Dear Parents and Campers, I would like to take this opportunity to welcome you back to another summer here at Gilmour Day Camp. For those who have been with us for the past two summers, the wait is over! Construction of the new natatorium and athletic complex is completed. As we enter into this new era, I welcome you to join us for a wonderful summer. The planning stages have begun. We will fill the natatorium with certified staff members and offer swimming lessons to campers throughout the day. In addition, we will offer time for free swim to play in the water and time for campers to practice their newly-learned strokes. Besides our Day Camp, Gilmour offers a variety of camps for children of different ages and interests. Our Preschool Camp will delight children ages 3-5. These little campers will enjoy changing weekly themes—dancing, interacting with animals, making music, performing in plays, and reading books. Day and Weekly Camps featuring sports, arts, or entertainment are offered for grades K-8. And our Sports and Hockey Camps for ages 4-18 are designed to build confidence and develop skills. From sports to film production, baking to drama, digital music to hip-hop and piùata making, Gilmour Camps have something for everyone! In addition to these wonderful programs, we offer Before and After Camp Care, and transportation is available for most camps. Thank you for your continued confidence and support for our staff and the Gilmour Community. Our goal at Gilmour Day Camp is to Make Your Summer Memorable. With the addition of the pool, we are one step closer to this. If you have any questions, please feel free to contact me at minotasb@gilmour.org or (440) 684-4580. Thank you for considering Gilmour Day Camp. Sincerely, Brian Minotas, Gilmour Day Camp Director
Extra! Extra! Swim all about it. Gilmour Day Camp will be offering swimming on campus this year in our new state-of-the-art natatorium. Absent for the last couple of years, our pool is better than ever. Not only is there a regular size pool, Gilmour now offers a learning pool for younger swimmers as well. A fun- and action-filled summer awaits you at Gilmour Day Camp! Now in it’s 57th year, Gilmour Day Camp offers numerous activities for boys and girls ages 5-14 from Kindergarten to eighth grade. Campers will participate in many different sports including basketball, baseball, soccer, tennis, volleyball, ice skating, and broomball. From sports, art, and entertainment, you are sure to find something you are looking for as Gilmour has something for everyone . Campers are introduced to the fundamentals of different sports with sportsmanship, team spirit, and fair play as the ultimate goals. What could be better than enjoying a delicious lunch in our Commons, or taking a field trip to one of the local attractions? How about participating in various sports, arts and crafts, picnics, and games on the 144-acre campus located in Gates Mills? Experienced faculty, alumni and students provide the guidance and supervision to create a summer camp experience that children will never forget.
WEEK 1: WEEK 2: WEEK 3: WEEK 4:
6/14 6/21 6/28 7/5*
DATES
WEEK 5: WEEK 6: WEEK 7:
7/12 7/19 7/26
*Four-day week because of holiday.
8:30 a.m. - 4:00 p.m. • $350/per week For additional information on Gilmour Academy Day Camp, please contact Brian Minotas at (440) 684-4580, or by email at minotasb@gilmour.org.
D E L I C I O U S L U N C H E S EV E RY DAY $350 nonrefundable deposit • All camp fees are due in full by June 1, 2010.
Register online at www.gilmour.org
Exciting Weekly Experiences
• $350/per week
All instructors are members of the Gilmour Academy faculty • Each camp runs weekdays 8:30 a.m. - 4:00 p.m. and includes lunch A $350 nonrefundable deposit is required with all registrations. All camp fees are due in full by June 1, 2010.
A. WEEK OF JUNE 14, 2010 • GRADES 3 – 4 And the Beat Goes On NEW with Camilla Cameron
D. WEEK OF JUNE 21, 2010 • GRADES 5 – 8 So You Think You Want To Dance? with Katie Clark
Explore the diverse world of music as we construct wood and metal xylophones, drums, flutes and ocarinas. This will be a week with hands-on discovery of how specific materials, lengths, and thicknesses alter the pitch and quality of the sound produced. As each project is completed, we will perform our own compositions on the instruments.
Come spend a week learning jazz, hip-hop, ballet, modern dance and more. Campers will begin each morning with a Pilates or yoga practice and then focus on a different dance each day. They will develop body rhythm, balance, flexibility, body alignment, and kinesthetic awareness through movement and also learn the basic elements of creating dances themselves. To foster physical fitness, we will discuss healthy food choices and lifestyle. Campers will receive a yoga mat, journal, and other dance materials.
B. WEEK OF JUNE 14, 2010 • GRADES 5 – 8 Be a Digital Rock Star with David Kilkenney Ever want to rock the house like your favorite music group or create a music video like the artists you hear on the radio today? Digital Rock Stars is for you! If you play an instrument, great! No need to worry if you don’t. We will learn to work as an ensemble to explore unique ways to compose and perform original music using the hottest software in our state-of-the-art digital media lab. Rock on!
C. WEEK OF JUNE 14, 2010 • GRADES 6 – 8 Behind the Curtain: Are You the Next Famous Playwright? NEW with Matthew Greenfield Do you think you have what it takes to write for live theatre? Develop and hone your playwriting skills with noted playwright/producer/director/ actor Mr. Greenfield in a weeklong summer session at Gilmour. Learn the basics of dialogue, character, plot, and setting. Discover the difference between writing for stage and writing for film, examine a brief history of playwriting and the theatre, and explore the challenges and rewards of writing for a 21st century audience. We will devote some time to writing workshops and testing your works in staged readings with your fellow playwrights. Acting skills or theatre experience are not required, just a willingness to experiment and put your writing out there before a live audience!
E. WEEK OF JUNE 21, 2010 • GRADES 3 – 6 Create Your Own Movie with John Overman Team up to create your own short movie, invent your own character, and brainstorm an amazing story concept. Campers will take on all aspects of film production: scriptwriting, acting, costuming, filming, and editing video. While “Harry Potter” and “Twilight” remain popular, you can have fun learning how to make your own five-star film. No previous experience is necessary. You can even take home a memorable DVD of your work. Sign up soon because space is limited.
F. WEEK OF JUNE 21, 2010 • GRADES 3 – 5 Ace of Bakes NEW with Cynthia Lowry Becoming an “Ace of Bakes” means you like to lick the icing out of the bowl and eat the cupcakes you make and decorate. Students will learn to read a recipe and measure ingredients to create various edible delights for breakfast, lunch, and dinner. Dessert will be the icing on the cake when campers learn to bake and decorate their own cakes and cupcakes. They will learn to measure and follow recipes to create various homemade delights. The camp includes an introduction to the basics of decorating cupcakes. Amaze your family and friends with the treats you learn to bake from the Gilmour kitchen, and possibly win the title Ultimate Ace of Bakes!
