JUNE 10 - Amazon S3s3. Pottery: Making Art with lay Drawing & Painting: Develop Your Artistic...

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Transcript of JUNE 10 - Amazon S3s3. Pottery: Making Art with lay Drawing & Painting: Develop Your Artistic...

  • JUNE 10-12 GRADES DAYS TIME

    Baseball Elementary & Middle School M-W 8:30-12:00

    Volleyball Elementary & Middle School M-W 8:30-12:00

    JUNE 17-20 GRADES DAYS TIME

    Health Science Immersion: From Microbiology to Patient Care Rising 11th-12th Graders M-Th 9:00-4:00

    Working Well: Learn Lifetime Skills Rising 9th-12th Graders M-Th 9:00-4:00

    Public Safety: First Responders & Investigators Rising 9th-12th Graders M-Th 1:00-4:00

    Electronic Music: Be a DJ Rising 8th-12th Graders M-Th 9:00-12:00

    Pottery: Making Art with Clay Rising 7th-12th Graders M-Th 1:00-4:00

    Drawing & Painting: Develop Your Artistic Skills Rising 7th-12th Graders M-Th 9:00-12:00

    Teacher Cadet Camp: How to Teach Young Children Rising 6th-8th Graders M-Th 9:00-12:00

    Mr. T’s Science Adventures Rising 3rd-6th Graders M-Th 9:00-12:00

    Veggie Ventures: Healthy Cooking for Kids Rising 2nd-6th Graders M-Th 9:00-12:00

    Cosmetology for Kids Rising 2nd-6th Graders M-Th 1:00-4:00

    JUNE 24-27 GRADES DAYS TIME

    Pottery: Making Art with Clay Rising 7th-12th Graders M-Th 1:00-4:00

    Drawing & Painting: Develop Your Artistic Skills Rising 7th-12th Graders M-Th 9:00-12:00

    Maker Space: Create & Innovate Rising 6th-8th Graders M-Th 9:00-12:00

    Public Safety: First Responders & Investigators Rising 6th-8th Graders M-Th 1:00-4:00

    Applied Science with Mr. T Rising 5th-9th Graders M-Th 9:00-12:00

    Veggie Ventures: Healthy Cooking for Kids Rising 2nd-6th Graders M-Th 9:00-12:00

    Cosmetology for Kids Rising 2nd-6th Graders M-Th 1:00-4:00

    Tennis (Beginner/Intermediate) Rising 6th-9th Graders M-Th 9:00-10:30

    Elementary Tennis (Beginner/Intermediate) Rising 1st-5th Graders M-Th 10:30-12:00

    JULY 8-11 GRADES DAYS TIME

    Electronic Music: Be a DJ Rising 8th-12th Graders M-Th 9:00-12:00

    Creative Writing Rising 8th-12th Graders M-Th 1:00-4:00

    Healthy Cooking: Eat Well, Live Well Rising 6th-12th Graders M-Th 9:00-12:00

    Build a Business: Be an Entrepreneur Rising 6th-8th Graders M-Th 9:00-12:00

    Computer Science First: Making Projects with Code Rising 6th-8th Graders M-Th 1:00-4:00

    Cosmetology Rising 6th-9th Graders M-Th 1:00-4:00

    JULY 22-24 GRADES DAYS TIME

    Baseball Elementary & Middle School M-W 8:30-12:00

    Volleyball Elementary & Middle School M-W 8:30-12:00

  • SUMMER CAMP AT RCC REGISTRATION DOCUMENTATION Student’s Name: ______________________________________________ Date of Birth: _______________________ Address: ____________________________________________________ Grade Entering in Fall 2019: ____________ I, _____________________________________________________________________, am the legal parent/guardian Print name of Parent/Guardian

