2103 JCC Day Camp Brochure

2013 Summer Day Camp Guide

New this summer: jccstl.org facebook.com/jdaycamps

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Wet & Wild Water Camp Maryville University Basketball Camp Lego Robotics Camps Expanded …Plus Lunch!

Girls Field Hockey Camp Expanded Arts Offerings Much more!

Baseball Fields

Millstone Campus Creve Coeur

Silver Pavillion

Camp Nat Koplar

Tennis Court

Playground Flag Pole

Israel

Basketball Court

Staenberg Family Complex

Indoor Pool

New Pavillion

Soccer Fields

Sports Wall Gym

Air Conditioned Program Space

Art

Cooking

Drama

Camp Nurse

Blast Off Campers entering grades K – 5 Staenberg Family Complex 9am – 3pm May 28 – 31

Contact: Patrick Fox 314-442-3198 pfox@jccstl.org

There’s no better place to kick off your summer than at the J Day Camps. Campers experience the “best of camp,” including lots of swimming in the outdoor recreational pool and games on the sports fields. Hang out, make new friends and have a blast!

New specialty camp!

Maryville Basketball Camp Campers Campers entering grades 1 – 8 Staenberg Family Complex Staenberg 9am – 3pm 9am May 28 – 31 May

Contact: Chris Horan 314-442-3498 choran@jccstl.org

Maryville University’s Head Coach Kevin Carroll and his team of players and coaches lead a week of basketball training. Campers will enhance their skills on the hardwood. Don’t miss this opportunity to receive coaching and training from a collegiate-level basketball coach.

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Camp Kehillah Sidney R Baer Track, Hyman Multin Sports Track, Gymnastics Cheer and Dance Track and Milton Frank Camp of the Arts Track. Choose your track, see details below.

Morning flagpole, field trips, themed weeks, Friday Shabbat and all-camp events (including Maccabi Color Day and Israel Day) are all included in these camps.

Campers participate in recreational swim and Red Cross instructional swim lessons daily. Specialized activities in arts, sports, nature and science will be offered. We also partner with Abra Kid Abra, KidzArt, Science Center, the Fencing Academy and Dan O’Keefe (soccer) to make the summer extra special. An optional trip* to Camp Sabra, our overnight camp at the Lake of the Ozarks, is offered for campers entering grades 3 – 5 from June 18 – 20. *extra fee of $125 applies

Sidney R. Baer Track Campers entering grades K – 5 Staenberg Family Complex 9am – 3pm June 3 – August 9

Contact: Joey Boime 314-442-3423 jboime@jccstl.org

The perfect track for kids who enjoy a little bit of everything: nature, sports, music, arts and crafts, drama and cooking. Campers also enjoy fencing, fishing, archery, fire-building, nature hikes and mural painting. Activities are taught by professional instructors. “Discover the spirit” and learn what has made this the J’s most popular camp for more than 40 years!

Hyman Multin Sports Track Campers entering grades K – 5 Staenberg Family Complex 9am – 3pm June 3 – August 9

Contact: Natalie Lesko 314-442-3104 nlesko@jccstl.org

Ideal for the active, sports-minded camper, this track features the right balance of professional and staff sport instruction along with recreational play. Each day is filled with a variety of individual and team sports, including baseball, soccer, basketball, flag football, floor hockey and weekly tennis instruction. Campers also play ga-ga, hit the pin, mat ball, kickball, capture the flag, wall ball, plus all-camp favorites tennis baseball, exciting World Cup Soccer & the much-anticipated Wifflemania tournaments. Afternoon activities include sports, art, nature, Israeli culture and swimming.

Dan O’Keefe Soccer July 29 – August 2

Girls Got Game – All Girls Hyman Multin Sports Track Campers entering grades K – 5 Staenberg Family Complex 9am – 3pm June 17 – 21 & June 24 – 28

Contact: Natalie Lesko 314-442-3104 nlesko@jccstl.org

More weeks!

A week-long sports track just for girls! Ideal for the active, sports-minded camper, this track features the right balance of staff sport instruction along with recreational play. Girls will learn new skills, make new friends and compete all week long.

Activities include lacrosse, basketball, soccer, softball, fitness, volleyball and more.

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Gymnastics, Cheer & Dance Track

New for kindergarten

Campers entering grades K – 5 Staenberg Family Complex 9am – 3pm June 3 – August 9

Contact: Natalie Lesko 314-442-3104 nlesko@jccstl.org

Boys and girls will learn to love everything about gymnastics in this track favorite!

Campers are placed in skill groups (levels 1-4) which accommodate each child’s ability and progress. Boys are placed in all-boys groups (subject to enrollment).

Campers will develop new skills and techniques including tumbling, stunts, dance and cheer. A special performance for family and friends is included.

Milton Frank Camp of the Arts Track Campers entering grades K – 5 Staenberg Family Complex 9am – 3pm June 3 – August 9

Contact: Cindy Lewis 314-442-3239 clewis@jccstl.org

Camp of the Arts is ideal for children who love to create! The first five weeks of the summer are filled with a variety of both performing art and fine art activities including theatre, music, pottery, jewelry-making, culinary arts, painting and more.

New to the Staenberg Family Complex this year, the last five weeks offers campers the opportunity to choose from specialty camps taught by professionals working in the arts. Around the World in a Week gives campers a taste of different cultures through cooking, music and art from a different country each day. Open Curtain Camp is all about theatre! Campers learn all facets of creative drama including improvisation, storytelling and character development – and they’ll even put on their own show. Kids learn about the ancient art of puppetry and create their own scripts and puppet show in Puppetry and Playwriting. Campers learn different types of dance and explore the art of movement in Yoga and Dance. Additionally, they will explore animated poses while increasing flexibility and focus. The final week of camp is all about ‘clowning around’ with Circus Camp, where kids practice acrobatics and juggling, and then put on a mini circus at the end of the week.

June 3 – July 5: Camp of the Arts July 8 – 12: Around the World in a Week July 15 – 19: Open Curtain Camp July 22 – 26: Puppetry and Playwriting July 29 – August 2: Yoga and Dance August 5 – 9: Circus Camp

New specialty camp!

LEGO® Robotics Campers entering grades 3 – 5 Staenberg Family Complex 9am – 3pm June 17 – 21

Contact: Patrick Fox 314-442-3198 pfox@jccstl.org

Campers spend a week learning how to make a LEGO® robot using the Mindstorms® NXT set. Program it on the computer to perform tasks ranging from the very simple to the most complex – it’s up to you! Campers will also participate in recreational swim each day. On the last day, invite friends and family to see what your robot can do. Space is limited, so sign up early!

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Pre and Post Care Campers entering grades K – 7 Staenberg Family Complex 7am – 9am and/or 3pm – 6pm May 28 – August 9

Contact: Patrick Fox 314-442-3198 pfox@jccstl.org

Ideal for working families – campers extend their camp days with even more fun fun and structured activities, including arts and crafts, games, cooking, science and and swimming. A kosher snack is provided in the afternoon. Families must enroll by by the week.