Exciting Weekly Experiences
• $350/per week
All instructors are members of the Gilmour Academy faculty • Each camp runs weekdays 8:30 a.m. - 4:00 p.m. and includes lunch A $350 nonrefundable deposit is required with all registrations. All camp fees are due in full by June 1, 2010.
G. WEEK OF JUNE 21, 2010 • GRADES 6 – 8 Keepers of Light and Time: The Magic of Photography with Mark Most Come and learn what photography is all about. In this class we will cover the history and importance of photography and how it impacts our world. We will start by building our own pinhole cameras and using them while learning basic theory. We will work in the traditional darkroom and create our own photos. Next we will progress to the age of digital photography and students will be encouraged to bring their digital cameras to better understand how to use them. We will learn how to use the computer as our digital darkroom and to download photos and manipulate them using Photoshop. This camp will give everyone a chance to learn skills that will benefit them no matter what type of photography they want to do.
H. WEEK OF JUNE 28, 2010 • GRADES 5 – 8 Star in Your Own Movie with John Overman You’re the star. You’re life is the movie. This week, we will take you to fantastic destinations and film your adventures. Hop onboard the “William G. Mather Steamship.” Explore the Cleveland Botanical Gardens. Keep your eyes on the skies at the NASA Glenn Research Center. Ride the rides and play the games at Fun ‘N’ Stuff. At each destination, you get to tell the camera what you think, how you feel, and what you are learning about yourself. On Friday, you will take home a group-produced DVD of the entire week. Start turning your life into a movie today. Sign up soon because space is limited.
I. WEEK OF JUNE 28, 2010 • GRADES 6 – 8 Ace of Bakes with Cynthia Lowry
NEW
Becoming an ace of bakes means you like to lick the icing out of the bowl and eat the cupcakes you make and decorate. Students will learn to read a recipe and measure ingredients to create various edible delights for breakfast, lunch, and dinner. Dessert will be the icing on the cake when campers learn to bake and decorate their own cake and cupcakes. The camp includes an introduction to the basics of decorating cakes using hand piping. Amaze your family and friends with the treats you learn to bake from the Gilmour kitchen, and possibly win the title Ultimate Ace of Bakes!
J. WEEK OF JUNE 28, 2010 • GRADES 4 – 6 NEW Girls - First Discovery with Carmel Fantelli
Pick & choose
Dreaming about writing a children’s book? You’ve from the come to the right place! There is a story in every one of us, a story that only YOU can tell in a way following camps. that only YOU can tell it. With Girls First Discovery inspiration is everywhere – in the classroom, on stage, on field trips and excursions, and These camps can between the pages of books! The classroom be combined with will nurture the writer in a print-rich environment. The daily interaction between our other camps. peers and Mrs. Fantelli is a unique experience where campers will immerse themselves in a writer’s workshop to write and illustrate that story just waiting to emerge. Campers will gain a sense of pride and accomplishment at their very own author signing celebrating their book publication!
K. WEEK OF JUNE 28, 2010 • GRADES 5 – 7 It’s Time to Speak Your Mind with Gay Janis
NEW
Have you ever wanted to win an argument with your friends, teachers, or even parents? Have you ever desired to prosecute or defend a favorite character from a storybook tale or to walk into your classroom confidently knowing that you were about to make a presentation that would impress your classmates and instructor? It’s Time to Speak Your Mind is just the opportunity for you. This class, which will be varied, fast paced, and fun, will give you the tools you need to succeed in a variety of speaking situations. You will learn the basics of courtroom procedure while you prepare the case of a character taken from history or a storybook for both the prosecution and defense. You also will practice a standup comedy routine, a dramatic presentation, and even pair off with a friend for duo interpretation. Finally, you will learn techniques that will make you a more persuasive speaker. On the last day of class, show off your newfound skills when you present your work to an invited audience of family and friends. So come out and discover your voice, and confidence while participating in a fun-filled week of speaking.
Exciting Weekly Experiences
• $350/per week
All instructors are members of the Gilmour Academy faculty • Each camp runs weekdays 8:30 a.m. - 4:00 p.m. and includes lunch A $350 nonrefundable deposit is required with all registrations. All camp fees are due in full by June 1, 2010.
L. WEEK OF JULY 5, 2010* • GRADES 5 – 8 All the World’s a Stage with Matthew Greenfield
O. WEEK OF JULY 12, 2010 • GRADES 3 – 7 Dream It. Plan It. Make It. with Joe Tait
Own the stage by mastering the actor’s basic skills: overcoming fear, warming up, reducing tension, breathing, articulating, projecting, understanding and using stage directions, creating illusion, and improvising. The benefits of this class will go beyond the basics of theatre. Campers will learn to be relaxed and confident in situations that require thinking on their feet, projecting their personality, and working well in groups. These activities will enable campers to bring their own creativity to the stage and to use these basic skills to prepare a short production for the final day of class.
In “Dream It. Plan It. Make It.” the big idea is simple to describe but limitless in its scope: students entering third through seventh grades need only to bring their urge to create an art piece or series of art pieces. Over the course of five days, students will create a strategy for their piece of art with the guidance of an experienced instructor and artist. Medium options include sculpture in clay, Sculpey or Model Magic; acrylic painting on canvas or paper; drawing in pastel, pencil, chalk or ink on paper; assemblage using paper, wood, or parts from a large collection of found objects available for construction. Combinations of these mediums are encouraged. In this camp, the vision of the young artist is the big idea.
M. WEEK OF JULY 5, 2010* • GRADES 6 – 8 Keepers of Light and Time: The Magic of Photography with Mark Most Come and learn what photography is all about. In this class we will cover the history and importance of photography and how it impacts our world. We will start by building our own pinhole cameras and using them while learning basic theory. We will work in the traditional darkroom and create our own photos. Next we will progress to the age of digital photography and students will be encouraged to bring their digital cameras to better understand how to use them. We will learn how to use the computer as our digital darkroom and to download photos and manipulate them using Photoshop. This camp will give everyone a chance to learn skills that will benefit them no matter what type of photography they want to do.
N. WEEK OF JULY 12, 2010 • GRADES 3 – 6 Parlez-vous Français? with Margaret Dool
NEW
Do you speak French? Come and learn the basics of the French language, learn about the French culture, and have FUN learning a second language. Students are involved in many creative activities such as reading books in French, labeling drawings of themselves, singing French songs, learning colors through finger painting, and celebrating Bastille Day on July 14th while feasting on French food. This camp is for beginners only, those who have taken no previous French classes.
