Summer Camp Form

THE WINNING ACADEMY

621 WALNUT ST.

Warner Robins, GA 31093

Office: 478-302-5815 Fax: 478-302-5810

WlNNING.SCHOOL
BEE AHEAD SUMMER CAMP (BASC) 2021

ENROLLMENT FORM
June 1, 2021 — July 23, 2021

(July 5, 2021 - Summer Camp Closed)
Camper's Name:
School Grade Fall 2021
Date of Birth

Month Day Year
Date
Gender
"Gender Identity: Each camper will be addressed as male or female. (TWA will ONLY recognize GENDER BY BIRTH and NOT GENDER BY CHOICE).
PARENT INFORMATION
Parent's Name:
Please Print Clearly
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email (Mom)
example@example.com
Email (Dad)
example@example.com
Phone (home):
.
Phone (home):
Work (Mom):
Work (Dad):
Cell (Mom):
Cell (Dad):
Employer's Name:
Phone:
Please enter a valid phone number.
Employer's Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Registration Fee:
$25.00 - Per Child (Current TWA Students)
$35.00 - Per Child (General Public)

*Tuition (Weekly): -*Discounts apply for multiple children who reside in the same household. See Below.

*(1st Child) - $100.00 per week *Rates are due in full each Monday to avoid late fee of $20 per day.
*(2nd Child) - $75.00 per week *Rates are due in full each Monday to avoid late fee of $20 per day.
*(3rd Child & After) - $50.00 per week *Rates are due in full each Monday to avoid late fee of $20 per day.

Daily Rate (Per Child) - $30.00 per day *Rates are due in full each Monday to avoid late fee of $20 per day.
Please Note: Tuition (Week of July 4th) 1st Child: $75.00¡ 2nd Child & After: $50.00 *Due July 6th

BEE AHEAD SUMMER CAMP 2021 FINANCIAL RESPONSIBILITY
• The Winning Academy (BASC) has enlisted the services of The Financial Law Firm and/or The Advance Bureau of Collections to collect on delinquent accounts. All personal information obtained by TWA (BASC) will be given to The Financial Law Firm and/or The Advance Bureau of Collections in the collection process, and will be used solely for collection purposes only. *All responsible parties must include their personal information.
*Financial responsibility will be assumed by:

Print Name: First MI LAST
Relationship to student:
Social Security #
Responsible Party
Home Address: (Responsible Party)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Employer Name:
Employer Telephone
Please enter a valid phone number.
Employer Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
*Financial responsibility will be assumed by:

Print Name: First MI LAST
Relationship to student:
Social Security #
Responsible Party
Home Address: (Responsible Party)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Employer Name:
Employer Telephone
Please enter a valid phone number.
Employer Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
• TWA (BASC) can enlist the service of any collection firm and is not limited to services provided by The Financial Law Firm and/or The Advance Bureau of Collections. In the event, the collection firm that has been chosen changes, then all responsible parties will be notified.
PAYMENTS: (We do not accept personal checks as a form payment).

• “Bee Ahead” Summer Camp payments are due every Monday. Payments must be received by the close of business on Monday. If payments are not received on the day they are due, the camper(s) will not be allowed to return until all money that is owed for the week is paid along with any applicable late fee charges of $20 per day.
• *Please Note - On July 5th, 2021, “Bee Ahead” Summer Camp will be closed.
• You may make payments by Cashier's check, Money order, Cash, Credit/Debit Card or the New Recurring Payment method - (From Checking or Savings Account). Please make Cashier's checks or money orders payable to: The Winning Academy. Please Note: If you choose to use the New Recurring Payment option and this method fails or is returned for any reason, you will be charged a $30 return item fee and late fees of $20 per day including weekends.
• For your convenience, payments can be made online. Please visit our website to access online payments at winning.school (www nor.com is not needed). Once there, please click the tab for “Online Payments” and proceed.

PICK-UP NOTICE:

• ALL CAMPERS MUST BE PICKED UP BY 5:30 P.M. EVERYDAY. Campers who are picked up prior to 3:00 p.m., must be picked up in the school office otherwise all campers are picked up in The Gathering Plaice (located on the back side of the school building). If campers are not picked up by 5:30 p.m., then parents will be charged an additional $25.00 - NO EXCEPTIONS.

• Circumstances involving late pick-up WILL BE evaluated by the Administrator and the Financial Manager, prior to any late fees being waived, (if any). If you cannot pick up your camper, then please have someone else to pick them up. Please make sure the person picking up your camper other than those listed on the Emergency Contact List, has a valid I.D.

• If the person picking up your camper is not on the list, please make sure you notify the school prior to pick up. *Please Note: If your camper is not picked-up by 6:00 p.m. then we will notify law enforcement for further investigation. Please note: The daily charge must be paid in full the day the charge is incurred. Other- wise, the participant cannot attend camp until the fee is paid.

As a Parent, Legal Guardian, or Responsible Party of the child(ren) who attend TWA's (BASC), I agree to comply with the school policies, rules, and regulations. Also, I agree to meet the terms of the agreement concerning financial responsibilities, business details, and so forth, as outlined by TWA's (BASC) Program. *Please Note: The Administrator reserves the right to make any changes that will be in the best interest of TWA (BASC), as deemed necessary.

