR Reoccurring Camp Fees Based on Registration Please charge this amount to my: MasterCard or Visa (Please circle one) Card Number:___________________________________________________ Expiration Date: _________________________ Name that appears on card: ________________________________________ Billing Address: _________________________________________________ _________________________________________________ Authorized Signature: __________________________Date ______________