Summer Day Camp 2021

Summer Day Camp 2022

June 6-17, 2022 8:30 a.m. to 4:30 p.m.
Registration Form
Welcome to Rocky Mountain Deaf School's Summer Camp!
We are thrilled that your family has chosen Rocky Mountain Deaf School’s Summer Camp as a summer experience for your child. We want to make this summer a fantastic experience for everyone… campers, parents, and staff alike. Each day at camp, your child is going to get to explore, create, grow and learn. We know you want your child to learn as much as possible, so we make sure they are learning in a hands-on way, so they’ll be more likely to pay attention and develop an interest in these areas.

At camp, we have a lot of adventures, but safety is our number one priority. All of our staff members are well trained, and they were specifically chosen for their ability to work with kids. We keep a close eye on every camper, to ensure they are safe throughout the day.

The very first step is to help make the registration process as streamlined as possible. Please be sure your paperwork is completed and the payment is submitted before the due date. The paperwork is necessary to ensure that your child is under good care and we have all the information to support your child’s needs in communication, medical, and other areas. Your payment must be received in order to be considered registered.

More details of Let's Move! Summer Camp will be sent out in a parent letter after we receive your registration packet.

If you have any questions or concerns regarding the registration packet, please contact Stephanie Carson at scarson@rmds.co or 720-961-9211.

We are looking forward to having a great summer camp with your child!
General Information:
The program runs from June 6th to 17th, Monday through Friday from 8:30 am to 4:30 pm. The first day of camp is on Monday, June 6th. The mornings until 11:30 have an academic focus, with trips and activities in the afternoons.
Purpose and Philosophy:
With our summer program, we believe that fun and learning go hand-in-hand. We are committed to supporting each child’s joy of learning by nurturing their emotional, creative, and intellectual needs. Our summer curriculum is nature-based and encourages experiential outdoor learning.
Language Rich Learning Environment:
All staff members are fluent in both American Sign Language and English. So your child will have a language-rich learning environment, with full access to language throughout the day from a variety of peers and adults.
Eligible Children:
- Ages 3-12th Grade
- Deaf or Hard of Hearing
- Child must be potty trained
Tuition:
- Full Day Camp (8:30 a.m.-4:30 p.m.)
- Rate: $500 *10% sibling discount*
- Extended School Year (ESY) (8:30 a.m.-11:30 a.m.) FREE *this program is for students that qualify for ESY*
- Camp for 15 years old to 12th grade
  - Students ages 15-17 are encouraged to apply through the Division of Vocational Rehabilitation (DVR). Potential DVR funding support may be available to those who apply and qualify for DVR. If the student does not qualify, the full-day summer camp will be $500.00
  - Qualifies for ESY: no charge for half day camp (8:30-11:30 a.m.) ESY students can participate full-day camp for $300.00
- Payment must be submitted by May 23, 2022, with complete registration.
  - To make a credit card payment, call Stephanie Carson at 720-961-9211 (VP)
  - To send cash/check mail it to RMDS: Summer Camp Tuition, 10300 W. Nassau Ave, Denver CO 80235; or drop off the check at the Front Office.
Questions/Concerns:
Summer Camp Coordinator: Stephanie Carson

Email: scarson@rmds.co

Phone: (VP) 720-961-9211

Text: 720-660-4555
Camper Information
Camper Name: *

First Name Last Name
Camper's Age *
Camper's Grade: *
Camper's Shirt Size:

Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult X-Large Adult XX-Large Other
Parent/Guardian Email: *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *
Please enter a valid phone number.
Parent/Guardian Text Number *
Please enter a valid phone number.
Work Phone Number: In case of emergencies
Please enter a valid phone number.
Does your child have special needs (including allergies) that the summer camp staff needs to be aware of? *
Enrollment:
I am enrolling my child: *

Full Day Summer Camp: $500.00 ESY: Half Day ONLY 8:30-11:30 a.m. FREE (Must qualify for ESY) ESY PLUS Afternoon Camp: $300.00 (must qualify for ESY) Ages 15-12th Grade: DVR Support Services: Must qualify for DVR Ages 15-12th Grade: ESY: Half Day: 8:30-11:30: FREE (Must qualify for ESY) Ages 15-12th Grade: ESY PLUS Afternoon Camp: $300.00 (must qualify for ESY and does not qualify for DVR services)
Emergency Release Form
Camper's Date of Birth: *