If my child voluntarily withdraws, or is requested to withdraw by the school, it is understood and accepted that a refund of any expenses will NOT be made
The Parent, Legal Guardian, or Responsible Party must sign in the space provided below.
Signature of Applicant/Responsible Party

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Date

Month Day Year
Date
Signature of Applicant/Responsible Party

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Date

Month Day Year
Date
“Bee Ahead” Summer Camp - June 2021 **Commitment Calendar**
List the days attending according to above table
List the days attending according to above table

BEE AHEAD SUMMER CAMP 2021 MEDICAL INFORMATION
My child has the following special need(s):
My child is currently on medication(s) prescribed for long-term continuous use and/or has the following pre-existing illness, allergies, or health concern
Physician/Clinic
Telephone Number
In the event of a serious injury or illness TWA (BASC) staff will attempt to contact the parent or authorized person immediately. The staff will call 911. If the situation warrants, the child will be taken to the Houston County Medical Center. A staff member will stay with the child until a parent or authorized person arrives. I hereby warrant that to the best of my knowledge, my child is in good health, and I assume all responsibility for the health of my child.
Signed:

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Date

Month Day Year
Date
Signed:

Clear
Date

Month Day Year
Date
GENERAL INFORMATION
Camp is for children 2 - 16 years of age. (2 yr. olds must be fully potty-trained to attend camp). Camp activities include: Bible Time, arts and crafts, math, reading, life skills, and movies. *Summer Camp meets Monday-Friday from 6:30 a.m. until 5:30 p.m. *Summer Camp is not in session on July 5th, 2021.

Daily Schedule: All camp programs begin at 6:30am and end at 5:30pm.

Behavior: The camp reserves the right to dismiss any camper, without refund, whose conduct is detrimental to other campers.

Electronic Devices: No radios, toys, computer games, or other valuables are to be brought to camp without written permission of the teacher/director. TWA (BASC) will not be responsible for lost or broken items.

Dress: Campers are urged to wear cool, comfortable clothes, sneakers, and socks. No flip-flops or open-toe shoes.
All clothing must be appropriate at all times. Campers cannot wear tight fitting or revealing clothing.

Face Masks: All Campers must wear a face mask.

Please label all Items of Clothing.

Breakfast/Lunch: A light lunch is provided. Parents are responsible for providing their child(ren) with 2 light snacks (mid-morning & afternoon)

Nap Time: Young students (Ages 2-5) should bring their own small pillow and throw. Cots will be provided by the school.

Field Trips: At this time, Field Trips are TBD.
BEE AHEAD SUMMER CAMP 2021 EMERGENCY INFORMATION LIST
Child's Name:
Parent(s):
Work Phone:
Home Phone:
Emergency Contact Name:
Phone:
Email:
example@example.com
Person Authorized to Sign Child Out:

Clear
NOTE: If a person's name is not on this form, your child(ren) will not be released to that person.
Name:
Phone:
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Name:
Phone:
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Name:
Phone:
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Name:
Phone:
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Release and Assumption of Risk
Camp only carries a secondary insurance that will pick up any cost your primary insurance does not cover. I am aware that during camp hours my child will be participating in regular camp activities that involve certain risks including, but not limited to different sports and etc., swimming, and *travel by bus on field trips. This statement shall serve as a release and assumption of risk for my child. I hereby hold The Winning Academy (BASC) harmless from any and all liability.

I authorize the school to obtain emergency care for my child in my absence. I agree to assume responsibility for any medical services rendered for my child and not to hold The Winning Academy (TWA), The Winning Church (TWC), or BASC responsible for these services.

*In addition, if my child sustains an injury or conracts or is exposed to any illness while attending BASC, I will not pursue any legal actions against The Winning Academy (TWA), The Winning Church (TWC), or BASC.
Signature

Clear
Date

Month Day Year
Date
*WARNING UNDER GEORGIA LAW

There is no liability for an injury or death of an individual entering these premises. If such injury or death results from the inherent risks of contracting COVID-19, you are assuming this risk by entering these premises.
BEE AHEAD SUMMER CAMP 2021 TRANSPORTATION FORM
I, (print name) blanks, hereby authorize The Winning Academy (BASC) Staff, volunteers, and directors and any other authorized camp personnel to transport

my child, blank, to and from 621 Walnut Street Warner Robins, Georgia 31093 during the 2021 Summer Camp. I understand that authorized drivers have a valid driver's license, registration and insurance. I agree to indemnify and hold harmless TWA (BASC}, its officers, agents, teachers, employees, volunteers, directors from and against all liability, claims, judgments, suits demands for damages to persons or property, or injury or death which arise out of, result from or are in any manner connected with all transportation related to camp activities. *(Field Trips of any kind are TBD).
Parent/Guardian Signature

Clear
Date

Month Day Year
Date
PHOTOGRAPHY RELEASE FORM
I, (print name) give The Winning Academy (BASC) permission to use my son's daughter's photograph and/or likeness in its promotional materials and Publicity efforts to include social media.

I, (print name) do not give The Winning Academy (BASC) permission to use my son's daughter's photograph and/or likeness in its promotional materials and Publicity efforts to include social menit

I, further understand the photographs taken during the 2021 Summer Camp activities may be used in publication, print, ads, direct-mail piece, electronic media or other form of promotion to include social media. I release TWA (BASC), photographer, their offices, employees, agents and designees of liability for any personal or proprietary right I may have in connection with such use.
Name of Student:
Signature of parent/guardian:

Clear
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone
Date

Month Day Year
Date
-C R E A T I N G C H A M P I O N S F O R C H R I S T-

BEE AHEAD SUMMER CAMP 2021 INTERNET/COMPUTER USAGE
Student's Name (please print)
Dear Parent of Guardian:

With your permission your child will be able to use the computer and access the Internet at TWA (BASC) as part of their class instruction. Below are the rules for use at The Winning Academy (BASC). Please read this letter before you consider granting permission.

Guidelines for Computer/Internet Usage
- All students must have a signed permission slip from their parents that authorizes them access to the Internet.
- Respect for the equipment of TWA (BASC) and its network is a condition for use of the computers.
- Computers are defined as all computer units, printers, keyboards, drives, monitors, mice and software.
- Access to material that is profane, obscene, pornographic, promotes illegal acts, violence or discrimination is restricted. Students are to notify the teacher immediately of any disturbing material they may encounter on the web or in email. This protects your against any violation of policy.
- Students are not to give out personal information like telephone number, full name, address, etc. to anyone on the Internet.
- Students are to never give anyone their password to any of their accounts or allow another students to use their account to access the Internet or school network.
- Downloading of files/program is prohibited unless prior permission is given by a school official or technology coordinator.
- All CD-R’s and flash drives brought to the lab to be used in the computers must first be scanned for viruses by the teacher.
Violation of any of these rules may result in forfeiture of permission to use the Computer and Internet, along with appropriate disciplinary action. Please sign below if granting permission and return the entire form.
Permission
I give permission for my child to access the Internet in accordance with the above guidelines.
Parent sign here

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Date

Month Day Year
Date
-C R E A T I N G C H A M P I O N S F O R C H R I S T-

BEE AHEAD SUMMER CAMP 2021 DISCIPLINE POLICY
Staff and parent/guardian communication is encouraged to resolve issues quickly, However, if a participant is disrespectful to other participants, staff and/or property, or does not follow camp rules, The Winning Academy (BASC) reserves the right to remove the participant without refund.

General Camp /Classroom Rules

1. Camp instructors are in charge at all times.
2. Students will respect their peers and adults.
3. Students must not leave the classroom unaccompanied. This includes trips to the restroom.
4. Students must keep hands to themselves at all times.
5. Students must walk, and not run inside buildings.
6. Students can not bring cell phones, or electronic devises to camp, unless requested by an instructor
Confiscated items such as cell phones— may be picked up by parents in the school office.
7. Students must keep classrooms orderly and clean up after themselves at the end of a lesson, and at the end of each day.

If a participant does not follow camp rules or is disrespectful to instructors , assistants, or other participants, the following actions will be taken:

Strike One— The camp instructor will initiate a time-out and talk with the student about his/her behavior and document the situation. The camper will be encouraged to make a better choice and will continue to be involved in the program. Camp instructors and assistants will make every effort to make sure the camper is engaged in a way that sets him/her up for success.

Strike Two— The camp instructor will talk with the student about his/her behavior and document the situation. The instructor will notify the administrator. The participant will be given time to think about their actions and given the choice to either be involved with other participants or to spend time alone.
Strike Three— The participant will be removed from the camp program, and escorted to the school office.
The administrator will contact the parent/guardian to handle the matter. Depending on the situation, the administrator may discuss with the parent if the participant should remain in the program. There is NO REFUND if a student is expelled from the camp.

In addition, there are certain situations for which a “No Tolerance Policy” is in effect. Unacceptable behaviors are: blatant disrespect for authority, destruction of The Winning Church (TWC's) and/or TWA's (BASC's ) property, bullying, fighting, and bringing weapons or dangerous objects to school.
Parent sign here

Clear
Date

Month Day Year
Date
Participant's Signature

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Date

Month Day Year
Date
-C R E A T I N G C H A M P I O N S F O R C H R I S T-
Should be Empty:

PARENT INFORMATION

BEE AHEAD SUMMER CAMP 2021 FINANCIAL RESPONSIBILITY

“Bee Ahead” Summer Camp - June 2021 **Commitment Calendar**

BEE AHEAD SUMMER CAMP 2021 MEDICAL INFORMATION

GENERAL INFORMATION

BEE AHEAD SUMMER CAMP 2021 EMERGENCY INFORMATION LIST

BEE AHEAD SUMMER CAMP 2021 TRANSPORTATION FORM

PHOTOGRAPHY RELEASE FORM

BEE AHEAD SUMMER CAMP 2021 INTERNET/COMPUTER USAGE

BEE AHEAD SUMMER CAMP 2021 DISCIPLINE POLICY

“Bee Ahead” Summer Camp - June 2021 Commitment Calendar