P. WEEK OF JULY 12, 2010 • GRADES 5 – 8 3D Masterpiece Design Shop with Cynthia Lowry
NEW
NEW
Students will explore a myriad of sculptural material from clay to plaster. If you like to get your hands dirty and be creative while having fun this camp is for you. Students will create a stone and glass mosaic, and choose from various clay pieces including basic pinch pots to more advanced techniques using slip and glaze.
Q. WEEK OF JULY 12, 2010 • GRADES 5 – 8 Take a Hike – In the Natural World with Jeff Klein
NEW
Get ready for excitement and adventure as we explore the forests, creeks, ravines, and marshes of our “backyard.” This summer we will explore Northeast Ohio’s natural world through hikes and orienteering. Working with energetic science teachers in nature’s classroom, our explorers will uncover the ecology and geology that makes Northeast Ohio such a great place to live. Join other campers as we get outside, get muddy, and have a great time. Trips are held rain or shine, so dress for the weather and get ready for some serious fun. * Four-day week because of holiday.
Exciting Weekly Experiences
• $350/per week
All instructors are members of the Gilmour Academy faculty • Each camp runs weekdays 8:30 a.m. - 4:00 p.m. and includes lunch A $350 nonrefundable deposit is required with all registrations. All camp fees are due in full by June 1, 2010.
R. WEEK OF JULY 19, 2010 • GRADES 3 – 6 Fun with Piñatas with Joyce Ware
NEW
Children from all Spanish instructional levels will learn how to make their own piñata from scratch. We will incorporate Spanish songs and vocabulary. The last day of camp will be a fiesta, and one piñata will be broken with goodies for all!
S. WEEK OF JULY 19, 2010 • GRADES 5 – 8 And Sew On … with Cynthia Lowry
NEW
Students will learn the basics of crocheting by creating a dish towel, knitting by creating a scarf, and sewing by creating a hand-sewn pillow.
T. WEEK OF JULY 19, 2010 • GRADES 4 – 6 Become a Botanist for a Week with Meg Anderson
NEW
Do you like to dig in the earth and uncover the mysteries you find there? Miracles of life, science experiments, and eating scrumptious plants will capture your curiosity during this weeklong foray into the world of botany. Not only will we use gardening tools, but we will employ scientific tools, such as microscopes to investigate soil, seeds, and the creepy crawly critters that share the garden. Campers will also create mini gardens that can be taken home to grow, and we will use other harvested materials to make crafts.
U. WEEK OF JULY 19, 2010 • GRADES 4 – 6 Boys - First Discovery with Carmel Fantelli
NEW
Dreaming about writing a children’s book? You’ve come to the right place! There is a story in every one of us, a story that only YOU can tell in a way that only YOU can tell it. With Boys First Discovery inspiration is everywhere – in the classroom, on the ball field, on stage, on field trips and excursions, and between the pages of books! This camp will nurture the writer in a print-rich environment. The daily interaction between peers and Mrs. Fantelli is a unique experience where campers will immerse themselves in a writer’s workshop to write and illustrate that story just waiting to emerge. Campers will gain a sense of pride and accomplishment at their very own author signing celebrating their book publication!
V. WEEK OF JULY 26, 2010 • GRADES 3 – 6 Create Your Own Movie with John Overman Team up to create your own short movie, invent your own character, and brainstorm an amazing story concept. Campers will take on all aspects of film production: scriptwriting, acting, costuming, filming, and editing video. While “Harry Potter” and “Twilight” remain popular, you can have fun while learning how to make your own five-star film. No previous experience is necessary. You can even take home a memorable DVD of your work. Sign up soon because space is limited.
Pick & choose from the following camps. These camps can be combined with our other camps.
W. WEEK OF JULY 26, 2010 • GRADES 4 – 6 For the Love of Poetry with Bob Gralnick
NEW
Immerse yourself in the world of poetry! Read, experience, and write in a variety of poetic styles. Open your mind to the world of incredible imagination and the love of the written word. Expand your vocabulary and ability to be descriptive in ways you never thought were possible. Poets are deep thinkers who express themselves in ways that make words paint pictures that come to life. Poets are people who use words in the way an artist uses paint on a canvas. Enjoy the fun and exciting way young people can express themselves. Come in, come in, come in and don’t dream it; be it!
For more information about Weekly Camps, please contact Brian Minotas at (440) 684-4580 or by email at minotasb@gilmour.org.
Travel the world and celebrate other traditions with the globetrotting Gilmour campers. Countless memories will be made during our Preschool Camp experiences. Virtual travels will be documented in each child’s personal scrapbook with pictures, photos, recipes and different keepsakes along their way. Gilmour Academy’s preschool camps are for children ages 3-5. Engaging weekly themes will appeal to all campers and will integrate music, cooking, arts, drama, storytelling, and fitness exercise. Swimming will be great in Gilmour’s new natatorium. Nature walks, creative play, field trips, hands-on science, ice skating, tennis, taekwondo and the outdoor playground equipment and sports are incorporated into the program. Both half- and full-day sessions are offered for your convenience. Each group is supervised by a degreed teacher and senior counselors. Before- and after-camp care is available. Our longer camp hours are ideal for working parents.
PRESCHOOL ODYSSEY 2010 WE E KLY CAM PS ROCK & ROLL AROUND THE WORLD
Get ready to “rock” as we explore the many ways our bodies can bend and twist! We will “roll” doing beginner tumbling movements such as forward and backward rolls. Gilmour’s gymnastic instructor Mrs. Katie Clark will use music and rhythm to keep your child moving and grooving.
I’D LIKE TO TEACH THE WORLD TO SING… AND PLAY
COLOR MY WORLD MAGICAL
Africa, Israel, Nepal, and Ireland! Let’s discover and create a world of musical experiences. The children’s experiences will involve listening, moving, singing, and playing in this musical environment.
STARS & STRIPES AMERICA
ANIMAL PLANET
Roar! Grrrr! Woof! Squeak! Animals will take over Gilmour during the 4th week of wild adventure! Get up close and personal with these fuzzy, slimy, furry, and scaly creatures as we safari to the zoo and trample through the rainforest during this week of wild adventure. Examine the wonders of science. Design your own roller coaster, grow magical seeds, and take steps into a 3D world. Mind stretching and imagination abounds while campers discover the scientific world around them.
Hop on the Gilmour caravan as we make pit stops along some of our country’s great national landmarks. We will explore what our country has to offer and join in a celebratory 4th of July parade. “Get your kicks on Route 66.”
WE ARE THE WORLD CHILDREN’S THEATRE It’s showtime at the Lancer Theatre. Your little thespians will channel their creative energy on the stage. The final curtain will close on your child’s theater experience with a group performance to showcase their talents.
