Please print this form and submit it to the address below.
Check the LETTER of the sessions you are attending.
Please fill out this form completely and mail to the address indicated below.
Session I (A)__ (B)__ (C)__ (D)__
Session 1: Summer Day Camps 2006 |
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| Dates | Times | Grades |
Price |
| A)June 5 - 9 | 7:30 a.m. - 3:00 p.m. | 4-8 |
$1 per day |
| B)June 12 - June 16 | 7:30 a.m. - 3:00 p.m. | 4-8 |
$1 per day |
| C)June 19 - June 23 | 7:30 a.m. - 3:00 p.m. | 4-8 |
$1 per day |
| D)June 26 - June 30 | 7:30 a.m. - 3:00 p.m. | 4-8 |
$1 per day |
Day Campers will be taken to Camp Clements by bus. You must arrive at Police Headquarters before 8:00 AM on the day of camp. Campers will be brought back to the Police Station between 3:00 and 3:30 P.M. Campers should bring a sack lunch or money to buy their lunch from the local store in Abington. Other items, such as towels, shoes, clothing, or swim wear may be needed when we swim in the river. Any campers lower than the 4th grade wishing to attend should be discussed between the officer running the camp and the camper's parent.
Session II (A)__ (B)__
Session 2: Summer Overnight Camps 2006 |
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| Dates | Days | Grades | Price |
| A)July 26 - July 30 | Wed - Sun | Counselors Only | $50 |
| B)July 31 - August 4 | Mon - Thur | 4-8 | $50 |
Name:___________________________________________________________________
Address:_________________________________________________________________
Home Phone: _____________________________________________________________
Parents' Work Phone:_______________________________________________________
What school will your child attend next year? _____________________________________
Grade: __________________________________________________________________
If you need help with the cost of the camps(s), please check on of the following:
_____ I need full scholarship
_____ I need partial scholarship
I can pay: $_____
I give permission for _________________________ to attend the D.A.R.E. Camp(s) that I
have registered my child for. I also give permission for my child to participate in all field trips that
may be involved during the camp(s). I expect my child to follow all rules that may be implemented
by camp officers, counselors, and staff. I agree not to hold the Richmond Police Department,
Wayne County Sheriff's Department, Richmond Community Schools, Camp Clements 2 property
owners or any of their agents responsible/liable for any injury or loss of property that might occur
to my child.
_______________________________
Signature of parent or guardian
_______________________________
Date
There will be a parent meeting before the overnight camp to answer questions.
For questions, Call Rick Thalls at 973-3331 or 855-1045.
You may also mail this form to:
5291 Abington Pike
Richmond, IN 47374