BTW Summer Camp Registration

Parent/Guardian Information

Emergency Contact Information

Child's Health History

The following informaiton is required for all campers to be registered in the Youth Summer Program. 

Child's Immunization Information

All campers must be current on all immunizations and a copy of the most recent immunization records must be given to the Camp Director prior to the start of camp. 

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by BTW H.O.P.E. Center during the selected camp. In exchange for the acceptance of said child’s candidacy by BTW H.O.P.E. Center. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless BTW H.O.P.E. Center and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

 In case of injury to said child, I hereby waive all claims against BTW H.O.P.E. Center, including all camp assistants and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball, swimming and other physical activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Medical Release and Authorization

Food Allergy Notice: Food Prepared In This Establishment May Contain Nuts

As Parent and/or Guardian of the named child, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

 Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

 Permission is also granted to the BTW H.O.P.E. Center and its affiliates including Directors and Camp Assistants to provide the needed emergency treatment prior to the child’s admission to the medical facility.

 Release authorized on the dates and/or duration of the registered season.

 This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

• I give permission for my child's image/name to be used in social media & public relations materials, such as the camp newsletter. 
• I give permission for my child to participate in any mentoring programs and for BTW to share data from my child's participation for related funders and grants.
• BTW staff takes pictures and video of the children while they are participating in summer camp activities. These pictures will be used by the children to create a scrap book showing some of the activities they have participated in during the summer and to develop a media presence. By signing this agreement, you waive the right to pursue legal action against BTW for any pictures taken of your child while at BTW H.O.P.E. Center. If I do not want my child to participate in any pictures or videos I must communicate this to the program director in writing. 
• I give permission for my child to participate in all Camp Activities, and all field trips as identified in program brochures, newsletters and parent communications.  If I do not want my child to participate in a trip or activity, I must communicate this to the program director in writing.
• BTW will provide free group transportation and breakfast in the morning. Parents will be responsible for providing a water bottle, a clean towel for swimming, swimming gear and purchasing any additional t-shirts that will be used when traveling.  Parents must also provide the appropriate attire for their children. Sneakers, water shoes and swimwear are necessary clothing for the summer camp. (Two-piece swimsuits are not permitted at BTW Youth Camp. Female students are only permitted to wear one-piece bathing suits during water activities.) Any parents that want to volunteer with BTW must give 48 hours advanced notice and must undergo a background check for child abuse/molestation. 
• I understand the Camp's policy regarding disciplinary actions that my child may be expelled/suspended from the camp without reimbursement of fees paid. 
• I understand that there are inherent risks associated with participating in BTW Youth Camp activities and I do not hold the camp, directors or staff responsible from injuries, resulting from camp participation.

1. You must submit a fully completed Medical Declaration  form which will be provided via email.  Please list all allergies, medications taken (if medicaiton is to be administered during camp hour), and/or special health needs.  If medication needs to be administered while your child is with us, please have your child's doctor complete the 'Care Plan for Childen with Special needs' form. 
2. In order for BTW to maintain the quality of its program, all parents/guardians are required to commit their children to a minimum of five weeks to BTW H.O.P.E. Center. If a parent/guardian is unable to commit to five weeks. This is a binding legal contract beginning on the date entered below.
3. If your child will be absent for more than 2 days, vacations longer than 2 days are planned, or you no longer need camp, please inform the Camp Director or staff as soon as possible. If the staff has no prior knowledge of your child's vacation, planned absence or removal from camp, you will be responsible for your child's summer camp tuition for that week(s) of camp. No refund or credit will be given for dropping out without the required notice or registering a child who does not attend paid sessions
4. BTW H.O.P.E. Center has a philosophy of self-discipline, respect and safety. BTW expects respectful, safe and gentle behavior at all times. Given the nature of this expectation, children with a disclosed or undisclosed behavioral difficulty, children displaying unacceptable behavior, or that cannot perform to these standards while attending BTW H.O.P.E. Center, will be dismissed early, suspended or expelled. Children who are dismissed early, suspended or expelled for any reason are not entitled to a refund or credit or release from financial obligations. A copy of the summer parent handbook will be given to each parent or upon request at the church office. 

By initialing above & signing my name below, I certify that I have read the above information. Any questions or concerns regarding these policies have been discussed with the Camp Director or staff. My signature also certifies I understand and agree to adhere to the above policies. Additionally, I understand that I am responsible for all charges applicable to me child or children’saccount.

Tuition

All campers are required to pay $185 weekly.  A sibling discount of $50 will be given for each sibling after the first registered. 

Tuition may be paid weekly, bi-weekly, or by the month.  However, it MUST be prepaid.  If you opt to pay the tuition weekly, payment is due in full for the week on Friday before services are rendered. Under the Bi-weekly and Monthly tuition payment plans, tuition is due in full on the Friday before your Monthly or Bi-weekly period begins.  Regardless of the tuition payment plan elected, the parents or guardians are obligated to pay in advance for services.  There is a $55.00 NSF fee if a check is returned. 

Parents will be charged a $25.00 late fee added onto the balance in the event that tuition is not paid on time (and this does include when checks are returned).  Additionally, a $1 per minute late fee will be charged for students not picked up by 5:30 pm each day.  Furthermore, there will not be any refund of tuition in the event a child withdrawn, transferred, or dismissed.  At least two weeks prior written notice is required if you plan on removing your child.  You are required to make payments that will cover the camp tuition through the last day of the child’s attendance.  Camp tuition fees are based on reasonable economic trends.  Parents/guardians will be notified of any tuition increase at least 30 days in advance.

 
*** BTW will take all outstanding accounts to court and collections.  In any matter turned over to Small Claims Court or an attorney for collections, parent/guardians shall be liable to BTW for attorney’s fees, together with any other costs for legal proceedings. ***

Your family may qualify for Child Care Connection (CCC)

For information contact Child Care Connection:

Mercer County: 1001 Spruce St., Suite 201 Trenton, NJ 08638-3955 | Tel: 609.989.7770 Hours: 9am - 5pm, Mon-Wed, Fri 9am - 6pm,

Burlington County BCCAP: 1 Van Sciver Pkwy, Willingboro, NJ 08046 | Tel: 609.835.4329 Hours: 9am - 5pm, Mon-Fir