Camp Nat Koplar Campers ages 3 – 5 years Staenberg Family Complex Full Day - 9am – 3pm Half Day - 9am – 12:30pm or Combo - M/W/F 9am – 3pm &

T/TH 9am – 12:30pm June 3 – August 2

Contact: Ellen Scholten 314-442-3230 escholten@jccstl.org

Camp Nat Koplar has been the best camp program for preschool age children for art, over 25 years. Your camper will have tons of fun experiencing music, storytelling, art, swimming, sports and nature in our one of a kind wooded campgrounds. Campers daily. also participate in recreational swim and Red Cross instructional swim lessons daily.

Campers must be fully toilet trained.

...Plus Lunch!

Take a break from making lunch on Tuesdays and/or Thursdays. For just $5/meal, campers can enjoy a delicious, nutritious, kosher sack lunch. Register for lunch when you register for camp. Lunch registrations must be completed at least one week in advance.

Tuesdays: Hot dog, pretzels, cucumber slices and a delicious chocolate chip cookie Thursdays: Pizza bagel, chips, carrot sticks and a delicious chocolate chip cookie Beverage is included. Sorry, no substitutions.

Expanded by popular demand!

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New! Ovenight Camping Trip!

Ben Akiba Teen Mitzvah Campers entering grades 6 – 8 Staenberg Family Complex 9am – 3pm June 3 – August 9

Contact: Joey Boime 314-442-3423 jboime@jccstl.org

Campers participate in traditional camp activities with an emphasis on Mitzvah, or community service projects. We’ll team up with other organizations to provide community service as well as diversity education. Receive community service project hours for school or Bar/Bat Mitzvah. Weekly field trips to St. Louis attractions are incorporated into the schedule. New this summer: an overnight camping trip! Teen camp also takes the Mitzvah on the road with two trips, to Nashville (June 25-27) and Indianapolis (July 16-18). An additional $195 will apply for the road trips.

Leaders in Training (L.I.T.)

Half Price!

Campers entering grade 9 Staenberg Family Complex 9am – 3pm June 3 – August 9

Contact: Joey Boime 314-442-3423 jboime@jccstl.org

Half-price tuition! The Leaders in Training program prepares campers who have almost concluded their day camp careers for high school by providing programs that focus on team-building, leadership development, sports, arts and crafts, and Jewish education. L.I.T.s meet for part of the week and also spend time with Ben Jewish Akiba Teen Mitzvah Camp. Receive community service project hours for school. LITs Akiba will also take the Mitzvahs on the road with two trips, to Nashville (June 25-27) and will Indianapolis (July 16-18). An additional $195 will apply for the road trips.

Indianapolis

Counselor in Training (C.I.T.) Campers Campers entering grade 10 9am – 3pm 9am June 3 – August 9 June

Contact: Joey Boime 314-442-3423 jboime@jccstl.org

The The J’s C.I.T. program: where counselors are made! Participants are trained to become counselors during pre-camp orientation and are placed in a variety of become different groups and camps throughout the summer so they can decide what they different like best. Receive community service project hours for school. C.I.T.s are required to like fill out a staff application and go through the interview process. FREE Training! fill

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Teen Skills 16 – 20 year olds with developmental disabilities Staenberg Family Complex 8am – 4pm June 3 – August 2

Contact: Inclusion Coordinator 314-442-3295

Campers work on acquiring essential social and vocational skills as they transition into adulthood. Participants spend the majority of the week in the community, engaging in a variety of interesting volunteer and recreational activities. In the past, we’ve gone to places like the St. Louis Artists’ Guild, Habitat for Humanity, Missouri Botanical Garden, Worth Industries and more. At the J, the group plays games and sports, swims, cooks, works out, explores nature and has an all-around great time utilizing our facilities.

Senior Maccabi Sports Camp Campers entering grades 6 – 8 Marilyn Fox Building 9am – 3pm June 3 – August 9

Contact: Chris Horan 314-442-3498 choran@jccstl.org

Sports camp in Chesterfield features great competition, skill-building, professional and technical instruction and swimming just for middle schoolers. “Race for the Cup” is a four-week, ongoing competition that is sure to create rivalries, enhance friendships and facilitate some of the greatest sports moments in J history! The “Race” concludes with an overnight sleepover/lock-in and party on June 27 – 28.

Don’t miss this awesome opportunity to compete! New Wet & Wild Camp, cool off and join us for a week of fun filled field trips to water parks and local pools. Campers will participate in water sports, water parks, and water games throughout the week.

New June 3 – 28: Multi Sports “Race for the Cup” July 1 – 5: Wet & Wild Camp - NEW (Holiday discount does not apply) Lineup!

July 8 – 12: J Baseball and Softball Academy Camp July 15 – 19: NFL Flag Football Camp July 22 – 26: Soccer Performance Camp July 29 – August 2: Kelvin Lee Basketball Camp August 5 – 9: Lacrosse Camp Camp Sabra – All the Elements of a Great Summer

EARTH

FI R E

W AT E R

A IR

Camp Sabra Campers entering grades 3 – 10 Session 1: June 9 – July 5 Session 2: July 8 – August 2

Contact: Terri Grossman 314-442-3180 terri@campsabra.com campsabra.com

Spend a magical summer at the Lake of the Ozarks sleeping in cabins, eating s’mores and singing camp songs! With 205 acres of wooded terrain and 3.5 miles of private shoreline, you’ll never run out of things to do. Develop new skills, new interests and make lifelong friendships as you sail, water tube, water ski, funyak, climb the high & low ropes courses, act, sing, play sports and so much more…and did we mention the food is awesome?!

Not quite ready for sleep-away camp? Some day camps (entering grades 3-5) offer a short, optional trip to Camp Sabra, June 18-20.

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Fox Campus Chesterfield

Playground

Garden Gym

Sports Camp

GAME

Music, Cooking, Drama

Indoor Pool

(Air Conditioned)

Slides

Carpool

Water Water Basketball Basketball

Climbing Rock Wall

Baseball Fields

Outdoor Pool

Flag Pole

Blast Off Campers Campers entering grades K – 5 Marilyn Fox Building Marilyn 9am – 3pm 9am – May 28 – 31 May 28

Contact: Patrick Fox 314-442-3431 pfox@jccstl.org

There’s There’s no better place to kick off your summer than at J Day Camps. Campers experience the “best of camp,” including lots of swimming in the outdoor recreational experience pool and team games on the sports fields. Hang out, make new friends and have a pool and blast!

Cheer, Dance & Spirit

New expanded grades 8

Campers entering grades K – 6 Marilyn Fox Building Marilyn 9am – 3pm 9am May 28 – 31 May

Contact: Fanchon Auman 314-442-3420 fauman@jccstl.org

Learn Learn to cheer, jump, tumble and dance while building self confidence, teamwork and friendships. This week also focuses on a healthy heart and includes arts & crafts, and and and fun in the pool. Campers receive a t-shirt and poms. Families are invited to a culminating culminating pep rally.