WORLD UNDER THE SEA
Your mermaids and little Neptunes will navigate through a week of underwater excursions. From shipwrecks to undiscovered treasures, your child will swim in our very own enchanted Blue Lagoon, also known as Gilmour’s new natatorium.
WEEK 1: WEEK 2:
6/14 6/21
WEEK 3: WEEK 4:
6/28 7/5*
DATES
WEEK 5: WEEK 6:
7/12 7/19
Week 7:
7/26
*Four-day week because of holiday
HALF DAY: 8:30 a.m. - 12:30 p.m. • $225/per week • FULL DAY: 8:30 a.m. - 4:00 p.m. • $350/per week For additional information on Gilmour Academy Preschool Camp, please contact Kathie Lipowski at (440) 684-4574, or by email at lipowskik@gilmour.org. $225 nonrefundable deposit • All camp fees are due in full by June 1, 2010.
Register online at www.gilmour.org
June 14 - August 13 • Camps run weekdays 8:30 a.m. - 4:00 p.m. and include lunch • Cost $350/per week A $350 nonrefundable deposit is required with all registrations. All camp fees are due in full by June 1, 2010.
MULTI-SPORTS CAMP:
Our goal is to provide a positive, enthusiastic, and enjoyable camp experience for participants while they sample a multitude of sports, activities and field trips. Camp may include the following activities: baseball, softball, swimming, golf, basketball, volleyball, skating, broomball, soccer. AGE GROUP: Boys & Girls 5-14 years old - Campers will be divided by age group. EQUIPMENT: shorts, sneakers, change of clothes, swimsuit/trunks and sunscreen. Gilmour provides most necessary equipment, but you are welcome to bring your own.
GOLF CAMP: The golf instructional staff is dedicated to achieving the ultimate goal of helping your child learn and enjoy the sport of golf in a fun and safe environment. In addition to Gilmour Academy’s on-campus driving range, short game area and putting green, campers will play nine holes of golf on the final day of camp. All campers will have an in-depth video analysis of their swing. AGE GROUP: Boys & Girls 5-14 years old - Campers will be divided by age group. EQUIPMENT: Golf clubs (putter, wedge & driver) & bag, golf balls, sneakers or golf shoes, change of clothes & swimsuit/trunks (when needed) BASEBALL CAMP:
The goal of the Gilmour Academy Baseball Camp is to provide quality instruction for improvement of a player’s team and individual skills in a positive, enthusiastic and enjoyable environment. AGE GROUP: Boys & Girls 5-14 years old - Campers will be divided by age group. EQUIPMENT: Baseball glove & pants, sneakers & athletic supporter; bat, spikes, and batting glove are optional.
OUTDOOR ADVENTURE PROGRAM: This program for girls and boys is designed to focus on developing skills in a variety of activities and adventure trips. Camp may include the following activities: hiking, fishing, orienteering, rock climbing, canoeing, survival skills, arts & crafts, team building and an overnight camping trip. AGES GROUP: Boys & Girls 7-14 years old CAMPS INCLUDE
MEALS: Lunch is provided every day. EXTRA ACTIVITIES: Each week, the campers will also be able to participate in a number of activities which may include: swimming, skating, field games, and indoor games. CAMP STAFF: Camp staff may include current Gilmour Academy staff and students as well as college athletes.
THE FACILITIES
One NHL-size ice rink • Gym • Pool • State-of-the-art football/soccer field with Pro-Grass Turf • Two baseball fields Indoor fieldhouse the size of a football field • 144-acre campus • Practice green and driving range with sand trap. *Week’s activities are subject to change. Camp schedule and general information will be mailed approximately one week prior to your selected camp. In addition to the excellent facilities at Gilmour, transportation is provided for campers to specialized training at such places as the Golf Dome, batting cages, golf range, local golf courses and Swings-N’-Things.
Registration after June 1st will be taken on an availability basis and will require full payment at the time of registration. Please call (440) 449-7490 or (440) 449-7491 for availability.
Register online at www.gilmour.org
June 14 - August 13 • Camps run weekdays 8:30 a.m. - 4:00 p.m. and include lunch • Cost $350/per week A $350 nonrefundable deposit is required with all registrations. All camp fees are due in full by June 1, 2010. Gilmour Hockey Schools allow for intensive skill-specific training for players who love the game of hockey and desire to be the best at their positions. Players—both boys and girls—are grouped by age and ability to help build confidence and develop their skills. HOCKEY/BASEBALL CAMP: Hockey Baseball Camp provides a unique opportunity for players to receive individual and team instruction in both sports. The camp focuses on skills that will enable players to improve their individual performance. LEARN-TO-PLAY HOCKEY CAMP: This is an instructional program for new or nearly-new hockey players. It is recommended that participants have a basic skating background. The emphasis of this program is on developing an appreciation of ice hockey through skill development and fun on-ice activities. Ask us about our Rental Equipment Program. HOCKEY/GOLF CAMP: Whether you are a beginning golfer or a seasoned competitor, this camp provides an atmosphere of safe, informative and fun instruction. Campers will receive excellent hockey and golf training provided on the Gilmour campus and at the Golf Dome. “ONE-ON-ONE” DEFENSEMAN CAMP: We choose to call this specialized defensemen camp “One-on-One” because all of the best defensemen have the ability to consistently win one-on-one situations. This is the foundation of their game and allows defensemen to be the backbone of any team. “SHOOT AND SCORE”: The number one focus of this camp is to score goals. Scoring strategies covered include, wrist shots, snap shots, back hands, dekes, tips and rebounds. We will teach the basics of on ice vision, awareness and reading the goaltender. Become a goal scorer! “THE PUCK STOPS HERE” GOALTENDING CAMP: The most important position on ice is the goaltender. “The Puck Stops Here” (PSH) has developed an innovative program that fosters confidence while significantly increasing the goaltender’s ability to stop the puck. The PSH staff believes that goaltenders need to find a style that fits their size, flexibility, quickness and creativity. HIGH INTENSITY TRAINING – “H.I.T.”: The High Intensity Training Camp is Gilmour’s signature hockey camp. It is one of the best camps in North America when ice time, instruction, and cost are compared. Players skate close to FIVE hours a day. The instructional staff demands hard work physically and mentally. All drills are designed to increase the players’ speed, as well as their ability to read and react quickly. The “H.I.T.” Camp is for players who have developed a solid base of fundamentals and want to keep improving. SKILLS DEVELOPMENT PROGRAM – “S.D.P.”: This is the best camp for players who wish to improve their knowledge and skills necessary to play this fast-paced game. The “S.D.P.” camp provides three hours of ice time each day and over 25 hours of total instruction time. POWER SKATING CAMP: Power skating is the most overlooked skill in hockey. Our staff will teach the techniques necessary to improve stride, agility, speed, quickness, and power. The focus will be on proper use of edges to maximize speed and body control. This camp offers approximately four hours of on-ice instruction per day. Additional off-ice instruction will focus on leg strength and balance. THE STAFF: Training techniques in all sports have improved tremendously. We have made a commitment to utilizing instructors who have played the game at high levels and know how to impart that knowledge to the age group they are teaching. Gilmour offers staff who can demonstrate, instruct, and then provide appropriate drills. Most players need to see it, hear how to do it and then practice the skill. Gilmour Academy’s Summer Hockey School staff provides an atmosphere that is conducive to learning and improving skills. Registration after June 1st will be taken on an availability basis and will require full payment at the time of registration. Please call (440) 449-7490 or (440) 449-7491 for availability.
Register online at www.gilmour.org
July 5 - July 10 • Monday through Saturday • Cost Day Camper $400/Overnight Camper $500 A $350 nonrefundable deposit is required with all registrations. All camp fees are due in full by June 1, 2010. PROGRAM INCLUDES: • On-ice training • 5 ice sessions daily • Puck skills development: passing, shooting, stick handling • Scrimmage to allow the players to just play! • Skating skills development, posture, stride, balance (including video breakdown) • Team play: concepts of 1 on 1, 2 on 1, 2 on 2, 3 on 2, zone, entry, fore checking, defensive positioning • Small area games to allow the development of puck skills and decision making in a reduced area that is competitive and fun OFF-ICE PROGRAM INCLUDES: • Team building activities to stress team work and problem solving skills • Shooting area activities to develop the different shots used in hockey • Video that will include a skating skills breakdown of each player and video on the game of hockey • Classroom that will include visual instructional aides to help the players learn systems, body positioning, and the rules of the game STAFF: On-ice staff will include coaches from Gilmour Academy Girls Prep team and female college players TYPICAL DAY: 7:00 AM - Breakfast 8:00 AM - On-ice skating 9:00 AM - Team building 10:00 AM - On-ice skills 11:00 AM - Shooting area
12:00 PM - Lunch 1:00 PM - Team play on-ice 2:00 PM - Video 3:00 PM - Small area games on-ice 4:00 PM - Classroom
5:00 PM - Dinner 6:15 PM - Group 1 scrimmage 7:30 PM - Group 2 scrimmage
BREAK DOWN: We want every player to be challenged within her ability level. The camp will be divided into two groups by age and experience. RELATED INFORMATION: Check-in time is between 3:00 - 4:00 p.m. Eastern time on July 5. First meal served will be 4:30 p.m. on Monday evening. Last meal will be 8:00 a.m. on Saturday. Commuters will join the camp at 8:00 a.m. and should stay with us all day. Equipment Needed - All players including goaltenders must provide and properly wear their own full legal equipment (helmets, pads, sticks, gloves, etc.) Medical Insurance - EACH PARTICIPANT MUST HAVE HER OWN MEDICAL INSURANCE. A medical and liability release statement including vital medical information can be found in the back of this booklet. It must be completed and signed by both parents or guardians and returned with registration. No camper may participate without this completed form. Confirmation Mailing - You will receive an email confirming your registration in the Girls Hockey Camp. Transportation Assistance - Contact Jackie King at (440) 449-7489.
Enrollment will be held to 60 players to provide the best coach-to-player ratio. Applications accepted on a first-come, first-served basis. For more information, call Rick Filighera (440) 449-7489.
Register online at www.gilmour.org
DAY CAMP (Entering Kindergarten to entering eighth grade) APPLICATION FOR ADMISSION • JUNE 14 - JULY 30 For more information call Brian Minotas at (440) 684-4580 CAMPER’S NAME _____________________________________________________________________________ M _____ F _____
MONTHS ____________ BIRTHDAY __________________________________________
ADDRESS ___________________________________________________________________________________________________ STREET CITY STATE ZIP AGE (AS OF 06/01/10) ____________ SCHOOL ATTENDED ___________________________________________________GRADE (FALL 2010) ______________________
) ______________ CELL PHONE (
) ______________ BUSINESS PHONE (
) _______________
MOTHER’S NAME ____________________________________________________________________________________________ HOME PHONE (
) ______________ CELL PHONE (
) ______________ BUSINESS PHONE (
) _______________
FATHER’S NAME _____________________________________________________________________________________________ HOME PHONE (
EMAIL ADDRESS _____________________________________________________________________________________________ SPECIAL REQUEST: If possible, please group my child with __________________________________________________________
Register online at www.gilmour.org o Week 1: o Week 5: 6/14 7/12
o Week 2: o Week 6:
6/21 7/19
o Week 3: o Week 7:
Choose from the following weeks. • $350/per week
o All Seven Weeks o Week 4: 7/5*
*Four-day week because of holiday.
$75 PER FAMILY PER WEEK.
o L (14-16)
7/26
o BOTH o XL (18-20)
o 7:15 - 8:30 a.m. o 4:00 - 6:00 p.m.
oPLEASE CHECK IF YOU REQUIRE TRANSPORTATION:
o M (10-12)
o American Express
TOTAL:$__________________
o Discover
6/28
There will be no camp Monday, July 5, 2010, in observance of the July 4 holiday. A $50 discount for enrollment during this week will be applied. A $350 nonrefundable deposit is required with all registrations. • All camp fees are due in full by June 1, 2010. No refunds will be given once camp begins.
ALL CAMPS RUN FROM 8:30 a.m. to 4:00 p.m. • LUNCH INCLUDED EVERY DAY.
WHERE DID YOU HEAR ABOUT OUR CAMPS? _____________________________________________________________________
o S (6-8)
o Mastercard
o Personal check (payable to Gilmour Academy)
o Visa
BEFORE AND AFTER CAMP CARE ($5.00 Per Hour): SHIRT SIZE:
METHOD OF PAYMENT:
Card Number: ____________________________________________________________ Exp. Date: ___________________
(Required for all credit card payments)
Signature: _______________________________________________________________ Verification Code______________ ______________________________________________________________________________________________________ Signature of Parent/Guardian Date PLEASE BE SURE TO FILL OUT ADDITIONAL PARENT RELEASE AND EMERGENCY MEDICAL AUTHORIZATION FORMS IN THE BACK OF THIS BOOKLET.
MONTHS ____________ BIRTHDAY __________________________________________
) ______________ CELL PHONE (
) ______________ BUSINESS PHONE (
) _______________
) ______________ CELL PHONE (
) ______________ BUSINESS PHONE (
) _______________
o Mastercard
o Personal check (payable to Gilmour Academy)
o Visa
TOTAL:$__________________
o American Express
(Required for all credit card payments)
PLEASE BE SURE TO FILL OUT ADDITIONAL PARENT RELEASE AND EMERGENCY MEDICAL AUTHORIZATION FORMS IN THE BACK OF THIS BOOKLET.