    I. Waiver

    WAIVER: READ CAREFULLY BEFORE SIGNING

    The student and the student’s parent, guardian or custodian therefore agrees to assume all of the potential risks and dangers, whether or not foreseeable, in any way associated with his/her participation in this Rockingham Community College Summer Camp(s) (including without limitation any and all medical expenses incurred resulting from any illness or injury to the participating student) and associated activities. In consideration of, and in return for the services, facilities, and other assistance provided to the student by Rockingham Community College in this Summer Camp(s) and related activities, the student and the student’s parent, guardian or custodian hereby release and agree to hold harmless Rockingham Community College (and its board of trustees, officers, employees, servants and agents) from any and all liabilities, claims, and actions that may arise from injury or harm to the student or to any third-party, from the students death or that of any third party proximately caused by the student, or from damage to the student’s or any third-party’s property in connection with Rockingham Community College Summer Camp(s) or associated activities. The student and the student’s parent, guardian or custodian understand that this Agreement and Release covers liability, claims, and actions caused entirely or in part by any acts or failure to act Rockingham Community College Summer Camp (or its board of trustees, officers, employees, or agents), including but not limited to the alleged or actual negligence, mistake, or failure to supervise by Rockingham Community College Summer Camp.

    The student and the student’s parent, guardian or custodian agree and understand that this Agreement and Release means I am giving up, among other things, the right to sue Rockingham Community College Summer Camp, its Board of Trustees, officers, employees, servants or agents for injuries, damages, or losses that the student or the student’s parent, guardian or custodian may incur. The student and the student’s parent, guardian or custodian also understand that this Agreement and Release binds the student and the student’s parent, guardian or custodian, any non-custodial parent, heirs, executors, administrators, and assigns.

    The student and the student’s parent, guardian, or custodian acknowledge that they have read this entire Agreement and Release, that they fully understand it, and that they agree to be legally bound by it. They also agree that this represents the entire agreement and that there are no other oral or written promises or representations which in any way modify its terms.

    ____________________________________________________________ _____________________________ Parent/Guardian Signature Date ____________________________________________________________ _____________________________ Home Phone Number Cell Phone Number

  • II. Consent to Use Photograph

    CONSENT TO USE PHOTOGRAPH:

    As a parent or legal guardian of ____________________________________________________, registered in the Summer Camp Student’s Name offered by R

    __________________________________________________________________ _____________________________ Parent/Guardian Signature Date

    III. Emergency Contact

    EMERGENCY INFORMATION:

    Person to notify in case of emergency: ______________________________________________ _______________________ Name Relationship

    Emergency Phone: Day ( ) ____________________ Night ( ) __________________ Cell ( ) ______________________

    Date of last tetanus immunization: ___________________ Any allergies to medicine? Yes ___ No___

    If so, list ________________________________________________________________________________________________

    Any current or past health conditions/food allergies staff should be aware of? Yes ___ No ___

    If YES, please list: ________________________________________________________________________________________

    Health Insurance Policy Number ____________________________Health Carrier ____________________________________

    Address of Health Carrier _________________________________________________________________________________ Street City State Zip

    Physician _________________________ Dentist ___________________________ Hospital ___________________________

    I hereby authorize any actions recommended by a physician or other health care provider attending my child during the camp. I acknowledge and understand that my child may sustain physical illness or injury (minimal, serious, or catastrophic), in connection with this camp. I agree to indemnify and hold harmless Rockingham Community College, its officers, employees and agents from and against any claims for personal illness or injury that my child may sustain. Parent or Guardian (circle relationship): ____________________________________________________________________ Print Name ___________________________________________ _______________ Signature Date (Optional) It is recommended (though not required) that this form be notarized to expedite medical treatment for your child by health care providers. State of ________________ County of ______________________I, ___________________________________, a Notary Public of said County and State, do hereby certify that ________________________________________ personally appeared before me this day and acknowledged the execution of the foregoing instrument. Witness my hand and official seal this the _____ day of ________,20________. Notary Public __________________________________________________ My commission expires: _____________________ (Optional) NOTARIAL SEAL:

  • IV. Permission Form In order to attend camp, this form must be signed by a parent/guardian. Your child will not be allowed to participate in a camp at Rockingham Community College without this form being completed.

    Student’s Name__________________________________________________________ Date of Birth _____________________

    Address _________________________________________________________________________________________________ Street City State Zip Parent or Guardian (circle relationship): _______________________________________________________________________ Print Name