Maccabi Sports Camp Campers entering grades K – 5* Marilyn Fox Building 9am – 3pm June 3 – August 9

Contact: Chris Horan 314-442-3498 choran@jccstl.org

“Race for the Cup,” returns this summer! The four-week, ongoing competition inspires rivalries, builds friendships, and creates some of the greatest sports moments in J history! Don’t miss this awesome opportunity to compete in The MultiSport “Race for the Cup.” The “Race” concludes with an overnight sleepover/lock-in and party on June 27-28. New Wet & Wild Camp, cool off and join us for a week of fun-filled field trips to water parks and local pools. Campers will participate in water sports, water parks, and water games throughout the week. An optional trip** to Camp Sabra, our overnight camp at the Lake of the Ozarks, is offered for campers campers entering grades 3 – 5 from June 18 – 20. **extra fee of $125 applies June 3 – 28: Multi Sports “Race for the Cup” July 1 – 5: Wet & Wild Camp - NEW (Holiday discount does not apply) July 8 – 12: J Baseball and Softball Academy Camp July 15 – 19: NFL Flag Football Camp July 22 – 26: Soccer Performance Camp July 29 – August 2: Kelvin Lee Basketball Camp August 5 – 9: Lacrosse Camp

NEW Wet & Wild Camp

*Check out the Teen Opportunities page for Senior Maccabi Sports Camp for grades 6 – 8.

Girls Got Game – All-Girls Maccabi Sports Camp Campers entering grades 2 – 8 Marilyn Fox Building 9am – 3pm July 15 – August 2

Contact: Chris Horan 314-442-3498 choran@jccstl.org

Back by popular demand, this girls-only camp provides an opportunity to learn new new skills, make new friends and compete in a variety of different sports and games. The games. The week of July 15 will allow girls to sample a little bit of all sports. The week of July July 22 will focus on Field Hockey – brand new this summer! The week of July 29 will will focus on soccer. Girls will participate in a variety of different soccer drills and games. and games.

Christie Cigno, current coach for Scott Gallagher Soccer Club and former Auburn Auburn University and St. Joseph’s Academy standout, will be the lead instructor. Come for all instructor. Come for all three weeks and be prepared for fun!

Expanded to 3 weeks!

July 15 – 19: Multi Sports Camp July 22 – 26: Field Hockey Camp July 29 – August 2: Soccer Performance Camp

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Hi-NRG Gymnastics Campers entering grades 1 – 5 Marilyn Fox Building 9am – 3pm August 5 – 9

Contact: Chris Horan 314-442-3498 choran@jccstl.org

Hi-NRG Gymnastics is back! You know that gymnastics builds coordination, strength and flexibility, but it also builds determination, confidence and self-esteem!

Knowledgeable coaches instruct campers as they cartwheel and bounce their way through the gym. Space is limited – sign up early!

Camp Essman Gadol Campers entering grades K – 5 Marilyn Fox Building 9am – 3pm June 3 – August 9

Contact: Joey Boime 314-442-3423 jboime@jccstl.org

The perfect camp for kids who enjoy a little bit of everything: nature, sports, music, arts and crafts, drama and cooking. Activities are taught by professional instructors.

Campers participate in recreational swim and Red Cross instructional swim lessons daily. Specialized activities in arts, sports, nature and science are offered. Abra Kid Abra, KidzArt, Science Center, the Fencing Academy, and Dan O’Keefe soccer are just some of our partners who help make the summer extra special. “Discover the spirit” and learn what has made this one of the best camps in Chesterfield. An optional trip* to Camp Sabra, our overnight camp at the Lake of the Ozarks, is offered for campers entering grades 3 – 5, June 18 – 20. *extra fee of $125 applies

LEGO® Robotics

New specialty camp!

Campers entering grades 3 – 5 Marilyn Fox Building 9am – 3pm July 8 – 12

Contact: Patrick Fox 314-442-3198 pfox@jccstl.org

Campers spend a week learning how to make a LEGO® robot using the Mindstorms® NXT set. Program it on the computer to perform tasks ranging from the very simple to the most complex – it’s up to you! Campers will also participate in recreational swim each day. On the last day, invite friends and family to see what your robot can do. Space is limited, so sign up early!

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J Players Campers entering grades 5 – 8 Marilyn Fox Building 9am – 3pm June 24 – July 5* and/or July 8 – 19*

Contact: Cindy Lewis 314-442-3239 clewis@jccstl.org

New this summer!

Learn everything there is to know about theatre, from stepping into the spotlight to spotlight to working behind the scenes at the debut of The J Players camp! Campers will learn learn the art and humor of improvisation and sketch comedy, and they will play a variety variety of improv games and perform scenes from plays with partners. The campers will select a theme and write their very own play to be performed at the end of the twoweek session for parents and the community. They will create sets, make props and design costumes to dress their productions. There will be a different ensemble and production each session, but campers are welcome to participate in all four weeks.

No experience in theatre necessary. *Must register for full two-week session

Milton Frank Camp of the Arts Campers entering grades 2 – 6 Marilyn Fox Building 9am – 3pm June 3 – August 9

Contact: Cindy Lewis 314-442-3239 clewis@jccstl.org

The summer begins with six weeks of specialty camps taught by professionals working in the arts and culminates with four weeks of Camp of the Arts for a taste of everything art.

Start the summer with Pottery Camp, and work with the most pliable art form, from molding to finish. (We’ve added an optional second week for those who love pottery and want to try more elaborate projects, but you may register for either or both weeks.). Open Curtain Camp is all about theatre! Campers learn all the facets of creative drama including improvisation, storytelling, and character development – and will even put on their own show. Around the World in a Week gives campers a taste of different cultures through cooking, music and art from a different country each day. Explore the art of food and culinary perfection catered to kids in Cooking Camp. Kids can ‘clown around’ with Circus Camp, where they’ll also practice acrobatics and juggling, and put on a mini circus at the end of the week.

Camp of the Arts is ideal for children who love to create! Throughout these four weeks campers will participate in a variety of both performing art and fine art activities, including theatre, music, pottery, jewelry-making, painting, culinary arts painting, culinary arts and more.

All campers participate in recreational swim and/or Red Cross swim lessons daily, as Cross swim lessons daily, as well as other general camp activities.

June 3 – 7: Pottery Camp June 10 – 14: Pottery Camp June 17 – 21: Open Curtain Camp June 24 – 28: Around the World in a Week July 1 – 5: Cooking Camp July 8 – 12: Circus Camp July 15 – August 9: Camp of the Arts

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Camp Essman Katan Campers age 3 – 5 years Marilyn Fox Building Full Day- 9am – 3pm Half Day- 9am – 12:30pm or Combo- M/W/F 9am – 3pm &

T/TH 9am – 12:30pm June 3 – August 2

Contact: Linda Rosenblatt 314-442-3456 lrosenblatt@jccstl.org

This is the perfect camp experience for your preschooler. Campers will enjoy music, storytelling, art, nature, daily swimming and sports, building a foundation for fun Jewish experiences. Campers participate in recreational swim and Red Cross instructional swim lessons daily. Campers must be fully toilet trained.

