Summer Camp Registration

Elementary and Middle School Camps

Session 1: Climate Change - Bears Day Camp (July 6 - 17)

Bears Day Camp Session 1: July 6-17 (limit 10 campers)

Climate Change
9:00am - 3:00pm
(Rising 3rd - 8th Grade)
With Ms. Jennie
Research the history of climate changes and its impact to the Earth and explore the science behind the environmental changes that are happening.

Session 2: Let's Create - Bears Day Camp (July 20 - 31)

Bears Day Camp Session 2: July 20-31 (limit 10 campers)

Let's Create
9:00am - 3:00pm
(Rising 3rd - 8th Grade)
With Ms. Jennie
If you admire the creativity of others and love to create yourself, this is the camp for you! Explore patterns in mathematics, literature, science and cultures through creation and crafts. Campers will gain knowledge, make connections between content areas and come home each day with a masterpiece of their own!

Mural Camp - July 6th-10th

Mural Camp - July 6th -10th (limit 10 campers)

Mural Camp
9:00am - 12:00pm
(Rising 5th - 9th Grade)
With Ms. Reed
Leave your mark and showcase your artistic talents to the world as a member of mural painting camp. Under the guidance of Karin Reed, spend the week imagining, designing and ultimately creating murals that tell a story and share a message.

Little Bears Camp - July 6-10

Little Bears Camps Week 1: July 6-10 (limit 10 campers)

Let's Explore
9:00am-12:00pm
(Rising K through 2nd-grade)
Students will explore books, art, music, history and science in this creative and playful camp. There will be projects that allow students to create and dig deep into learning. The kids will have plenty of opportunities to run and play outside with their friends too!

Little Bears Camp - July 13-17

Little Bears Camps Week 2: July 13-17 (limit 10 campers)

STEAM!
9:00am - 12:00pm
(Rising K through 2nd-grade)
Every day students will engage with an activity addressing an element of STEAM (Science, Technology, Engineering, Art and Math). Students will work independently but towards a common goal as a group. Students will be engaged in fun and rich tasks to develop math, science and art abilities but also develop team building skills in a safe social distancing environment.

Little Bears Camp - July 20-24

Little Bears Camps Week 3: July 20-24 (limit 10 campers)

Mythology
9:00am - 12:00pm
(Rising K through 2nd-grade)

Learn about cultures near and far as you research ancient mythology through reading, writing and math! Young learners will explore this new theme through multiple avenues to develop their academic skills, play, create and be active! Campers will spend their mornings growing as readers, writers and mathematicians by exploring Mythology, alongside Ms.Rauth and Ms.Alex, who have a passion for teaching.

Little Bears Camp - July 27-31

Little Bears Camps Week 4: July 27-31 (limit 10 campers)

Read, Write, and Play
9am - 12:00pm
(Rising K through 2nd-grade)

Find inner peace this summer! Your child will learn to relax, restore, and re-energize their mind and body. Through games, projects, and activities, learn strategies to be present while having fun and connecting with others!

Theater Camps

Theater Camp - Lion King

Theater Camp: Lion King - July 6-10 (limit 18 campers)

LION KING, KIDS
9:00am – 3:00pm
Rising 1st-5th graders
With Angela Kelly
Join Mrs. Kelly and Ms. Alex for this social distancing theater camp. The African Savannah will come to life on the new CDS outdoor stage with Simba, Rafiki and an unforgettable cast of characters as they journey from Pride Rock to the jungle … and back again, in this inspiring, coming-of-age tale.

Theater Camp - Moana

Theater Camp: Moana, Jr. - July 13-17 (limit 18 campers)

Moana, Jr.
9:00am - 3:00pm
(Rising 3rd - 8th Grade)
With Angela Kelly
Join Mrs. Kelly and Ms. Alex for this social distancing theater camp. They will be bringing the adventures of Moana and her village of Motunui to life on the new CDS outdoor stage.

Baseball Clinics

Session 1 - July 20th-23rd

Session 1 Baseball Clinic - July 20th - 23rd (Limited to 8 Campers)

Baseball Clinic Session 1
9:00am - 12:00pm
Monday-Thursday
(Rising 3rd - 5th Grade)
Do you love baseball? Come work on your skills and sportsmanship inside the CDS gym. Along with practicing baseball, we will play games together!

