2023 Love & Care Exceptional Children’s Day Summer Camp Application

PLEASE READ CAREFULLY
Unfortunately, due to pre-planned events and scheduled staffing, we are unable to issue any refunds for days missed. 7-day advance notification is required for preplanned absences. If your child misses a week(s) without advance notification, full tuition for the weeks missed and the current week MUST be paid to return. A $50 late fee will be automatically charged the day after payments are due.

The NON-REFUNDABLE registration fee is $100 per child for Summer Camp. This ensures your child a spot in our summer camp. If this fee is not paid when the application is submitted, placement is not guaranteed, and your camper may end up on our waitlist.

Pricing is reevaluated semi-annually. It is our goal to keep the cost as low as possible while offering an excellent, quality-rated experience.

The cost per week is $300 per child (8 AM – 2 PM) which equates to $10 per hour. This is a SPECIAL SUMMER RATE, excluding extra services that are added. Regular Day Camp Pricing is not the same as the Summer Rate. Late pick-up will result in a $25 per hour fee. At 2:15 PM, a late fee will be charged. Tuition includes all activities, onsite entertainment (i.e., magic shows, professional face painting, bouncy houses, waterslides, local musicians, and more), morning, and afternoon snacks, specialty treats, such as Kona Ice, the Ice Cream Truck, Pizza Parties, Carnival Day treats, etc. PLEASE PACK A SACK LUNCH each day. Many of our Love Bugs have food allergies and sensory sensitivities, so we want to be sure they have something they enjoy. Aftercare is available until to 4 PM and Late Care is available until 6 PM. There will be an additional $50 until 4 PM and $100 until 6 PM charge per week.

The cost is $350 per week (8 AM-2 PM) for ALL NON-POTTY TRAINED AND MEDICALLY COMPLEX ATTENDEES THAT REQUIRE INDIVIDUALIZED CARE. NON-POTTY TRAINED SLOTS ARE FOR AGES 10 AND UNDER. While registration is allowed for non-potty trained and medically fragile attendees, final approval is required. Your application will be reviewed, and you will be contacted by the Director for a phone/in-person conference. Extended Camp Day is available, up to 4 PM. There will be an additional $50 charge per week. Late Care is available until 6 PM for an additional $100 per week.

All 4-year-old attendees are only permitted to attend part-time, 8 AM-12 PM, except for Field Trip Days, per the category 6 exemption restrictions. The cost for the 4-year-old slot is $300 per week. You are paying per slot, not time. We are unable to prorate due to a waitlist for those requesting full time care. Extended Camp Day is not permitted. 4-year-old NON-POTTY TRAINED or MEDICALLY COMPLEX attendees is $350 per week.

There is a ONE-TIME field trip package fee of $100. This will take care of ALL FIELD TRIPS & SUMMER CAMP T-SHIRT that we wear on field trips. The fee is due on the first day of camp and will need to be paid in cash, as we pay locations directly with cash. We will attend 4 offsite field trips and 4 on-site specialty events. Onsite, event cost is included in the tuition. If you do not wish for your Love Bug to attend field trips, please opt out below. Field trip locations vary by age group and level of care. Perspective Fieldtrips: Dave & Buster’s, Putt-Putt Fun Center, Dutch Creek Farm, Evans Cinema, Riverwatch Luxury Cinemas, Gateway Park Splash Pad, and many more. Our older kids may attend a few more off-site field trips than our younger groups, but they will always have onsite entertainment as a replacement.

A Parent MAY BE REQUIRED to attend Offsite Field Trips for NON-POTTY TRAINED and MEDICALLY COMPLEX attendees. This will be determined by many factors, such as destination, individual needs, etc., and MUST BE APPROVED by Director.
Field Trips*

YesNo
By signing this document, I verify that I have read through the 2023 Love & Care Exceptional Children's Summer Camp packet in its entirety. I verify that I have gone through the pricing and understand the fee schedule for the weeks I have requested. I understand that submission of this form AND payment of the registration fee is reserving my child a spot in the requested sessions if still available, or a spot on the waitlist if the session has been filled before my submission.
Signature*

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EMERGENCY CONTACTS (Others that may be reached, if we cannot reach you.)
Emergency Contact 1*
Emergency Contact 1 Home Phone
Emergency Contact 1 Work
Please enter a valid phone number.
Emergency Contact 1 Cell
Please enter a valid phone number.
Emergency Contact 2
Emergency Contact 2 Home Phone
Emergency Contact 2 Work
Please enter a valid phone number.
Emergency Contact 2 Cell
Please enter a valid phone number.
Emergency Contact 3
Emergency Contact 3 Home Phone
Emergency Contact 3 Work
Emergency Contact 3 Cell
Doctor's Name*
Phone*
Health Insurance Co.
Policy Number
Allergies*
Medications*
Special Needs*
(Anything we should know about your child to ensure he/she has a good camp experience, private meetings with Director available upon request.)
Authorized to pick up child*
Authorized to pick up child
Authorized to pick up child
NOT Authorized to pick up child
NOT Authorized to pick up child
NOT Authorized to pick up child

Camper Personal Information
Please describe your child's Special Needs*
Please describe any triggers and what makes your child happy.*
When upset, what behavior does your child display?*
What calms your child down?*
Allergies*
Additional Details (Please Share Information Regarding Behaviors and Mannerisms)

Disclosures
Invoices must be paid by the due date, or your registration will be canceled, and you will lose your slot. Unfortunately, due to preplanned events and scheduled staffing, we are unable to issue any refunds. Please try to finalize plans before paying your invoice.