Pre and Post Care Campers entering grades K – 7 Marilyn Fox Building 7am – 9am and/or 3pm – 6pm May 28 – August 9

Contact: Patrick Fox 314-442-3431 pfox@jccstl.org

Ideal for working families – campers extend their camp day with even more fun and structured activities, including arts and crafts, games, cooking, science and swimming. A kosher snack is provided in the afternoon. Families must enroll by the week.

...Plus Lunch!

Expanded by popular demand!

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Take a break from making lunch on Tuesdays and/or Thursdays. For just $5/meal, campers will enjoy a delicious, nutritious, kosher sack lunch. Register for lunch when you register for camp. Lunch registrations must be completed at least one week in advance.

Tuesdays: Hot dog, pretzels, cucumber slices and a delicious chocolate chip cookie Thursdays: Pizza bagel, chips, carrot sticks and a delicious chocolate chip cookie Thursdays: Beverage included. Sorry, no substitutions.

Beverage

Director: Joey Boime • 314-442-3423 • jboime@jccstl.org Registrar: Sara Jones • 314-442-3432 • sjones@jccstl.org Inclusion Coordinator: 314-442-3295 Everyone can camp at the J! The J invites and welcomes ALL persons, including those with disabilities, to participate in camp and other programs. Contact the Inclusion Coordinator at 314-442-3295 before April 1, 2013 for more information about our inclusion program. Space is limited.

J Day Camps encourage diversity. Campers of all backgrounds are welcomed regardless of race, faith or national origin. We instill a sense of community and connection to Jewish culture, values and history.

J Day Camps include Red Cross-certified swim instruction.

Both J locations have multiple indoor and outdoor pools and offer Red Cross-certified swim instruction daily. Our swim program helps campers achieve confidence and success in the pool.

For Alpha Waves Swim Team and Swim Academy after-camp lessons, contact Kyle Fetick at 314-442-3296 or kfetick@jccstl.org.

Financial Aid To apply for financial assistance go online at www.jccstl.org and download a scholarship application, email slang@jccstl.org or call 314-442-3241. A Day Camp application and scholarship application must be submitted in order to be considered. Scholarship dollars are limited. Scholarship applications must be received no later than April 15, 2013- with payment arrangements made prior to the start of camp.

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2013 JCC DAY CAMP APPLICATION

Return your application and forms by: Mail- JCC, Attn: Day Camp Registrar, 2 Millstone Campus Drive, St. Louis, MO 63146 Fax- 314-442-3404 Email- sjones@jccstl.org Or In Person- at either J location IMPORTANT REGISTRATION INFORMATION Please read carefully before completing application.

Complete ONE application for each child Registrations will not be processed until ALL forms have been completed with appropriate deposit or payment and your account is in good standing.

Registration includes ALL FORMS: Day Camp Application completed, Camp Waiver and Releases of Liability signed, Protocol Medication Consent/Behavior Policy signed and a Physician’s Statement (signed and dated by a physician from September 2011- present).

CAMPER INFORMTION: JCC Membership #_________________________ o Non Member

o Male

o Female

Camper’s First Name ___________________________________Camper’s Last Name ________________________________________ Grade Entering in Fall ____________ Camper’s Date of Birth ___________ School Attending ________________________________ Buddy Request ___________________________________________________________________________________________________ Address _________________________________________________________________________________________________________ City _____________________________________________________ State ________________Zip ______________________________ Home Phone _____________________________________________ Religious Affiliation ______________________________________ E-mail address for camp communication ____________________________________________________________________________ Parent # 1 Full Name _____________________________________________ Cell Phone ______________________________________ Work Phone ______________________________________________ Home Phone ___________________________________________ Address (if different from child) _____________________________________________________________________________________ Parent # 2 Full Name _____________________________________________ Cell Phone ______________________________________ Work Phone ______________________________________________ Home Phone ___________________________________________ Address (if different from child) _____________________________________________________________________________________ PICK UP FOR CHILD: The following people are authorized to pick up my child from the JCC: Name _______________________________________________________Phone______________________________________________ Name _______________________________________________________Phone______________________________________________ Name _______________________________________________________Phone______________________________________________ INSURANCE INFORMATION: Camper’s Primary Physician & Phone # _________________________________________________ Insurance Company_______________________________________ Insurance ID# ___________________________________________ Name of Insured __________________________________________________________________________________________________ In the event that you can’t be reached in an emergency, who should be contacted?

1. ____________________________________ Phone _____________________________ Cell Phone ___________________________ 2. ____________________________________ Phone _____________________________ Cell Phone ___________________________ Allergies: Does your child have food or other allergies? o Yes o No If yes please describe _____________________________________________________________________________________________

Inclusion Services: Does your child have special needs that require a shadow at camp?

Does your child receive any support services during the school year? o Yes o No If yes, please check all that apply: o Speech Therapy o Occupational Therapy

o Yes o No o Resources

In order to reserve a space for your child, please call our Inclusion Coordinator at 314-442-3295. Inclusion Coordinator MUST confirm your registration. SPACE IS LIMITED! Payment Information PLEASE READ CAREFULLY AND SIGN: A credit card must be on file for ALL registrations. Please fill out the credit card information to be used for camp payments and additional camp charges. This authorizes all payments regarding Day Camp to be charged to this credit card.

A $50 REQUIRED NON-REFUNDABLE DEPOSIT per child per week up to $200 is required to complete an application and will be applied toward camp fees.

All camp fees must be paid IN FULL by May 15th. If registering after May 1st camp fees must be PAID IN FULL with application.

POLICIES FOR CANCELLATIONS • Notify the day camp registrar in writing of any cancellations.

• Cancellations at least 14 days prior to the start of camp will result in a full refund, less the non-refundable deposit (No deposit will be withheld if total registration remains greater than four weeks).

• NO REFUND will be issued for any programming that begins within 14 days of cancellation notice.

• NO PRO-RATED OR FULL REFUND shall be permitted if a camper leaves before the end of the period for which he or she has been registered.

• NO REFUNDS for missing camp due to illnesses. We DO NOT offer partial payment for days missed.

Change policy When two or more changes in a camper’s summer schedule are requested a $25 camp change fee will be assessed for the second and each subsequent change.

Late Registrations Applications submitted LESS THAN 1 WEEK prior to the start of camp will be assessed an additional $25 processing fee. ** I have read and understand the policies listed in this document.

REQUIRED: Signature of Parent or Guardian ___________________________________________ Date ______________________ PAYMENT OPTIONS (A credit card must be on file for all registrations) o Check for Full Amount Enclosed (Check payable to JCC) o Charge my credit card for the full amount of camp today. o Check enclosed for deposit and a VOIDED check for automatic payments.* o Charge my credit card for the deposit today, then for automatic payments.* o Check for deposit is enclosed, charge my credit card automatic payments.* o I will be submitting an application for Financial Assistance**, enclosed is a check for the non-refundable $25 deposit per child. o I will be submitting an application for Financial Assistance**, please charge my credit card for the non-refundable $25 deposit per child.