______________________________________________________________________________________________________ Signature of Parent/Guardian Date
Signature: _______________________________________________________________ Verification Code______________
Card Number: ____________________________________________________________ Exp. Date: ___________________
METHOD OF PAYMENT:
o S (6-8)
o Discover
o 7:15 - 8:30 a.m. o 4:00 - 6:00 p.m. o BOTH o M (10-12) o L (14-16) o XL (18-20) BEFORE AND AFTER CAMP CARE ($5.00 Per Hour): SHIRT SIZE:
o Q. Take a Hike - 7/12 o R. Fun with Piñatas - 7/19 o S. And Sew On . . . - 7/19 o T. Become a Botanist - 7/19 o U. Boys—First Discovery - 7/19 o V. Create Your Own Movie - 7/26 o W. For the Love of Poetry - 7/26
$75 PER FAMILY PER WEEK.
*Four-day week because of holiday.
o I. Ace of Bakes - 6/28 o J. Girls—First Discovery - 6/28 o K. It’s Time to Speak Your Mind - 6/28 o L. All the World’s a Stage - 7/5* o M. Keepers of Light and Time - 7/5* o N. Parlez-vous Français? - 7/12 o O. Dream It. Plan It. Make It. - 7/12 o P. 3D Masterpiece Design Shop - 7/12
o PLEASE CHECK IF YOU REQUIRE TRANSPORTATION:
o A. And the Beat Goes On - 6/14 o B. Be a Digital Rock Star - 6/14 o C. Behind the Curtain - 6/14 o D. So You Think You Want To Dance? - 6/21 o E. Create Your Own Movie - 6/21 o F. Ace of Bakes - 6/21 o G. Keepers of Light and Time - 6/21 o H. Star in Your Own Movie - 6/28
Choose from the following weeks. • $350/per week • These camps can be combined with our other camps.
Register online at www.gilmour.org
There will be no camp Monday, July 5, 2010, in observance of the July 4 holiday. A $50 discount for enrollment during this week will be applied. A $350 nonrefundable deposit is required with all registrations. • All camp fees are due in full by June 1, 2010. No refunds will be given once camp begins.
ALL CAMPS RUN FROM 8:30 a.m. to 4:00 p.m. • LUNCH INCLUDED EVERY DAY.
WHERE DID YOU HEAR ABOUT OUR CAMPS? _____________________________________________________________________
SPECIAL REQUEST: If possible, please group my child with __________________________________________________________
EMAIL ADDRESS _____________________________________________________________________________________________
HOME PHONE (
FATHER’S NAME _____________________________________________________________________________________________
HOME PHONE (
MOTHER’S NAME ____________________________________________________________________________________________
SCHOOL ATTENDED ___________________________________________________GRADE (FALL 2010) ______________________
AGE (AS OF 06/01/10) ____________
ADDRESS ___________________________________________________________________________________________________ STREET CITY STATE ZIP
CAMPER’S NAME _____________________________________________________________________________ M _____ F _____
For more information call Brian Minotas at (440) 684-4580
WEEKLY CAMPS (third grade - eighth grade) APPLICATION FOR ADMISSION • JUNE 14 - JULY 30
PRESCHOOL CAMP (Ages 3 - 5) APPLICATION FOR ADMISSION • JUNE 14 - JULY 30 For more information call Kathie Lipowski at (440) 684-4574 CAMPER’S NAME _____________________________________________________________________________ M _____ F _____
MONTHS ____________ BIRTHDAY __________________________________________
ADDRESS ___________________________________________________________________________________________________ STREET CITY STATE ZIP AGE (AS OF 06/01/10) ____________ SCHOOL ATTENDED ___________________________________________________GRADE (FALL 2010) ______________________
) ______________ CELL PHONE (
) ______________ BUSINESS PHONE (
) _______________
MOTHER’S NAME ____________________________________________________________________________________________ HOME PHONE (
) ______________ CELL PHONE (
) ______________ BUSINESS PHONE (
) _______________
FATHER’S NAME _____________________________________________________________________________________________ HOME PHONE (
EMAIL ADDRESS _____________________________________________________________________________________________ SPECIAL REQUEST: If possible, please group my child with __________________________________________________________
o Half-Day:
o Week 1: o Week 5:
Register online at www.gilmour.org 6/21 7/19
o Week 3: o Week 7:
o Week 4:
7/5*
8:30 a.m. - 4:00 p.m. • $350/per week
7/26
6/28
Choose from the following weeks.
o Week 2: o Week 6:
o FULL-Day:
*Four-day week because of holiday.
8:30 a.m. - 12:30 p.m. • $225/per week
7/12
6/14
There will be no camp Monday, July 5, 2010, in observance of the July 4 holiday. A $25 discount for half-day and $50 discount for full-day enrollment during this week will be applied. Lunch is provided for both half- and full-day enrollment. A $225 nonrefundable deposit is required with all Preschool Camp registrations. All camp fees are due in full by June 1, 2010. • No refunds will be given once camp begins.
WHERE DID YOU HEAR ABOUT OUR CAMPS? _____________________________________________________________________
o M (10-12)
o BOTH o American Express
TOTAL:$__________________
o Discover
o 7:15 - 8:30 a.m. o 4:00 - 6:00 p.m.
, LL PRESCHOOL CAMPERS MUST HAVE REACHED AGE 3 ON OR BEFORE JUNE 15, 2010, AND MUST BE TOILET TRAINED. A TRANSPORTATION IS NOT AVAILABLE FOR PRESCHOOL CAMPERS.
o S (6-8)
o Mastercard
o Personal check (payable to Gilmour Academy)
o Visa
BEFORE AND AFTER CAMP CARE ($5.00 Per Hour): SHIRT SIZE:
METHOD OF PAYMENT:
Card Number: ____________________________________________________________ Exp. Date: ___________________
(Required for all credit card payments)
Signature: _______________________________________________________________ Verification Code______________ ______________________________________________________________________________________________________ Signature of Parent/Guardian Date PLEASE BE SURE TO FILL OUT ADDITIONAL PARENT RELEASE AND EMERGENCY MEDICAL AUTHORIZATION FORMS.
MONTHS ____________ BIRTHDAY __________________________________________
) ______________ CELL PHONE (
) ______________ BUSINESS PHONE (
) _______________
) ______________ CELL PHONE (
) ______________ BUSINESS PHONE (
) _______________
o July 19 - 23 • Outdoor adventure o July 26 - 30 • Outdoor adventure o August 2 - 6 • Sports** o August 9 - 13 • Sports**
o Personal check (payable to Gilmour Academy)
TOTAL:$__________________
o American Express
o BOTH
(Required for all credit card payments)
PLEASE BE SURE TO FILL OUT ADDITIONAL PARENT RELEASE AND EMERGENCY MEDICAL AUTHORIZATION FORMS IN THE BACK OF THIS BOOKLET.
