Summer Camps 2014
Get up and get moving! There’s so much to do! At the Chapel Hill Country Club, the summer days are full of exploration, fun and learning! Begin the day with Tennis, Golf, or Course and Courts Camp, then stay for the afternoon for Super Summer Camps featuring a new theme each week! We also have morning camps for ages 3 & 4.
TENNIS CAMPS For ages 4 through 7...
For advanced players..
July 7 - 11 August 11 - 15
June 16 - 19 July 21 -24
August 4 - 7
Monday - Friday 9 AM - 12 PM
Monday - Thursday 9 AM - 11 AM
For ages 8 and up...
$200 per session $225 for non-members
$155 per session $180 for non-members
Monday - Thursday 9 AM - 12 PM $160 per session $185 for non-members
COURSE & COURTS CAMPS
GOLF CAMPS
For ages 5 - 10...
For ages 5+
June 23 - 26 July 14 - 17 July 28 - 31 Monday - Thursday 8:30 AM - 2:30 PM $295 per session $320 for non-members
Course and Courts is our most popular camp experience!
June 16 - 19 June 30 - July 3 August 11 -14
Children attending Course & Courts Camp learn golf and tennis skills from our very talented staff, as well as swim, play games and enjoy snacks and lunch!
Monday - Thursday 9 AM - 11:30 AM
These camps fill quickly, so sign up soon!
$160 per session Non-members: Please call
CHCC afternoon camps make this summer a... NORTH CAROLINA CAMP JUNE 16 - 20 For ages 4 - 7
11 AM - 4:30 PM (after Tennis and Golf Camps)
$295 This camp includes a full day of camp activities on Friday! Learn all about what makes North Carolina such a wonderful state to live in. Children will gain an appreciation and knowledge of their home state with games, activities and food. North Carolina beholds a wealth of amazement! We’ll play, swim, and have lunch at the club!
ECOLOGY CAMP JUNE 23 - 27 2:30 PM - 4:30 PM (after Course & Courts) For ages 5 - 10 $155 This camp includes a full day of camp activities on Friday! We’ll explore plants, trees, weather, animals and learn about being environmentally friendly with activities and adventures around the club premises. Learn about solar power, energy, and conservation while we play, have lunch and enjoy the beautiful club property!
ENGINEERING CAMP JULY 7 - 11 12 PM - 4:30 PM (after Tennis Camp) For ages 8 and up $250 Build, wind, pull, push, and see what you can make! Learn all about physics and engineering with games and activities. Build towers, play with pulleys, and even learn about the engineering that goes into sports equipment. Engineering is everywhere! In addition to these activities, we’ll have lunch and enjoy time at the pool, too!
VISUAL ARTS CAMP JULY 14 - 18 2:30 PM - 4:30 PM (after Course & Courts) For ages 5 - 10 $155 This camp includes a full day of camp activities on Friday! Young artists will enjoy afternoons of creative exploration with various visual arts media such as pencil sketching, painting, sculpting, batik, collage, and more! Our young members will spend their afternoons learning how to expand their creative minds.
FIELD DAY CAMP
... SUPER SUMMER!
JULY 21 - 25 11 AM - 4:30 PM (after Tennis Camp) For ages 4 - 7 $250 This camp includes a full day of camp activities on Friday! Get out and play! Campers will play classic field day games such as kick ball, sack races, foot races, and all sorts of active fun! We’ll spend time at the pool to cool off, have lunch, and the week will fly by with non-stop action!
CULINARY CAMP JULY 28 - AUGUST 1 2:30 PM - 4:30 PM (after Course & Courts) For ages 5 - 10 $155 This camp includes a full day of camp activities on Friday! Young chefs will learn all about the art and skill of cooking, and baking, as well as chemistry of cooking, nutrition and agriculture. We’ll visit with our chefs, and have a great time learning all about dining and the kitchen.
THEATER CAMP AUGUST 4 - 8 9 AM - 4:30 PM For ages 5 - 12 $450 Places! Lights! Curtain! It’s time to put on a play! Theater involves art, construction, creativity, technology, and teamwork. We’ll create sets, learn lines, make costumes, and experience all that goes into creating a world on stage. Kids will enjoy building, painting, crafting, writing, and working together to create a production to be performed for parents at the end of the week. Since this is our only week of all-day all-week Super Summer Camp, we’ll also spend time playing other camp games, having snacks and lunch, as well as play time at the pool!
ACTION CAMP AUGUST 11-15 For ages 8 and up
12 PM - 4:30 PM (after Tennis and Golf Camps) *Golf Camp ends at 11:30, but we will take care of our Golf Campers until 12!
$250 Play and learn about all sorts of physical activities like climbing, dance, yoga, and more! In addition to a variety of introductions to different activities, we’ll have lunch and play at our ever-popular pool! It’s a great way to kick off summer and get moving!
LITTLE MEMBERS CAMPS 9 AM - 12 PM, Monday - Friday June 9 -13 June 16 - 20 June 23 - 27 July 7 - 11 July 14 - 18 July 21- 25 July 28 - August 1 August 4 - 8 For ages 3 & 4 $150 / week CHCC camps are for our littlest members, too! Our preschool aged campers will have fun making simple crafts, playing outside, having snacks, singing songs, playing music and making instruments, story time, and getting to know new friends. Last years’ camps were so much fun, and we love seeing our little members get to know and enjoy the club. It’s wonderful to see the group become friends and play together even after camp ends. It’s a great way to get to know other member-parents with small children, and have our little members become part of the club community. Our staff will entertain and engage them with group activities while parents enjoy summer mornings to relax and get things done. *Little Members Camp does not go to the pool for safety reasons.
Questions? For Tennis Camp and Course and Courts Camp, please contact Jaime Montalvo: (919) 932-2855 or jmontalvo@chapelhill-cc.com For Golf Camp, please contact the Golf Pro Shop: (919) 932-2857 For Super Summer and Little Members Camp, contact Alisa Minshall: (919) 945-0411 or aminshall@chapelhill-cc.com
What to Bring to Camp: For Little Members Camp: • • • •
Please apply sunscreen before arrival Extra underwear/pants if your child may need it Athletic shoes (no sandals please) Please dress in comfortable clothes they can get a bit dirty in
For All Other Camps: • • • • • • • • • •
Please apply sunscreen before arrival & bring sunscreen to camp Wear well-fitting tennis shoes with socks (required- we don’t want blisters!) Please dress in comfortable clothes they can get a bit dirty in A hat or visor A water bottle A tennis racquet for Tennis & Course and Courts Camp (a few loaners are available) Bathing suit (please let us know if your child is NOT allowed to swim) Towel A backpack to keep everything in Please label all of your child’s items in case they are misplaced
We strive to make your child’s camp experience as enjoyable as possible. Please let us know if you have any questions, or if there is anything else you would like us to know in order to make your child’s summer the best it can be at the Chapel Hill Country Club! We look forward to a terrific summer of fun!