Session 2 - July 27th - 30th

Session 2 Baseball Clinic - July 27th - 30th (Limited to 8 Campers)

Baseball Clinic Session 2
9:00am - 12:00pm
Monday-Thursday
(Rising 6th - 8th Grade)
Do you love baseball? Come work on your skills and sportsmanship inside the CDS gym. Along with practicing baseball, we will play games together!

Total

$0.00

Camper Information

Child*

First Last

Birth Date*

Chronic physical problems, pertinent developmental information, or special accommodations needed*

Previous child day care programs and schools attended*

If child attends this center and another school/program, give name of school/program*

Parent/Guardian Information

Parent 1 Name*

First Last

Parent 1 Employer*

Parent 1 Email*

Person(s) or agency having legal custody of child*

Parent 1 Home Phone*

Parent 1 Business Phone*

Parent 1 Cell Phone*

Parent 1 Address*

Street Address City State ZIP Code

Parent 2 Name

First Last

Parent 2 Employer

Parent 2 Email

Parent 2 Home Phone

Parent 2 Business Phone

Parent 2 Cell Phone

Same address as Parent 1

Parent 2 Address

Street Address City State ZIP Code

Emergency Info

Child's Physician*

Child's Physician Phone*

Emergency Contact 1*

Please list 2 LOCAL emergency contacts that are NOT the parents or guardians of the child.

First Last

Emergency Contact 1 Address*

Street Address City State ZIP Code

Emergency Contact 1 Phone*

Emergency Contact 2*

Please list 2 LOCAL emergency contacts that are NOT the parents or guardians of the child.

First Last

Emergency Contact 2 Address*

Street Address City State ZIP Code

Emergency Contact 2 Phone*

Allergies or Intolerance to Food, Medication, etc., and Action to Take in an Emergency*

Person(s) Authorized To Pick Up Child*

Person(s) NOT Authorized To Pick Up Child*

Agreements

COVID-19 STATEMENT

An inherent risk of exposure to COVID-19 exists in any public place where people are present.

Participant agrees to abide by all rules promulgated by CDS while participating in any CDS program including, without limitation, any and all instructions and rules regarding social distancing, hygiene, the wearing of masks, and anything else required, at the discretion of CDS, to help reduce the likelihood of the spread of COVID-19.

Participant agrees that CDS cannot and does not guarantee that participant or family will not contract or become infected with COVID-19 or related disease.

By visiting CDS and/or participating in CDS programs of any kind, participant voluntarily assume all risks related to exposure to COVID-19.

PARTICIPANT HEREBY RELEASES, WAIVES, AND AGREES TO HOLD HARMLESS CHARLOTTESVILLE DAY SCHOOL, INC., ITS TRUSTEES, OFFICERS, EMPLOYEES, VOLUNTEERS, AND AGENTS (COLLECTIVELY, “CDS”) FROM AND AGAINST ANY ECONOMIC OR NON- ECONOMIC LOSSES, DAMAGES, SUITS, CLAIMS, ATTORNEY’S FEES, COSTS, OR DEMANDS, OF EVERY KIND AND NATURE WHATSOEVER, WHETHER FOR BODILY INJURY, PROPERTY DAMAGE, DEATH, OR LOSS OTHERWISE, WHETHER CAUSED IN WHOLE OR IN PART BY CDS’S NEGLIGENCE ARISING FROM, OR ALLEGED TO HAVE ARISEN FROM PARTICIPANTS PRESENCE ON CDS PROPERTY OR PARTICIPATION IN ANY CDS PROGRAMS.

PARENTAL AGREEMENT
1. The child day center agrees to notify the parent(s)/guardian(s) whenever the child becomes ill and the parent(s)/guardian(s) will arrange to have the child picked up as soon as possible if so requested by the center.
2. The parent(s)/guardian(s) authorize the child day center to obtain immediate medical care if any emergency occurs when the parent(s)/guardian(s) cannot be located immediately. **
3. The parent(s)/guardians agree to inform the center within 24 hours or the next business day after his child or any member of the immediate household has developed a reportable communicable disease, as defined by the State Board of Health, except for life threatening diseases which must be reported immediately.
* Appropriate paperwork such as custody papers shall be attached if a parent is not allowed to pick up the child.

* NOTE: Section 22.1-4.3 of the Code of Virginia states that unless a court order has been issued to the contrary, the noncustodial parent of a student enrolled in a public school or day care center must be included, upon the request of such noncustodial parent, as an emergency contact for events occurring during school or day care activities. 032-05-252/11 (06/05)

Parental Signature*

Date*

Payment

Total

$0.00

Credit Card*

Card Details

Cardholder Name