______________________________________________________________________________________________________ Signature of Parent/Guardian Date
Signature: _______________________________________________________________ Verification Code______________
Card Number: ____________________________________________________________ Exp. Date: ___________________
o Discover
o Mastercard
o Visa
METHOD OF PAYMENT:
BEFORE AND AFTER CAMP CARE ($5.00 Per Hour): o 7:15 - 8:30 a.m. o 4:00 - 6:00 p.m. **No before or after camp care available for these weeks.
$75 PER FAMILY PER WEEK.
*Four-day week because of holiday.
o PLEASE CHECK IF YOU REQUIRE TRANSPORTATION:
o June 14 - 18 • Baseball o June 21 - 25 • Golf o June 28 - July 2 • Sports o July 6 - 9 • Sports* o July 12 - 16 • Sports
Choose from the following weeks. • $350/per week • These camps can be combined with our other camps.
Register online at www.gilmour.org
There will be no camp Monday, July 5, 2010, in observance of the July 4 holiday. A $50 discount for enrollment during this week will be applied. A $350 nonrefundable deposit is required with all registrations. • All camp fees are due in full by June 1, 2010. No refunds will be given once camp begins.
ALL CAMPS RUN FROM 8:30 a.m. to 4:00 p.m. • LUNCH INCLUDED EVERY DAY.
WHERE DID YOU HEAR ABOUT OUR CAMPS? _____________________________________________________________________
SPECIAL REQUEST: If possible, please group my child with __________________________________________________________
EMAIL ADDRESS _____________________________________________________________________________________________
HOME PHONE (
FATHER’S NAME _____________________________________________________________________________________________
HOME PHONE (
MOTHER’S NAME ____________________________________________________________________________________________
SCHOOL ATTENDED ___________________________________________________GRADE (FALL 2010) ______________________
AGE (AS OF 06/01/10) ____________
ADDRESS ___________________________________________________________________________________________________ STREET CITY STATE ZIP
CAMPER’S NAME _____________________________________________________________________________ M _____ F _____
For more information call (440) 449-7490
SPORTS CAMP (Ages 5 - 14) APPLICATION FOR ADMISSION • JUNE 14 - AUGUST 13
HOCKEY SCHOOLS (Ages 4 - 14) APPLICATION FOR ADMISSION • JUNE 14 - AUGUST 13 For more information call (440) 449-7490 CAMPER’S NAME _____________________________________________________________________________ M _____ F _____
MONTHS ____________ BIRTHDAY __________________________________________
ADDRESS ___________________________________________________________________________________________________ STREET CITY STATE ZIP AGE (AS OF 06/01/10) ____________ SCHOOL ATTENDED ___________________________________________________GRADE (FALL 2010) ______________________
) ______________ CELL PHONE (
) ______________ BUSINESS PHONE (
) _______________
MOTHER’S NAME ____________________________________________________________________________________________ HOME PHONE (
) ______________ CELL PHONE (
) ______________ BUSINESS PHONE (
) _______________
FATHER’S NAME _____________________________________________________________________________________________ HOME PHONE (
EMAIL ADDRESS _____________________________________________________________________________________________ SPECIAL REQUEST: If possible, please group my child with __________________________________________________________ WHERE DID YOU HEAR ABOUT OUR CAMPS? _____________________________________________________________________
ALL CAMPS RUN FROM 8:30 a.m. to 4:00 p.m. • LUNCH INCLUDED EVERY DAY.
A $350 nonrefundable deposit is required with all registrations. • All camp fees are due in full by June 1, 2010. No refunds will be given once camp begins.
Register online at www.gilmour.org Choose from the following weeks. • $350/per week • These camps can be combined with our other camps.
o American Express
TOTAL:$__________________
o Discover
o BOTH
o July 12-16 • Defenseman Camp Ages 11-14 o July19-23 • “Shoot and Score” Ages 6-10 NEW o July19-23 • “Shoot and Score” Ages 11-14 NEW o July 26-30 • High Intensity Ages 6-10 o July 26-30 • High Intensity Ages 11-14 o August 2-6 • Skills Development Ages 6-10* o August 2-6 • Skills Development Ages 11-14* o August 9-13 • Power Skating Ages 6-10* o August 9-13 • Power Skating Ages 11-14*
$75 PER FAMILY PER WEEK.
o June 14-18 • Learn-to-play o June 14-18 • Hockey/Baseball Ages 6-10 o June 14-18 • Hockey/Baseball Ages 11-14 o June 21-25 • Hockey/Golf “Happy Gilmour Ages 6-10 o June 21-25 • Hockey/Golf “Happy Gilmour Ages 11-14 o June 28-July 2 • “Triple Threat” Forward Camp Ages 6-10 o June 28-July 2 • “Triple Threat” Forward Camp Ages 11-14 o June 28-July 2 • “The Puck Stops Here” Goaltender Camp Ages 6-14 o July 12-16 • Defenseman Camp Ages 6-10
o PLEASE CHECK IF YOU REQUIRE TRANSPORTATION:
o Mastercard
o Personal check (payable to Gilmour Academy)
o Visa
BEFORE AND AFTER CAMP CARE ($5.00 Per Hour): o 7:15 - 8:30 a.m. o4 :00 - 6:00 p.m. *No before or after camp care available for these weeks.
METHOD OF PAYMENT:
Card Number: ____________________________________________________________ Exp. Date: ___________________
(Required for all credit card payments)
Signature: _______________________________________________________________ Verification Code______________ ______________________________________________________________________________________________________ Signature of Parent/Guardian Date PLEASE BE SURE TO FILL OUT ADDITIONAL PARENT RELEASE AND EMERGENCY MEDICAL AUTHORIZATION FORMS IN THE BACK OF THIS BOOKLET.
MONTHS ____________ BIRTHDAY __________________________________________
) ______________ CELL PHONE (
) ______________ BUSINESS PHONE (
) _______________
) ______________ CELL PHONE (
) ______________ BUSINESS PHONE (
) _______________
o Personal check (payable to Gilmour Academy)
TOTAL:$__________________
o American Express
(Required for all credit card payments)
PLEASE BE SURE TO FILL OUT ADDITIONAL PARENT RELEASE AND EMERGENCY MEDICAL AUTHORIZATION FORMS IN THE BACK OF THIS BOOKLET.
