SGRPRC Camp Quest Registration

Student Name

First NameLast Name
4. Release & Liability
Drop-Off & Pick-Up Procedures:

I have read and understand the procedures for the pick-up and drop-off for campers. I understand camp hours are 7:00 AM - 5:00PM. Campers may be dropped off in the morning 7:00-9:00 AM. Pick-up in the afternoon is 3:00 - 5:00 PM. I acknowledge that I will follow these guidelines or face the possibility of a late fee at pick-up. Late pick-ups after 5:00 PM will incur a fee of $1 per minute. More than 2 times increases the fee to $5 per minute. Further instances you risk termination from the program. This will be enforced.
I, the parent/guardian, hereby attest that I have carefully read the Drop-Off & Pick-Up Procedures, understand its contents, and agree to its terms and conditions.
Liability:

I fully understand and accept the risks involved in participating in any strenuous activity. I absolve the Spring Grove Regional Parks and Recreation Center, Spring Grove Borough, Paradise Township, Jackson Township from all liability for any personal injury incurred to my child through participation in SGRPRC Camp Quest or any Spring Grove Regional Parks & Recreation Center sponsored education and/or physical activity program.

I have read, understand and agree to the Spring Grove Regional Parks & Recreation Center Day Camp liability.
I, the parent/guardian, hereby attest that I have carefully read the Liability, understand its contents, and agree to its terms and conditions.
Lunch:

I understand it is my responsibility to send my child a nutritional lunch daily. Since there is not enough refrigeration available for all lunches, please pack an ICE- PACK. I also acknowledge that lunches MUST be non-perishable and packed in a disposable bag on field trips days.

I will be charged an additional $5 if SGRPRC has to provide my child a lunch.
I, the parent/guardian, hereby attest that I have carefully read the Lunch Policy, understand its contents, and agree to its terms and conditions.
Permission to Apply Sunscreen

I give permission for the SGRPRC Childcare Providers to assist my child applying sunscreen. I understand I am responsible for providing/sending my child's suncreen.I do NOT give permission for the SGRPRC Childcare Providers to apply sunscreen on my child.
Permission for Publication

I give permission for my child's picture to be taken for camp presentations, the SGRPRC website, and other advertising for SGRPRC programs.I do NOT give permission for my child's picture to be taken to be shared to the public or for use of any SGRPRC advertisements.
HAND SANITIZER PERMISSION:

SGRPRC takes precautions to avoid the spread of germs at all sites. While hand washing with soap and water is best practice, hand sanitizer (with a minimum of 60% alcohol) will be used as part of the Health & Safety Plan. For example, students will use hand sanitizer when first arriving to the program from home or school. Sanitizers will remain in the possession of the staff and be distributed by adults only. STUDENTS MAY NOT CARRY INDIVIDUAL HAND SANITIZERS ON THEIR BACKPACKS.

The state requires us to have permission by parents to allow the use of hand sanitizers.
I give permission for my child to use hand sanitizer under the supervision of staffI do NOT give permission for my child to use hand sanitizer.
Parent Signature is Required for each item below to indicate parents consent.
OBTAININBG EMERGENCY MEDICAL CARE
Signature*

Clear
WALKS AND TRIPS
Signature*

Clear
ADMINISTRATION of MINOR FIRST AID PROCEDURES
Signature*

Clear
TRANSPORTATION (BY THE BUS COMPANY ONLY)
Signature*

Clear
SWIMMING/WADING
Signature*

Clear

Health Assessment - Print (Must be signed by physician & submitted along with immunization records within 30 days of enrollment.)
ACH Form
Behavior Policy
Should be Empty:

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SGRPRC Camp Quest 2023 Registration :

1. Parent / Guardian Information

2. Emergency Contacts

3 . Child's Medical Information

4. Release & Liability