Type of Card: o Visa o Mastercard o Discover o AMEX Card Number: _______________________________________________ Name of Cardholder _____________________________________________________Expiration Date ___________________________ Signature of cardholder _______________________________________________________________ Date ______________________ *Automatic payments Automatic payments are available to those who submit a complete application before May 1, 2013. Otherwise payment is due in full.

Automatic payment schedule: Applications received before March 1 -three automatic payments of one third of camp balance each will be processed between the 5th and 10th business day of March, April and May. Applications received March 1 – March 31 -two automatic payments of half of camp balance will be processed between the 5th and 10th business day of April and May. Applications received April 1-30 -one automatic payment of camp balance will be processed between the 5th and 10th business day of May. Processing dates are subject to change. *Financial Assistance To apply for financial assistance go online at www.jccstl.org and download a scholarship application, email slang@jccstl.org or call 314-442-3241. A Day Camp application and scholarship application must be submitted in order to be considered. Scholarship dollars are limited. Scholarship applications must be received no later than April 15, 2013- with payment arrangements made prior to the start of camp.

2013 JCC Day Camp Application Camper’s Name:_________________________________________________Parent’s Name: ________________________________________________

CHESTERFIELD - MARILYN FOX BUILDING CAMPS

Week of: Grade

Time

Blast Off

K-5

9a-3p

Cheer, Dance & Spirit

K-6

9a-3p

Essman Gadol

K-5

9a-3p

Lego Robotics Maccabi Multi Sports “Race for the Cup” Sports Wet & Wild Camp Camp (Holiday Discount does not apply)

3-5

9a-3p

K-8

9a-3p

K-8

9a-3p

JCC Baseball/Softball Academy

K-8

9a-3p

NFL Flag Football

K-8

9a-3p

Soccer Performance Camp

K-8

9a-3p

Kelvin Lee Basketball Camp

K-8

9a-3p

Lacrosse Camp

K-8

9a-3p

Hi-NRG Gymnastics Girls Got Game Girls Got Game Multi Sports Girls Field Hockey Camp

1-5

9a-3p

2-8

9a-3p

2-8

9a-3p

Girls Soccer Performance Camp Milton Frank Pottery Camp Camp of Open Curtain Camp the Arts Around the World in a Week

2-8

9a-3p

2-6

9a-3p

2-6

9a-3p

2-6

9a-3p

Cooking Camp

2-6

9a-3p

Circus Camp

2-6

9a-3p

Camp of the Arts

2-6

9a-3p

The J Players

5-8

9a-3p

Preschool Camp Essman Katan

3-5yrs

9a-3p

take 35% off PPW Essman Katan Half Day

3-5yrs

9a-12:30p

take 15% off PPW Essman Katan Combo M/W/F - 9am-3pm Tu/Th - 9am-12:30pm

3-5yrs

Varies

K-7

7a - 9a

Post Care

K-7

3p - 6p

Pre and Post Care

K-7

Both

All

Lunch

All

Lunch

3-5

6/18-6/20

6/3

6/10

6/17

6/24

7/1**

7/8

7/15

7/22

7/29

8/5

Total Camp Weeks

Pre/Post Care Pre Care

…Plus Lunch …Plus Lunch Tues (Hot dog) …Plus Lunch Thurs (Pizza bagel) Optional Trips

5/28**

Total Pre/Post Weeks

Total Plus Lunch Weeks Optional Camp Sabra Trip

Total Camp Weeks

….Plus Lunch Weeks

x Price Per Week*

x Price Per Week*

Equals

Subtotal 3

Holiday Discount* Subtotal 1

Subtotal 1 Subtotal 2

Pre/Post Care Weeks

Subtotal 3

x Price Per Week*

Optional Trips*

Subtotal 2

Total

* See Price Per Week (PPW) Chart for ALL prices and discounts, located on back cover. **Holiday Discount - NO camp May 27 or July 4

Total 5% Sibling Discount Grand Total

Total wks

2013 JCC Day Camp Application Camper’s Name:_________________________________________________Parent’s Name: ________________________________________________

CREVE COEUR - STAENBERG FAMILY COMPLEX CAMPS

Week of: Grade

Time

Blast Off

K-5

9a-3p

Maryville Basketball Camp

1-8

9a-3p

Lego Robotics

3-5

9a-3p

K-5

9a-3p

K-5

9a-3p

Girls Got Game Track

K-5

9a-3p

Gymnastics Cheer & Dance Track

K-5

9a-3p

K-5

9a-3p

Camp Sidney R. Bear Track Kehillah Hyman Multin Sports Track

Milton Frank Camp of the Camp of the Arts Arts Track Around the World in a Week

Teen Camps take 50% off PPW Preschool Camps take 35% off PPW take 15% off PPW

K-5

9a-3p

Open Curtain Camp

K-5

9a-3p

Puppetry and Playwriting

K-5

9a-3p

Yoga and Dance

K-5

9a-3p

Circus Camp

K-5

9a-3p

Ben Akiba Teen Mitzvah

6-8

9a-3p

Leaders in Training (L.I.T)

9

9a-3p

Camp Nat Koplar

3-5yrs

9a-3p

Camp Nat Koplar Half Day

3-5yrs

9a-12:30p

Camp Nat Koplar Combo M/W/F - 9am-3pm Tu/Th - 9am-12:30pm

3-5yrs

Varies

K-7

7a - 9a

K-7

3p - 6p

K-7

Both

All

Tues

All

Thurs

5/28**

6/3

6/10

6/17

6/24

7/1**

7/8

7/15

7/22

7/29

8/5

Total wks

Total Camp Weeks

Pre/Post Care Pre Care Post Care Pre and Post Care …Plus Lunch …Plus Lunch Tues (Hot dog) …Plus Lunch Thurs (Pizza bagel)

Total Pre/Post Weeks

Total Plus Lunch Weeks Optional Trips

Optional Camp Sabra Trip Teen Camp Road Trips

3-5

6/18-6/20

6-9

6/25-27 & 7/16-18

Total Camp Weeks

….Plus Lunch Weeks

x Price Per Week*

x Price Per Week*

Equals

Subtotal 3

Holiday Discount* Subtotal 1

Subtotal 1

Total

Subtotal 2

5% Sibling Discount

Pre/Post Care Weeks

Subtotal 3

Grand Total

x Price Per Week*

Optional Trips *

Subtotal 2

Total

* See Price Per Week (PPW) Chart for ALL prices and discounts, located on back cover. **Holiday Discount - NO camp May 27 or July 4

-

2013 PHYSICIAN’S STATEMENT To ensure an informed response in case of an emergency, your child WILL NOT BE PERMITTED to attend Summer Day Camp without a completed 2013 Physician’s Statement signed by a physician. Your child must have had an exam since September 1, 2011 and have a copy on file.

THIS FORM TO BE COMPLETED BY A PHYSICIAN FILL IN CHILD’S NAME AND FORWARD TO YOUR PHYSICIAN. Child’s Name ____________________________________________________________Birth Date: _______________________________ Weight: ___________lbs

Height ___________

Note any abnormal findings:

Is the current examination normal?