Month Day Year
Date
Doctor's Name:
Doctor's Phone Number
Please enter a valid phone number.
Dentist's Name:
Dentist's Phone Number
Please enter a valid phone number.
Does your child have allergies to medications or latex? *

Yes No
Emergency Contacts:
Emergency Contact's Name: *

First Name Last Name
Relationship to Child:
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *
Please enter a valid phone number.
Text Number: *
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Medical Release Statement
In case of an accident, injury, or sudden illness requiring immediate medical care, and the child’s parent or physician cannot be reached, I authorize my child to be taken to the emergency room for treatment.
Parent/Guardian Signature

Clear
Today's Date

Month Day Year
Date
Insurance Company Name:
Policy Number
Hospital to be taken for emergency treatment:
Hospital's Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Hospital's Phone Number
Please enter a valid phone number.
Field Trip Permission Statement
My child has permission to leave the school property for the purpose of a field trip.
Signature

Clear
Today's Date

Month Day Year
Date
Jeffco Public Schools Release:
In consideration of my child’s voluntary participation in RMDS’ Summer Camp and related activity, I

__________________________________________________________ hereby release and discharge the Jefferson County School District and their/its successors, heirs, assigns, directors, officers, employees, supervisors, agents, attorneys, and representatives from any and all actions, causes of action, claims, demands, losses, damages, costs, attorney fees, judgments, liens, indebtedness, and liabilities whatsoever, known or unknown, suspected or unsuspected, past, present, or future with regard to all matters that could have been raised in an action on the merits regarding the aforementioned activity in which I and my child have elected to voluntarily participate.
Signature

Clear
Today's Date

Month Day Year
Date
Sunscreen Permission Slip
I give permission for my child, ______________________________, to wear spray sunscreen. I understand that I will provide spray sunscreen with my child’s name clearly printed on the bottle. I may apply sunscreen on my child before they come to RMDS Summer Camp and will inform the teacher(s) if this is the case. The teachers have my permission to reapply spray sunscreen as needed throughout the day.
*

Please allow my child to apply his/her own sunscreen, as needed. Please apply spray sunscreen on my child as needed.
Signature

Clear
Today's Date

Month Day Year
Date
Permission to Pick Up Student
Please list below the individuals who are authorized to pick up your child(ren) from Rocky Mountain Deaf School. It is important that we only release your child(ren) to person(s) you have entrusted with this responsibility.
The following person(s) have my permission to pick up this student from RMDS:
Name

First Name Last Name
Phone Number
Please enter a valid phone number.
Name

First Name Last Name
Phone Number
Please enter a valid phone number.
Name

First Name Last Name
Phone Number
Please enter a valid phone number.
Your child(ren) will only be released to authorized person(s) listed above. If you should authorize a person other than these listed above, please send a written note to your child(ren)’s teacher. If a person should show up at school to pick up your child(ren) without written permission, we will be unable to release your child(ren). Your child(ren) will remain at school until we are able to reach the parent(s) or legal guardian. If unable to reach a legal guardian, the proper authorities will be contacted to pick up your child(ren).

I understand the above statement and also understand I am responsible to keep this list updated or providing written consent to RMDS for someone other than those on the list to pick up my child. I understand a voice message or VP message is NOT acceptable.
Signature

Clear
Photograph, Video and Website Permission
We would like to invite all families to participate in the RMDS website/Social Media. We will be updating the information regularly to share all the wonderful things happening. We would like to take pictures and videos for our website/Social Media.

Please sign the form below, letting us know if you would or would not like your child’s picture or videos on the websites/Social Media.
*

No, I do not want my child's picture or video on the website/social media. Yes, my child's picture or video can be on the website/social media.
Signature

Clear
Registration and Payment DUE:

May 23, 2022
Should be Empty:

Summer Day Camp 2022

Registration Form

Welcome to Rocky Mountain Deaf School's Summer Camp!

General Information:

Purpose and Philosophy:

Language Rich Learning Environment:

Eligible Children:

Tuition:

Questions/Concerns:

Camper Information

Enrollment:

Emergency Release Form

Emergency Contacts:

Medical Release Statement

Field Trip Permission Statement

Jeffco Public Schools Release:

Sunscreen Permission Slip

Permission to Pick Up Student

Photograph, Video and Website Permission

Registration and Payment DUE: