Melbourne Village Summer Camp Registration
Camp is Monday June 14th and Wednesday June 16th, 9am-12pm, and Friday June 18th, 11-2pm. Camp is for kids 5-12 and is offered free to Melbourne Village kids/grandkids. Teens 12+ are encouraged to participate as camp helper volunteers.

Please submit a separate form for each child. If you have a 12+ child who would like to volunteer please fill out this form also.
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Email *
Child's First Name
Child's Last Name
Age of Child (Camp is for kids 5-12) *
Name of Parent/Caregiver
Parent/Caregiver daytime phone number
Emergency Contact Name and Phone Number
How will the child be transported to camp? Note children should not arrive prior to 8:45am and be picked up no later than 12:15pm.
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Please add any other information about transportation to camp we should know
Does your child have any of the following dietary needs/allergies/restrictions? (Check all that apply)
Add any additional information about your child's dietary needs:
Does your child have any health issues that would limits her/his participation in physical activities? Does your child use an Epi pen? If so, please explain the allergy and anything we should know.
Which days will your child be attending camp?  (Click all that apply)
We encourage families to sign up for any or all of the three days depending on which activities they feel comfortable participating in.  Monday will be a nature walk to learn about the different plants and pollinators in the village. We will explore the trails with our speaker. We will stop in Deer Hammock to do some nature observation, drawing, and journaling. We will then do a scavenger hunt. The rest of the day kids will have the option to stay outside and have supervised free play on the playground, play soccer, etc. Kids who need to cool off or be inside will have the choice to do some crafts or games inside the hall. Wednesday will be a field day with Coach Reed http://www.lilsports.net/index.php/about-us/ of Lil Sports. This will include an obstacle course, tug of war, relay races, etc. We will have times to cool down and do some less vigorous activities in the shade. During the second half of the day we will be on the basketball court for games that incorporate water squirters and water balloons to help keep the kids cooled down. At the end of these activities, we will have a contest for which kids can pick up the most spent balloons and extra care will be taken to ensure no balloons remain to cause an environmental hazard. We will have spread out tables in the hall for snack or cool down as needed. Friday 11-2pm will be our usual pool party with a lifeguard and pizza. Always so much fun. Parents are welcome to accompany kids to camp any of the three days if they wish to; however, they do not need to. Send questions to Nasima Pfaffl, Education Committee Chair npfaffl@gmail.com.
If you have a 12+ teen who would like to volunteer and earn brightfuture volunteer hours, please indicate the days they are available to help? (Check all that apply)
Friday Pool Party
I give my child permission to swim at the Melbourne Village Pool, Friday June 18th.
Will you be attending the pool party with your child(ren)?
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Although there will be a professional lifeguard in attendance, we would like to know if there are any concerns about your child's swimming ability that we should be aware of. If so, please explain.
Permissions and Waivers
We will be keeping as many activities outside as possible in consideration of covid precautions. While inside all adults, teens, and children will be asked to wear a mask; consistent with AHF current policy. While outside, masks will be optional.  We will encourage families while outside to do what helps them feel the most comfortable and is in line with the health considerations of their bubble. During morning check in we will take temperatures and ask health screening questions. Whenever practical, we will also incorporate handwashing, distancing, and cleaning.  We ask that children (or adults planning to attend camp with a child) who have any symptoms of Covid-19 (cough, fever, shortness of breathe, gastrointestinal upset, etc) or who have been exposed to anyone who may have or has been confirmed to have covid-19 during camp or in the 10 days prior not attend camp.  A full covid release waiver will be emailed or provided to parents/guardians prior to the beginning of camp. If you have questions please call the AHF office. *
Please visit https://drive.google.com/file/d/1QLGR7JLkEbV59-6x44Nj_C_0wflw-BOV/view?usp=sharing and print the  AHF Summer Camp Accident Waiver and Release of Liability Form. Copies of the form can also be picked up at the AHF office. Please bring or send this completed form with the child on the first day of camp they attend. *
As the above child's Parent or Guardian, please enter your name and date. This serves as a signature on this registration and permission form.
A copy of your responses will be emailed to the address you provided.
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