______________________________________________________________________________________________________ Signature of Parent/Guardian Date
Signature: _______________________________________________________________ Verification Code______________
Card Number: ____________________________________________________________ Exp. Date: ___________________
o Discover
o Mastercard
o Visa
METHOD OF PAYMENT:
Enrollment will be held to 60 players to provide the best coach-to-player ratio. Please call Rick Filighera at (440) 449-7489 for availability or for any questions you may have concerning the girls hockey camp.
o Overnight camper • $500 • Monday through Saturday
o Day camper • $400 • 8:00 a.m. until end of scrimmage
Choose from day camp (from 8:00 a.m. until end of scrimmage) or overnight camp. Enrollment is limited so please register early. Sign in is on Monday, July 5, 2010.
Register online at www.gilmour.org
A $350 nonrefundable deposit is required with all registrations • All camp fees are due in full by June 1, 2010. No refunds will be given once camp begins.
WHERE DID YOU HEAR ABOUT OUR CAMPS? _____________________________________________________________________
SPECIAL REQUEST: If possible, please group my child with __________________________________________________________
EMAIL ADDRESS _____________________________________________________________________________________________
HOME PHONE (
FATHER’S NAME _____________________________________________________________________________________________
HOME PHONE (
MOTHER’S NAME ____________________________________________________________________________________________
SCHOOL ATTENDED ___________________________________________________GRADE (FALL 2010) ______________________
AGE (AS OF 06/01/10) ____________
ADDRESS ___________________________________________________________________________________________________ STREET CITY STATE ZIP
CAMPER’S NAME _____________________________________________________________________________ M _____ F _____
For more information call Rick Filighera (440) 449-7489
GIRLS HOCKEY CAMP (Ages 6 - 18) APPLICATION FOR ADMISSION • JULY 5 - JULY 10
PARENTAL PERMISSION AND RELEASE/INDEMNITY FOR STUDENT PARTICIPATION IN SCHOOL-SPONSORED ACTIVITIES
____________________________________ Signature of Parent or Legal Guardian
___________________________________ Signature of Parent or Legal Guardian
I, ___________________________, state that I am the parent or legal guardian of ______________________ _____________, (my “Child”), a day camp participant at Gilmour Academy, an Ohio Not-for-Profit Corporation located at 34001 Cedar Road, Gates Mills, Ohio 44040 (the “School”), and that in consideration of the agreement by the School to permit my Child to participate in any and all School-sponsored activities, do state that: This document is provided in place of and to accommodate me and to replace individual authorization for each School-sponsored activity. School-sponsored activities include but are not limited to all athletic events, extracurricular activities, field trips and intra-campus activities. 1. I am aware of the nature of School-sponsored activities and understand there are risks/dangers attendant to my Child’s participation; 2. I hereby agree to permit my Child to participate in any and all such School-sponsored activities unless I advise the School in writing beforehand that I revoke my permission for a particular activity or activities; 3. I warrant that there is accident and health insurance coverage for my Child that will cover my Child while participating in all such School-sponsored activities; 4. In the event of a medical emergency, and after reasonable attempts have been unsuccessful to reach me, I hereby give permission for the representative of the School in charge of the School-sponsored activity to arrange for/and/or authorize emergency medical treatment for my Child; 5. I agree to release, indemnify, protect, defend and hold harmless The School, its teachers, administrators, trustees, supervisors, agents, employees, and all private persons or organizations volunteering services without charge to supervise or chaperone my Child while participating in the School-sponsored activities, from any claim or liability of whatsoever kind or nature, including but not limited to personal injury, including loss of life, or loss of any kind and/or property damage, court costs, attorneys’ fees and interest, as a result of my Child’s participation in the School-sponsored activities. I do not agree, however, to such release in the case of gross negligence or willful or intentional inappropriate actions or inactions by employees of the School which harm my Child; 6. I agree that The School, its teachers, administrators, trustees, supervisors, agents, employees and all private persons or organizations volunteering services without charge, may terminate my Child’s participation in any School-sponsored activities if my Child fails to behave or act in accordance with the School’s rules and/or regulations on conduct, fails to follow the instructions and/or directions of teachers, administrators, trustees, supervisors, agents, employees and all private persons or organizations volunteering services, or evidences conduct deemed to be detrimental to or incompatible with the interest, comfort or welfare of those participating in the School-sponsored activities including students, School representatives and supervisors as determined by the representative of the School in charge of the School-sponsored activity. Accordingly, I hereby authorize summer Camp Directors and other respective administrators to administer and enforce disciplinary action in the event of any violation of or noncompliance with such rules and/or regulations by my Child. __________ Date
FULL PAYMENT is due with the completed registration form on or before June 1, 2010. Any photos or video tape footage taken of your child are used for Gilmour Academy camp purposes only. Images may be used for promotional or educational purposes only.
Zip
Grade Level
Relationship
2. Name
Address
Address
Phone
Phone
Phone Phone
Dentist Eye Doctor
Most Recent Tetanus Shot: Immunization Update:
Recent Illness/Injury/Surgery: Other Medical Information:
Signature of Parent/Guardian__________________________________________
Date_________________
I DO NOT give my consent for emergency medical treatment of my child. In the event of illness or injury requiring emergency treatment, I wish the school authorities to take the following action: _________________________________________________________ ___________________________________________________________________________________________________________
Part 2: Refusal of Consent - Do not complete Part 2 if you completed Part 1
Signature of Parent/Guardian___________________________________________ Date_________________
Allergies:
Disabilities:
Current Medication being taken:
In the event reasonable attempts to contact me have been unsuccessful, I hereby give my consent for (1) the administration of any treatment deemed necessary by above named doctors, or, in the event the designated preferred practitioner is not available, by another licensed physician or dentist; and (2) the transfer of my child to any hospital reasonably accessible
Phone
Hospital
Physician
following medical care providers and local hospital to be called:
Part 1: To Grant Consent - In the event that the parents/guardians cannot be reached, I hereby grant consent for the
Relationship
1. Name
If I cannot be contacted and it is advisable to send my child home due to minor illness, or for emergency treatment due to injury, he/ she can be released in the custody of (I have notified this person of this listing):
Cell Phone
Cell Phone
Home Phone
Date of Birth
Group Number
Business Phone
Business Phone
State
Middle Name
ID Number
Occupation
Father/Guardian Name Name of Primary Health Insurance
Occupation
Mother/Guardian Name
Student Information:
City
First Name
Street Address
Last Name
Student Information:
PURPOSE: To enable parents and guardians to authorize the provision of emergency treatment for campers who become ill or injured while under school authority, when parents or guardians cannot be reached.
GILMOUR ACADEMY EMERGENCY MEDICAL AUTHORIZATION