Yes

No

List name of drug(s) currently used, dosage, frequency needed: ____________________________

______________________________________________________________________________________________ List any known allergies (drug, food, plants, insects): __________________________________________________________________ _________________________________________________________________________________________________________________ IMMUNIZATION DATES: (Please complete this section or attach a copy of the current immunization record.)

DPT:

1. __________

2. __________

3. ___________ 4. __________

5. __________

6. __________

7. __________

POLIO:

1. __________

2. __________

3. ___________ 4. __________

5. __________

6. __________

7. __________

MMR/MR:

1. __________

2. __________

3. ___________ 4. __________

5. __________

6. __________

7. __________

HIB: ______________ TB: ______________

Reaction: __________________________________________________________________________________

HEP-B: ___________

1. ____________

2. ____________

3. ____________

Is child under a physician’s care for any conditions? If so explain: ______________________________________________________ _________________________________________________________________________________________________________________ Is any treatment/medication needed during program participation? _____________________________________________________ _________________________________________________________________________________________________________________ Will medication be needed during participation? If so, please explain: __________________________________________________ _________________________________________________________________________________________________________________ Is child under any dietary restrictions? If so, please explain: ___________________________________________________________ _________________________________________________________________________________________________________________ Please mark information pertinent to this child: _______Anxieties

_______Heart Defect/Disease

_______Developmental Disability

_______Hearing Deficiency

_______Asthma

_______Attention Deficit Disorder

_______Behavioral Disorder

_______Down’s Syndrome

_______Speech Delay

_______Glasses/Contacts

_______Hearing Aids

_______Tourette’s Syndrome

_______Seizure Disorder

_______Orthopedic Disability

_______Wheelchair

_______Crutches

_______Cane

_______Walker

_______Incontinent

[

] Past

[

] Present

Any other special concerns (including behavioral) _____________________________________________________________________ DATE OF EXAM: _________________________

PHYSICIAN’S SIGNATURE: ________________________________________

Type or print Physician’s name: __________________________________________

Date Signed: _________________________

** RETURN THIS FORM BY MAY 6, 2013 or sooner. ** (If signing up for camp after this date, form is due immediately) Please return to: Jewish Community Center, Attn: Day Camp Registrar, 2 Millstone Campus Dr, St. Louis, MO 63146 or Fax to Attn: Day Camp Registrar 314-442-3404

JCC DAY CAMPS MEDICATION CONSENT FORM (This form is to be used only if a child is taking medication during camp) I hereby request and authorize JCC DAY CAMPS to give my child medication as specified below, according to the “Medication Protocol”. In making this request, I acknowledge that a physician or nurse will not be present or available during the administration of medication, and that medication may be administered by a non-medical person. *This form is to be completed by the health care provider who is prescribing the medication and signed by the health care provider and parent/guardian.

CAMPER’S NAME: ____________________________________________________________________ 1. Medication: _______________________________________________________________________ Reason for Medication: _____________________________________________________________ Dosage/Route: _________________________ Time(s) of day: _____________________________ Start date: _____________________________ End Date: _________________________________ Side Effects/Special Instructions: ____________________________________________________ __________________________________________________________________________________

2. Medication: _______________________________________________________________________ Reason for Medication: _____________________________________________________________ Dosage/Route: _________________________ Time(s) of day: _____________________________ Start date: _____________________________ End Date: _________________________________ Side Effects/Special Instructions: ____________________________________________________ __________________________________________________________________________________

____________________________________ Physician Signature/Date

____________________________________ Parent/Guardian Signature/Date

____________________________________ Physician Phone Number

____________________________________ Parent/Guardian Phone Number

2013 PROTOCOL FOR ADMINISTERING MEDICATION AND BASIC FIRST AID TO CAMPERS 1.

A signed consent form from the parent/guardian to administer the medication as prescribed must be on file in the camp office.

2.

In addition to the parent/guardian consent, one of the following must also be on file in the camp office, that includes the name of the camper, name of the drug, administration schedule, duration of administration, reason for medication, route of administration and any other specific instructions.

3.

a.

A Medication Consent form completed and signed by a licensed health care provider OR

b.

A written note signed by a licensed health care provider OR

c.

A faxed statement from the licensed health care provider.

d.

In the event prescription medication is to be given during camp, the medication must be brought to the camp in a container appropriately labeled by a pharmacist or physician, and given to the camp nurse or director by a parent/guardian.

The following medication protocols will apply: a.

Due to the potential of an adverse reaction, the JCC Day Camps will not administer the first dose of any medication. Even if the camper has had the medication in the past, but this is the first dose in a series of doses, the first dose will not be given at camp.

b.

The JCC Day Camp Administrator or designee will designate staff who will be responsible for the administration of medication. Those designated may not have had previous medical training.

c.

All medication must be in the original container (example: over-the-counter medication such as is given for cold symptoms) or in a container that had been appropriately labeled by a pharmacist or physician (example: prescription medication such as an antibiotic). Since some campers take medication at home and at camp, the pharmacist can be asked to put the medication into two containers with one containing the supply for home and one for camp.

d.

Medication containers must contain only the amount of medication necessary for the doses to be given at camp. For medication which is to be given once a day for two weeks, this generally means that 8-10 pills will be in the container depending on when the medication was started.

e.

When medication is brought to the JCC Day Camp, it must be turned in to the camp nursing office or day camp director at the beginning of the camp day where it will be stored in a locked cabinet if refrigeration is not required. Parents/guardians are encouraged to count the medication before delivering it to camp. No child is to have medication with them at camp unless it has been determined that the child can self-manage medications (See g).

f.

All discontinued or unused medication must be picked up by the parent/guardian or disposed of by the JCC Day Camp Administrator or designee at the end of the administration period or by the end of the camp sessions, whichever comes first.

g.

Consideration of self-managed medication administration by a camper will be evaluated on an individual basis following a written request by the parent/guardian to the JCC Day Camp administrator and a signed authorization from the prescribing health care provider.

It is anticipated that there may be situations which arise during camp activities which necessitate treatment of a child for a minor injury or unanticipated physical symptoms which develop or evolve unexpectedly in the camp setting. Often times, the injury or physical symptoms can be remedied with first aid treatments or over-the-counter, non-prescription medications and do not necessitate a significant loss of camp time. These medications are referred to as protocol medication and include but are not limited to *Acetaminophen (for headache, fever over 101, discomfort associated with flu-like symptoms, sore throat, earache), Bacitracin (for cuts and abrasions), Bactine (for insect bites, cuts and abrasions), Hydrogen Peroxide (to cleanse cuts and abrasions), Dacriose/Normal Saline (to clean the eyes if something has gotten into them), Baking Soda/meat tenderizer packs (for insect bites), Solarcaine or equivalent (for sunburn, local treatment of minor abrasions, breaks in the skin), Aloe Gel (for sunburn), Calamine lotion (for weed rash) and *sunscreen. *Adrenaline (or Epipen or Epipen Jr.) will be available for use by the camp nurse of JCC staff in the event of a severe life-threatening event involving campers 3 years of age or older. *These medications have age restrictions for use and may only be administered by emergency medical personnel or the camp nurse or staff. See Protocol Policy. To this end, protocols or standing orders have been established with approval by the (Doctor who ok’s), for use in the above noted situations. a.