PLEASE NOTE: WE DO NOT PRORATE FOR PARTIAL WEEKS, THAT INCLUDES HOLIDAYS. IF WE ARE CLOSED DUE TO A HOLIDAY WEEKEND, WE DO NOT MAKE ANY PRICE ADJUSTMENTS. THE CHARGE EACH WEEK IS PER SLOT, NOT PER DAY. 1 DAY= 1 WEEK.

Late pick-up will result in a $25 per hour fee. Late fees will be assessed 15 minutes after the selected Camp has ended.

**NO PERSONAL ELECTRONICS PERMITTED i.e., Cell Phones, Ipads, Gaming Systems, etc., except those needed for Non-Verbal attendees. If any electronics are sent with your child, we will lock them up in safekeeping, until pickup.

By signing this document, I verify that I have read through the Love & Care Exceptional Children’s Childcare packet in its entirety. I verify that I have gone through the pricing and payment schedule and understand the importance of paying invoices, by the due date. I understand that submission of this form AND payment secures my child’s slot.
Parent/Guardian Signature*

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As the parent/guardian of the listed child, I authorize my child to participate in all activities. I permit Love & Care Exceptional Children’s Childcare LLC., to administer first aid, and in the event of an emergency, to secure a physician for any emergency treatment needed for my child. I understand that a conscious effort will be made to locate me or a close relative before any action is taken. I understand and accept that this expense is my responsibility. I also understand that it is my responsibility to carry primary accident and health insurance.
Parent/Guardian Signature*

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Photography Release

I understand that photos may be taken and used for websites, social media, and promotional purposes. If I object, I have marked the * no photos/no videos option below.
Photo Use*
Parent/Guardian Signature*

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Date*

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Notice of No Liability and Acknowledge

I understand that I am being informed in writing, by signing this acknowledgment that this facility does NOT carry liability insurance to protect my child in the event of Covid-19, injuries, illnesses, accidents, etc. Love & Care Exceptional Children’s Childcare LLC., Love & Care Exceptional Children’s Summer Camp LLC., Love & Care Exceptional Children’s Love Bug Music Club, The T.Y.L.E.R Movement, or any of its other affiliates are NOT responsible for injuries, illnesses, accidents, medical costs, lost wages, etc.
Signature*

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Date*

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Bright From the Start Exemption Acknowledgement

This acknowledgment serves as a notice, that Love & Care Exceptional Children’s Childcare LLC., is NOT a licensed daycare facility. I understand that this program is not required to be licensed by the Georgia Department of Early Care and Learning and is exempt from state license requirements. The facility has been inspected by Columbia County Officials and each person volunteering and/or employed has gone through a thorough background check. Please sign below as an acknowledgment that you have received this notice.
Parent/Guardian Signature*

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Date*

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Please read and initial the following statements:
There is a $100 fee charged for ALL returned checks.*
No pro-rating, one day is considered a full week. NOREFUNDS. *
I received my parent handbook and understand that all rules are contained in it. *

Intervention Behaviors (Verbal and/or Written Notification): This notification is only so that we can work together as a team, to reduce certain behaviors.
- Excessive screaming
- Sensory overload
- Perseverative behaviors that interfere with the class such as noises or singing
- Running away from staff (That puts themselves in danger)
Behaviors that Require a Parent Pick-Up:

Behavior that continues even after interventions have been tried and affects the safety of the child, other children, and/or staff. Some of these behaviors may include intervention behaviors listed above, as well as:
- Self-injurious behaviors
- Fighting/Biting or any physical interaction with another student or staff member
- Inappropriate language
- Continuous non-compliance
- Spitting and/or intentionally using bodily fluids to be defiant
- Undressing outside of the Restroom
- Aggressive behaviors
Expulsion Behaviors: ALL Behaviors listed above, as well as:
- Repeated behaviors that require a parent pick-up and have not responded to
- Multiple interventions
**Aggressive behaviors towards Staff or fellow Consumers could be cause for expulsion. The program facility reserves the right to add to or change this list at any time*** Parents please be sure that you have read and understand the behavior policy. Any time an attendee is exhibiting behaviors that could injure themselves, staff, or other attendees or damage the facility or community property, Staff will call for the attendee to be picked up. Please understand that Love & Care Exceptional Children’s Childcare LLC. is not staffed to regulate severe behavior needs, as we are not a Behavioral Clinic or Therapy Center.
Does your child have a behavior plan? *
I have read the attached copy of the behavior policy. I understand and agree with the behavior policy at Love & Care Exceptional Children’s Childcare LLC.
Parent/Guardian Signature*

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Date*

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