REGISTERING FOR CAMPS
Please complete all forms and return them to the Activities Director, Alisa Minshall. Campers must have all forms on file in order to participate in camp activities. Please submit your forms by delivering them to the club’s front office mailboxes and leave them in Alisa’s staff mailbox. Camp fees will be billed to your member account. Please contact Jaime in the Tennis Shop or the Golf Pro Shop with specific questions about golf and tennis camps. REGISTRATION DEADLINES: Please submit your forms by May 1, 2014 at the latest, but it is advised that you submit your forms as soon as possible. Some camps fill very quickly! Our camp directors will confirm your registration or notify you of wait-list status as soon as possible after submission. CAMP FORMS: It is very important that all forms be completed in their entirety and returned promptly. Please note that campers will not be able to participate in camp activities until all forms are complete. There are 4 pages of forms that you will need to return: 1) registration, 2) waiver, 3) medical, 4) insurance, photo, authorization, & pick-up authorization. The registration and waiver are due immediately, and forms 3 and 4 are due by June 1st. CANCELLATION POLICY: Full refunds are only permitted until March 15th. Beginning March 16th, a 25% deposit for each session will be charged to your account and is non-refundable. DINING: We will provide snacks, water and other non-caffeinated beverages for all camps. For campers attending Course & Courts and Super Summer Camps, lunch will be provided. If you feel more comfortable providing food and snacks from home, please do so. We are not able to provide a camp price discount for providing your own food. For campers attending 5-day Tennis Camps, there will be a Pizza Party on Friday at the end of camp! TSHIRTS: Tshirts will be distributed on the last day of each camp. Please be sure to note your child’s appropriate size on the registration form. ILLNESS DURING CAMP: Children with the following symptoms cannot attend camp: Elevated temperature, diarrhea or vomitting, undiagnosed rash, sore or discharging eyes or ears or profuse nasal discharge, diagnosed contagious diseases such as chicken pox or strep throat. Children who become ill during camp will be provided with a comfortable place to rest until parents arrive. Parents will need to pick up ill children within one hour. Emergency services will be obtained through 911 for any instance that requires more than American Red Cross Standard First Aid training. Attempts to reach a parent or other designated guardian will be continued until someone is reached. Parents should be sure to let those around them know where they are during the day in case you are away so that coworkers or family can find you in case of emergency. WEATHER AND EMERGENCIES: During inclement or excessively hot weather, campers will be kept indoors and we will have alternate activities such as games, crafts and/or movies. In the event of fire, tornadoes, hail, or police emergencies, campers will be kept in an appropriate and safe location and camp staff will notify parents as soon as possible. During emergeny situations, parents may call the club (919-967-8201) to inquire about their children or permitted to retrieve their child from camp. DISCIPLINE: When a child does not observe the expected guidelines of camp staff, we will proceed with the following measures: 1) Verbal Warning, 2) Time out from activity and documented by staff, 3) If camper requires time out from activity more than twice in one day, parents will be notified to retreive their children so that we may continue with camp without distraction for other campers 4) Children who must be removed from activities twice or more per day on more for 2 days per camp session will not be permitted to return to other camp sessions for the summer, and your camp deposit(s) will be retained.
Both sides of this form are due immediately for registration. Please retain a copy for your own records.
1. REGISTRATION CHAPEL HILL COUNTRY CLUB SUMMER CAMPS 2014
Camper’s Name: _____________________________________________________________________________ First
T-shirt Size:
YS
YM
YL
AS
AM
AL
Middle
Last
AXL
Age: ______________
Parent or Guardian Names: ___________________________________________________________________ First
Middle
Last
___________________________________________________________________ First
Member Number: #____________
!
Middle
Last
Non-Member (Super Summer and Little Members Camps are for members only)
Phone Numbers: ( _______ ) ________ - ______________
to contact: __________________________
( _______ ) ________ - ______________
to contact: __________________________
( _______ ) ________ - ______________
to contact: __________________________
( _______ ) ________ - ______________
to contact: __________________________
Home Address: ______________________________________________________________________________ ______________________________________________ , _______ Email Addresses:
__________________
______________________________________________ to contact: _________________ ______________________________________________ to contact: _________________
Please Register My Child For:
(Super Summer Camps are available to CHCC members only)
! Tennis Camp, June 16 - 19
! North Carolina Camp, June 16 - 20
! Golf Camp, June 16 - 19
! Course & Courts Camp, June 23 - 26
! Ecology Camp, June 23 - 26
! Golf Camp, June 30 -July 3
! Tennis Camp, July 7 -11
! Engineering Camp, July 7 - 11
! Course & Courts Camp, July 14 - 17
! Visual Arts Camp, July 14 - 18
! Tennis Camp, July 21 - 24
! Field Day Camp, July 21 -25
! Course & Courts Camp, July 28 - 31
! Culinary Camp, July 28 - August 1
! Tennis Camp, August 4 - 7
! Theater Camp, July 4 - 8
! Tennis Camp, August 11 - 15
! Action Camp, August 11 - 15
! Golf Camp, August 11-14
Little Members Camps (for CHCC members only): ! June 9 - 13 ! July 14 - 18
! June 16 - 20 ! July 21 - 25
! June 23 - 27 ! July 28 - Aug 1
! July 7 - 11 ! August 4 - 8
2. Waiver
CHAPEL HILL COUNTRY CLUB SUMMER CAMPS 2014 RELEASE AND INDEMNIFICATION This agreement is made this ____day of ______2014, by ____________________, a parent or guardian (of the participant), to release and indemnify Chapel Hill Country Club (hereinafter referred to as the “Club”), its company, affiliated, or subsidiary companies and all their respective officers, directors, agents, contractors employees, heirs, successors and assigns (collectively the “Proprietors”), as set forth below. WITNESSETH WHERE AS, Participant, on his own behalf and on behalf of the other members of his family, including Participant’s spouse, parents, children, heirs and assigns (referred to hereinafter collectively and singularly as “Participant”), hereby grants to the Proprietors thisfull release and indemnification as a consideration for permitting Participant to participate in various camp programs at the Club (hereinafter referred to as the “Event”. NOW, THEREFORE, in consideration of these premises, Participant agrees as follows: 1. RELEASE. Participant acknowledges that he recognizes the risks of injury to the person inherent in any physical exercise program and HEREBY DOES RELEASE, DISCHARGE, WAIVE, RELINQUISH AND COVENANT NOT TO SUE with respect to any and all actions or causes of action for bodily injury, property damage, or death occurring to Participant, arising either directly or indirectly out of participating in the Event, wherever and however the same may occur and for whatever period said activities may continue. Participant HERBY RELEASES, DISCHARGES, WAIVES, RELINQUISHES AND COVENANTS NOT TO SUE with the respect to any of the aforesaid actions or causes of action which may hereafter arise for the benefit, directly or indirectly, of Participant, as well as those that might have a cause of action, by, through, or under Participant, and agrees that under no circumstances will Participant prosecute or present any claim for bodily injury, property damage, or death against the Proprietors, arising from any claim of any kind or nature in connection with Participant’s participation in the Event, whether same shall arise in whole in part from the ordinary negligence of the Proprietors or the ordinary negligence, gross negligence, or willful misconduct of any third party and whether such is the sole or concurring cause of bodily injury, property damage or death. 2. INDEMNITY. Participant further does HEREBY INDEMNIFY AND HOLD HARMLESS the Proprietors from any and all claims, actions, demands, costs, liabilities, expenses, or judgments whatsoever, including attorney’s fees and costs, which might arise by whomever, by, through, or under Participants or whenever made or presented for Participant’s bodily injury, property damage or death, which is alleged to have arisen out of or in connection, directly or indirectly with the Participant’s participation in the Event. It is the intention o the parties hereto that Participant will indemnify and protect the Proprietors from the consequences of acts or omissions of the Proprietors or any third party (including others who may be participating in the Event), who have a claim or cause of actions against the Proprietors that arose by, through, or under Participant, whether same arises, in whole or in part, from ordinary negligence of the Proprietors or the ordinary negligence, gross negligence, gross negligence, or willful misconduct of any third party and whether such is the sole or concurring cause of the bodily injury, property damage or death. 3. MEDICAL. Participant hereby declares Participant has either consulted Participant’s personal physician who has consented toParticipant’s participation in the Event or has elected to forgo a physical examination, but declares that the Participant is physically capable of participating in the Event. Participant hereby gives consent to emergency medical care, inclusive of necessary transportation, in order to obtain such treatment in the event of injury to Participant, as the Proprietor may deem appropriate. The release and indemnification set forth above extends to any and all liability arising out of or in any way connected with such provisions of medical treatment or transportation provided in the event of some emergency. PARTICIPANT HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, PROPERTY DAMAGE, OR DEATH TO PARTICIPANT DUE TO THE ORDINARY NEGLIGENCE OF THE PROPRIETORS AND THE ORDINARY NEGLIGENCE, GROSS NEGLIGENCE, OR WILLFUL MISCONDUCT OF ANY THIRD PARTY. 4. PARTICIPANT’S PERSONAL PROPERTY. Participant understands that all personal effects, jewelry and any other personal property owned, controlled or used by Participant (the “Personal Property”) and brought for the Event shall remain the sole responsibility of Participant to properly secure same from theft, damage, or injury to any other person. ALL “PERSONAL PROPERTY” LEFT AT THE CLUB IS LEFT AT THE SOLE RISK OF PARTICIPANT AS TO ITS THEFT, DAMAGE OR INJURY TO ANY OTHER THIRD PARTY AND ALL LOSS, DAMAGE OR INJURY RESULTING FROM PARTICIPANT “PERSONAL PROPERTY” SHALL BE AT THE SOLE EXPENSE OF PARTICIPANT. Participant further understands that the release and indemnity provisions of this Agreement include and relate to any and all damages, claims, causes of action, expenses or the like arising from the theft, damage or injury occurring to the Personal Property and hereby understands that the foregoing provisions of this agreement apply equally to the Personal Property. 5. PHOTOGRAPHY. Camp retains the right to use all photographs of campers for promotional use, unless notified in writing, and the parent/ guardian authorizes such use without compensation. 6. DISMISSAL. For the safety and welfare of all campers, the Camp reserves the right to dismiss a camper without refund, whose conduct and influence, in opinion of the Director, is deemed unsatisfactory or detrimental to the best interest of the Camp. For the safety and welfare of all campers, the Camp reserves the right to dismiss a camper without refund, whose conduct and influence, in opinion of the Director, is deemed unsatisfactory or detrimental to the best interest of the Camp. This enrollment is not valid, unless signed by the parent or guardian of the enrolled camper, and accepted by the Chapel Hill Country Club. NO DEDUCTION OR REMISSION ON FEES WILL BE ALLOWED BY THE CAMPER FOR ABSENCE, WITHDRAWAL, OR DISMISSAL. THE PARTICIPANT HAS READ AND VOLUNTARILY SIGNS THIS RELEASE AND INDEMNITY AGREEMENT and further agrees that no oral representations, statements or inducements apart from the foregoing written agreement have been made. THE PARTICIPANT UNDERSTANDS THAT THIS IS A RELEASE OF PARTICIPANT’S CLAIMS THAT MAY BE RAISED BY THROUGH OR UNDER PARTICIPANT AND OTHERS.
Date ________________________________ Participant Name ______________________________________________________________ Member # __________________________ Guardian’s Signature ___________________________________________________________
3. Medical
Both sides of this form are due by June 1, 2014.