The Recommended Procedures for Emergency Care of Illness and Injuries published by the Missouri Department of Health will be used as the guide for treatment of sudden illness or injury at camp.

b.

Guidelines for protocol medication administration including indications for use will be used.

c.

Protocols are reviewed and modified on a yearly basis as needed.

d.

The medications/treatments included in the protocols will only be administered with written consent or phone consent from the parent/guardian.

e.

Only one dose of oral medication covered under the protocols will be given during any camp day. If symptoms are not relieved, the parent/ guardian will be notified.

f.

The camp will notify the parent/guardian if oral protocol medication is to be given. It is most important that a parent/guardian notify the camp office if a medication was given to their child before camp, other than that which is taken regularly.

g.

Personnel designated by the JCC Day Camp Administrator to administer the medication/provide treatment following protocols will maintain documentation on each child who requires treatment or medication covered under the protocols.

h.

The parent/guardian may review the standing order and protocols that will be kept on file in the camp office by contacting the JCC Day Camp Administrator or designee.

Please note that a 2013 PHYSICIAN’S STATEMENT must be on file for every camper.

The PROTOCOL MEDICATION CONSENT form must also be on file in the camp office. Please fill out and return to the office by May 6, 2013.

A MEDICATION CONSENT FORM is available for those campers needing prescribed medication administered at camp. (Have on file if needed)

PROTOCOL MEDICATION CONSENT AND CONSENT TO MEDICAL TREATMENT Specific medications have been approved for use by campers as needed during camp-related activities if parent/guardian consent is on file. These medications are available for use by designated camp staff or the camp nurse as outlined in the “Protocol Medications Policy”.

I acknowledge that I have reviewed and am familiar with the Protocol Medication Policy and the Medication Policy and consent to terms and conditions of Policy.

I realize a physician will not be present or available during the administration of medication, that the Camp Nurse may not be present for this purpose, and that medication may be administered by a non-medical person. Further, I indemnify and hold harmless the Jewish Community Center employees from and against all claims arising our of the implementation of the Protocol Medication Policy and administration of medication under this policy and the Medication Policy.

JCC has my permission to have a physician treat my child(ren) if needed during my participation in the Activity or while my child(ren) is/are on the property of JCC. I authorize the Camp Director to use his or her judgment in arranging for any medical care for my camper which the Camp Director deems necessary. I hereby consent to any first aid, medication, medical treatment or surgery deemed necessary by the Activity Camp Director in his or her judgment. I release JCC and its agents, employees, representatives, volunteers and assigns of and from all claims for injuries or damages incurred by my child in connection with the delivery of such care in good faith. This release is also a condition of participation in the Activity. I consent that my child(ren) may be assessed and/or treated by the Camp Nurse or, if the Nurse is not available, by a designated Camp Staff in case of illness or injury.

I agree to pay all expenses of care administered to my child(ren).

Signature: .

Date:

BEHAVIOR POLICY The JCC programs are designed for children to function in an atmosphere dedicated not only to individual growth but also to group cohesion. These situations sometimes stimulate various behaviors including both positive and negative peer pressures. Since our program population is a sampling of the world we live in, we deem it advisable to delineate very clearly what the JCC’s standards and rules are and what action we will take in our role as “substitute parents” in the event that these rules are broken.

NOT ALLOWED: a. Illegal activity, including possession or use of any drug or substance. b. Possession or consumption of alcoholic beverages. c. Possession of tobacco products. d. Possession or sale of pornographic materials. e. Possession of knives or weapons of any kind. f.

Activity detrimental to the welfare or health of others, including, but not limited to, persistent physical or verbal abuse, theft, or vandalism. The JCC will charge the offender for repairs or removal of graffiti. g. Certain items and activities at the JCC are not necessary or are inappropriate. We ask that participants not bring to the JCC, CDs and iPods that contain language deemed inappropriate by JCC staff (i.e., violent or abusive lyrics, etc.), matches, lighters, fireworks, or incense of any kind. h. Unauthorized cell phones are not permitted at the JCC. Should we have reason to suspect a participant of violating any of the above rules, we shall respond as follows: for a, b, c, d & e, and in cases of theft (f), we reserve the right to search the participant’s possessions in their presence. If we determine a violation of the rules has occurred, we will notify the participant’s parents. Violation of a or b will result in immediate dismissal. In the case of c, d, or f, disciplinary action may be taken after full consideration.

In regard to f, the JCC encourages respect of other participants and staff. Any participant who does not adhere to this philosophy will be counseled, and, if necessary, disciplined by us. If such counseling and discipline does not result in cooperation and better behavior, we will consult with parents. We then reserve the right to suspend a participant from the program. This behavior may also affect future enrollment, and we do reserve the right not to allow a participant back into the program.

We also feel that a safe and successful programming experience requires adherence to a few rules and regulations regarding safety procedures. Persistent and willful disregard for these rules and regulations is considered sufficient reason for expulsion. This will not be enforced without first communicating with parents and making every effort to secure cooperation. Being a part of the JCC community means doing activities together. Participants are expected to join in group activities and are encouraged to participate in all program activities.

ON-SITE SOCIAL WORKER / PSYCHOLOGIST The JCC Day Camp works closely with Jewish Family and Children Services throughout the summer. A social worker and/or psychologist will be at camp periodically working with staff, children, and families. We consult these professionals to address behavior and educational plans for individual children. The social worker and/or psychologist may observe during the summer, interact with the children and discuss strategies with staff that will benefit the entire camp. The social worker’s and/or psychologist’s name and contact information are available to all families through the Day Camp Office. You may contact the director if you wish to speak directly to the social worker or psychologist about any questions or concerns you might have about your child(ren). Occasionally, the social worker or psychologist may request a meeting with a family to discuss specific educational and/or behavioral concerns. In this case, the director will contact you to facilitate such a meeting.

I understand that social workers or psychologists from Jewish Family and Children’s Service will be observing at camp.

Campers Name (please print)

Parents Name (please print)

Campers Signature

Parents Signature

Date

2013

Camp Waiver and Releases of Liability The Jewish Community Center of St. Louis

As a condition of my child(ren)’s participation in the following JCC day camps for which I am registering at Jewish Community Centers and, on behalf of myself and my child(ren), I agree that: STATEMENT OF PHYSICAL CAPABILITY I warrant and represent to JCC that: 1.

My child(ren) is/are in good physical health condition and is/are physically able to participate or compete in the Activity I have selected; 2.

I know of no physical restriction whatsoever which would prohibit my child(ren)’s participation or competition in the Activity that I have selected.

I have been advised by JCC that it would be in my best interest to consult my physician prior to my child(ren)’s preparation in regard to my child(ren)’s participation in the Activity; and 3.

I recognize and understand that the preparation and participation in the Activity may necessitate strenuous physical activity and could activate any unrecognized pre-existing cardiovascular disorder which my child(ren) may have, thereby resulting in serious or life threatening physical harm to my child(ren).

4.

I certify that my child(ren) is/are healthy and able to participate in all camp activities as of the date of making this application.