CHAPEL HILL COUNTRY CLUB SUMMER CAMPS 2014 Camper Name: ______________________________________________________________ First
Middle
Last
Date of Birth: _____________________________________
! Male
! Female
Chapel Hill Country Club will call when there is a question about your child’s health and/or in an emergency. Provide contact information for a custodial parent who will be available via phone while your child is attending our program: Parent/Guardian: ______________________________________________________________ Preferred Phone #: (________)___________________________________________________ Alternate Phone #: (________)___________________________________________________ Does your child have any limitations from participating in any camp activities? ! Yes ! No _______________________________________________________ ____________________________________________ ____________________________________________________________________________________________________ Date (month & year) of this child’s most recent tetanus immunization ____________________________________ If not immunized, would you allow camp to send this child to the ER for immunization if needed? . . . ! Yes ! No Is this child allergic to any food or medication? . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ! Yes
! No
If YES, name the allergen and indicate the reaction: ________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ Does your child use/carry an epi-pen? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ! Yes
! No
Does this child have medical concerns such as asthma, diabetes, seizures, etc.? . . . . . . . . . . . . . . . ! Yes
! No
If Yes, what: _______________________________________________________________________________ If YES, what triggers your child’s medical problem (asthma, diabetes, seizures, etc.)? _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ “Medication” is any substance a person takes to maintain and/or improve their health. This includes vitamins & natural remedies. Chapel Hill Country Club will not administer any medications to your child without your consent. List all medications including OTC medications/inhalers this child takes on a routine basis: ! This camper takes no routine medication. ! This camper will be expected to take the following routine medication (including dosage) while at camp: a. Med/dose: ____________________ Reason for taking this: ______________________________ Time/Schedule ______ b. Med/dose: ____________________ Reason for taking this: ______________________________ Time/Schedule ______ c. Med/dose: ____________________ Reason for taking this: ______________________________ Time/Schedule ______ 5. What else should we know about your child? Please provide any additional information about your child’s health that may impact your child’s participation in our program: ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ Date of last physical exam: ______________________________ Pediatrician’s Signature: _______________________________________________ Date: __________________________ Pediatrician’s Name: ______________________________ Pediatrician’s Phone: __________________________________ Signature of Parent/Guardian: __________________________________________________ Date: _________________
Insurance Information Subscriber’s Full Name (Parent/Guardian/Self): ___________________________________________________ Date of Birth ____/____/_______
4.
Name Insurance Company___________________________________________________ Insurance ID# ______________________________________________________________ Insurance Phone # ( _________ ) ________________ ____________________ *Please attach a copy of the front and back of the insurance card.
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Parent/Guardian Authorization
This information is correct and the child described has permission to participate in all camp activities except as noted on this form. I understand the camp has limited healthcare on site and the staff will call the indicated parent/ guardian (a) in an emergency, (b) if questions about my child’s health may arise, and/or (c) when my child is unable to continue because of injury or illness. I understand all medications including OTC meds are to be turned in to the camp medical staff and reviewed with the check-in medical professional. I acknowledge the camp’s healthcare professional will handle medication as described and the information on this form will be shared with staff on a needto-know basis. Signature of Parent/Guardian: __________________________________________________ Date: _________________
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Photo/Video/Audio Release Statement
In registering my child for any event at Chapel Hill Country Club, I agree to the use by Chapel Hill Country Club, Inc. of my child’s image, and/or video for art and/or promotional materials. Children will not be identified by name. Although pictures, audio, and video taken during camp may include your child, there is no guarantee that he/she will be featured in any of the aforementioned materials. These materials may be used online, in print, and may be distributed via the Internet, mail, public media, or over the air. Signature of Parent/Guardian: __________________________________________________ Date: _________________
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Authorized Pick Up
BESIDES THE LISTED PARENT/GUARDIAN, YOUR CHILD WILL NOT BE RELEASED TO ANY OTHER PERSON OTHER THAN THOSE INDICATED BELOW. IF YOUR CHILD IS SIGNED OUT BY SOMEONE OTHER THAN A PARENT, A PHOTO I.D. WILL BE REQUIRED BY THE PERSON PICKING HIM/HER UP. PLEASE LIST ANY OTHER GUARDIAN(S) PERMITTED TO RETRIEVE YOUR CHILD FROM CAMP: AUTHORIZIED PICK UP CONTACT: ______________________________________________ FIRST & LAST NAME: ________________________________________________________ RELATIONSHIP: _____________________________________________________________ DAYTIME PHONE NUMBER: ___________________________________________________ AUTHORIZIED PICK UP CONTACT: ______________________________________________ FIRST & LAST NAME: _________________________________________________________ RELATIONSHIP: _____________________________________________________________ DAYTIME PHONE NUMBER: ___________________________________________________