PERSONAL INJURY RELEASE As a condition of my child(ren) being permitted to participate in the Activity, I, the undersigned parent, on behalf of myself and my child(ren) agree that: 1.

I recognize that participation in the Activity involves risks of physical and emotional injuries and damages, including, but not limited to, injuries, damages or losses relating to or resulting from slips, falls, collisions, car accidents, drowning, trauma, health failure, and/or other mishaps whether known or inherent to the Activity or whether foreseeable or unforeseeable. Possible injuries to my child(ren) can include death, personal injury, paralysis, property damages, loss of service and other injuries and damages to my child(ren) or to third parties.

2.

I and my child(ren) assume full responsibility for any injuries, damages or losses which may occur to my child(ren) and agree that JCC and its trustees, officers, agents, employees, representatives, volunteers, students and assigns (the “JCC Parties”) shall not be liable for any damages arising from any personal injuries that my child(ren) may sustain in connection with the Activity whether occurring on or about the premises of the Millstone Campus at 2 Millstone Campus Drive or on the Harry and Jeanette Weinberg Campus at 16801 Baxter Road occurring adjacent to or outside of the property of JCC, or as a result of my child(ren)’s preparation for or participation in the Activity, to the extent that this Personal Injury Release provides for the release of such liability.

3.

On behalf of myself and my child(ren), we hereby fully and forever release and discharge and hereby agree to indemnify and hold harmless the JCC Parties from any and all present and future claims, demands, damages, rights of action or causes of action (collectively “Claims”) arising out of, resulting from, or connected in any way with my child(ren)’s preparation for and/or participation in the Activity, whether known or unknown, anticipated or unanticipated, and specifically including, but not limited to, any Claims arising out of or resulting from JCC Parties’ own negligence or fault or the negligence or fault of their agents, employees, representatives, volunteers and assigns, provided that this release and discharge shall in no way affect any claims which we cannot legally waive, such as grossly negligent acts, intentional acts occurring in the future and acts done with malfeasance.

4.

We understand that we are releasing the JCC Parties from liability to the full extent that the law allows not only from any risk inherently associated with participation in the Activity, but also any enhanced exposure to injury occasioned by any carelessness, negligence or fault of the JCC Parties or anyone acting on the JCC Parties’ behalf, including any and all liability for damage and injury or death to my child(ren) or to any person or property to the full extent that the law allows.

5.

I understand that THIS RELEASE OF LIABILITY IS INTENDED TO BE AS BROAD AS LEGALLY POSSIBLE, and I accept the terms as a condition of a Minor being permitted to use the property and facilities of JCC and JCC Day Camps and to participate in the JCC programs and activities and JCC sponsored programs and activities sponsored and programs and activities occurring at the JCC.

RELEASE FOR PERSONAL PROPERTY I acknowledge and agree that JCC and its agents, employees, representatives, volunteers and assigns (the “JCC Parties”) shall not be liable for any loss or theft of personal property and I release the JCC Parties for any liability for loss or theft of any personal property in connection with the Activity.

INDEMNIFICATION BY PARENT OR GUARDIAN In consideration of the below named child(ren) (“Minor”) being permitted by JCC to participate in the Activity and use its equipment and facilities, we further agree to indemnify and hold harmless JCC and Jewish Federation from any and all claims which are brought by, or on behalf of Minors or any of them, which are in any way connected with such use or participation by Minors or any of them. In the event parents are divorced or separated, the custodial parent must sign the registration form. In the event the parents have joint custody, both parents must sign this form.

MISCELLANEOUS CAMP MATTERS ACCEPTANCE WITH COMPLETED PHYSICIAN’S STATEMENT: I, as parents, understand that the application is subject to a physical examination of the child(ren) by a physician and review and approval of the examination by the Camp Director. Acceptance of enrollment will result in the camp reserving a place for the child(ren).

FIELD TRIPS: The parent or guardian grants permission to the camp for their child(ren) to participate in trips away from the camp and this camp waiver and releases of liability applies during such special trips.

I agree that the camp may adopt any other regulations that the camp deems necessary for the welfare of the camp and the campers.

Release of Information: I give permission for my child’s quotes and photos to be used for publicity purposes.

NOTICE: JCC Day Camps do not permit discrimination because of race, color, age, sex, handicap or national origin.

THIS DOCUMENT CONTAINS RELEASES OF THE RIGHTS OF PARTICIPATING CHILD(REN) AND THEIR PARENTS WHICH ARE INTENDED TO BE AS BROAD AS LEGALLY POSSIBLE. I HAVE READ AND UNDERSTAND THE TERMS OF THIS WAVER AND RELEASE AND I AGREE TO THE TERMS CONTAINED IN THIS DOCUMENT. Minor’s Name (Please Print)

Parent or Guardian Name (Please Print)

Parent or Guardian Signature

Date

1.____________________________

___________________________________

___________________________________

________________

2.____________________________

___________________________________

___________________________________

________________

PRICES PER WEEK (PPW) Day Camp Through 3/8

After 3/8

Weeks Member General Public 11* 199 224 10 208 233 9 209 234 8 210 235 7 211 236 6 212 237 5 213 238 4 214 239 3 220 245 2 226 251 1 230 255 *Includes Both Memorial Day and Independence Day Holiday Discounts

Member 214 223 224 225 226 227 228 229 235 241 245

Pre and Post Care Through 3/8 Pre Care Only Post Care Only Pre and Post Care

Member 38 56 75

LIT Take 50% off PPW

General Public 43 61 80

Camp Nat Koplar and Essman Katan half day take 35% off PPW

After 3/8 Member 43 61 80

Camp Nat Koplar and Essman Katan combo take 15% off PPW

…Plus Lunch- all meals $5 each Optional Sabra Trip- $125 Optional Teen Camp Road Trips- $195 each Discounts Holiday Discount- $30/week (No camp May 27 and July 4) Sibling Discount- 5% off total (Sibling discount will be taken off of the sibling with equal or fewer of weeks.)

Friends

General Public 239 248 249 250 251 252 253 254 260 266 270

General Public 48 66 85

Nonprofit Org US Postage

Jewish Community Center 2 Millstone Campus Drive St. Louis, MO 63146-5776

PAID St Louis MO Permit No 754

2013 Summer Camp Early Bird Registration Day Sunday, February 3 Noon – 3pm Creve Coeur and Chesterfield!

Sign up for camp on or before February 3, and register to win prizes and FREE camp.* You can get camp as low as $199 per week during early bird registration. Take the opportunity to meet Day Camp staff, and sample ....Plus Lunch!!

For more information or to register, contact Joey Boime at 314-442-3423 or jboime@jccstl.org. *Day Camp registration must be received by midnight, February 3, 2013 to be eligible to win. For each week of day camp that a child is registered, his or her name will be entered in the random drawing. Grand Prize: Free 2013 Summer Camp. One (1) name will be randomly drawn to receive a free summer of day camp based on the number of weeks that child has registered for before the February 3 deadline. Other Prizes: Five (5) names will be randomly drawn to receive other fabulous prizes. Prizes are not transferable.