Dear Parents and Guardians, Thank you for registering your child to participate in our Summer Cave program. We are looking forward to providing a safe, fun, and enjoyable summer experience. Attached is the registration packet for the Summer Cave. Please read carefully, complete, and return to our staff at the Summer Cave on the first morning your child will attend. Our staff will review for completeness with you so plan to spend a few extra minutes with us that morning just to make sure everything is in order. If you have any questions please feel free to contact us at: Summer CAVE 916-355-7203 Summer CAVE Cell 916-496-1987 Program Coordinator, Matt Zimmerling 916-461-6619 mzimmerling@folsom.ca.us Park and Recreation Offices at 48 Natoma St. 916-461-6601 Sincerely, SUMMER CAVE STAFF
City of Folsom - Parks and Recreation Department 2018 Summer CAVE EMERGENCY INFORMATION, MEDICAL AUTHORIZATION, WAIVER & RELEASE OF LIABILITY Participants Name: Date of Birth: Gender (M/F) Home Address: City: Zip: Parents Name Phone H: W: Cell: Parents Name Phone H: W: Cell: Guardian Name: Phone H: W: Cell: In case of an emergency, please notify other than parent: Name: Phone H: W: Cell: Emergency Information Physician: Phone: Insurance Co: Policy#: List any health issues/ allergies Will your child require administration of medication during our program? *YES* NO *If yes, you must also sign an Authorization to Administer Medication form. Sign-Out Procedure My child may sign themselves OUT: Yes No 1) 2) If Yes I understand that my child may leave the program at any time. Once my child signs out and leaves the program they will not be allowed to sign themselves back in until the following day. If No please list who may sign your child out other than the Parents/Guardians listed above: NAME PHONE # RELATIONSHIP 3) In emergencies, a name can only be added over the phone, the parent/guardian can contact the site leader at the CAVE 916-355-7203 or the Recreation Coordinator at 916-461-6619. The Summer Cave program is located at the Sutter Middle School, both indoors and outdoors, and ventures off-site on fieldtrips or excursions. I understand that The Cave is an active program that includes various sports and recreational activities that involve an element of risk and the danger of serious accidents. Knowing these risks, I hereby voluntarily assume such risks and waive, release and discharge all claims for damages for personal injuries, death or property damage that results from my participation in The Summer CAVE program and activities. I permit my child to view PG-13 movies at Summer Cave. PG-13 movies are contingent on staff s discretion. I will additionally permit the use of pictures of my child participating in Summer CAVE events in brochures, newspapers, websites, etc. I will update any information on this form as it changes. In case of emergency and in the event that I can not be reached, I authorize Folsom Parks and Recreation and it s employee s or officers to obtain medical care for my child including necessary transportation, in accordance with their best judgments. I further agree to indemnify, defend and hold harmless the City of Folsom and the Folsom Cordova Unified School district, their officers, employees and agents, from all liability, damage cost or expense which they may incur as a result of or connected in any way with my participation in the Summer CAVE program and activities. The waiver, release, and assumption of the risk are intended to be binding upon my heirs and assigns. As the parent or guardian of, I give permission for my child to participate in The Summer CAVE and further acknowledge that I have read this EMERGENCY INFORMATION, MEDICAL AUTHORIZATION, WAIVER & RELEASE OF LIABILITY and sign it on behalf of the participant with full knowledge and understanding of its contents. Signature of Parent/Guardian: Date: Print name of Parent/Guardian:
CODE OF CONDUCT FOR PARTICIPANTS AND STAFF As a member of THE CAVE I will: ACT WITH RESPECT TO OTHERS BE CONSIDERATE TO OTHERS AND STAFF BE RESPECTFUL WITH MY LANGUAGE AND GESTURES NOT ENGAGE IN OR BE UNDER THE INFLUENCE OF DRUGS NOT SMOKE OR USE ALCOHOL FOLLOW THE RULES GOVERNED BY THE CAVE I agree to uphold this Code of Conduct and my parents/guardians and I am aware that the Summer CAVE uses a three-strike policy when dealing with disciplinary issues. By signing the Code of Conduct, we agree that I will follow and abide by the rules while participating in Summer CAVE activities. I understand that staff will notify my parents/guardians regarding my behavior. Failure to comply with this Code of Conduct may result in my loss of privileges, suspension, or even permanent expulsion from the program, depending on the degree to which I violated the CODE OF CONDUCT. Participant's Signature: Date: Printed Name: Parent/Guardian Signature: Date: Printed Name:
THE SUMMER CAVE CONTRACT: 3 STRIKES & YOU RE OUT I am aware that I need to follow and abide by the CODE OF CONDUCT, (which I signed), while participating in CAVE activities. I understand that failure to comply with this Code of Conduct may result in my loss of privileges, suspension or permanent expulsion from THE CAVE. I understand that there is a 3-strike policy. I also understand that depending on the severity of a strike, one violation may result in loss of privileges, suspension, or expulsion, and will be determined at the discretion of City staff based on the severity of the violation. I understand that my parents will be notified when I receive a strike. NAME: 1 st strike Remedial Action Taken: Participant s Signature Date Staff s Signature Parent Signature Date 2nd strike Remedial Action Taken: Participant s Signature Date Staff s Signature Parent Signature Date 3rd strike Remedial Action Taken: Participant s Signature Date Staff s Signature Parent Signature Date
Dear Parents: The Summer Cave will take field trips to various local locations which may include, but are not limited to the Folsom Aquatic Center, Folsom Bowl, Old Town Folsom, and the Folsom Zoo Sanctuary. During these trips, Summer Cave participants either will walk or be transported by a city vehicle. These trips may require each participant to have a few extra dollars, depending on the activity. Trips are generally posted in the weekly schedule, but we may alter the schedule to accommodate the participants. In addition the Summer CAVE takes weekly field trips to out of town locations. For these trips transportation will be provided by FCUSD in their school busses with their drivers. The trips are listed on the weekly handouts, in the Sumer Camp activity Guide, and on line at the City of Folsom s web site. This letter serves as a permission slip for all trips. If you should have any questions, please feel free to contact Matt Zimmerling at (916) 461-6619. Field Trip Permission Form I give permission for my child/children, to participate in any of the field trips that will take place during they are enrolled in The Summer Cave. SIGNATURE DATE PRINTED NAME
Aquatics Center Guidelines To Summer CAVE Parents: We are pleased to include a trip to the Folsom Aquatics Center as part of your teen s camp experience. To help ensure a fun, safe experience for everyone, we want to provide you with the following information: The Aquatics Center is a large facility with three separate pool areas. Multi- Purpose Pool This is a 50 meter pool that ranges from 4 ½ feet 14 feet in depth. There are diving boards, including high dives located at the deep end of this pool. This pool is for more experienced swimmers. Instructional /therapeutic warm water pool - This pool is 25 yards in length and 3½ feet in depth. It is for swim instruction and less experienced swimmers. Activity pool this is a family leisure pool with beach slope entry and a water play Structure. It ranges from 0 foot to 3 ½ feet in depth. A 25-foot high water slide is located at the side of this pool. Only children over 48 in height may ride the slide. There are concession stands and locker rooms with restrooms and shower facilities. All day passes for the inflateable obstacle course can be purchased for an additional $3 (price subject to change). The Summer CAVE has access to the entire facility. Please be aware that when we attend the facility, it is open to the public for recreational swim. We cannot provide direct supervision over the Summer CAVE participants due to the size of the facility; however our staff provides general supervision, and our Summer CAVE staff has a designated meeting location at the Aquatic Center. Additionally, there are lifeguards stationed at each pool. We ask that our participants swim with a partner and notify our staff when they are using the restrooms. Please help us reinforce the concept of swimming with a partner by talking with your child about this at home. To further ensure that your child has a good experience at the pool, please apply sunscreen to your child on scheduled pool days, PRIOR to their arrival to camp. You may send additional sunscreen with them. We recommend that they bring sandals to wear on the pool deck. We will explain the pool rules to the participants prior to visiting the facility. Participants that do not comply with these rules may be required to stay and sit with staff on the pool deck. If you have concerns about your child s swimming ability or any other concerns regarding our trips to the Aquatics facility, please notify the Summer CAVE site leader at the Summer Cave phone number 355-7203, or the cell number 496-1987.
My signature below indicates that I have received, read, and understand the Aquatics Center Guidelines information sheet that applies to all Summer CAVE participants. Please sign and return this form to the Summer Cave prior to our first scheduled trip to the Aquatic Center. Thank you for your cooperation. Campers Name(s) Please Print Parent/Guardians Name Please Print Parent/Guardians Signature Date
Summer CAVE Late Fee Notice The late fee policy is as follows: $1 per minute after 6:00PM on the CAVE clock Please come into the CAVE to pick up your child with the fee or the Folsom Parks and Recreation Department will bill it to your address. Late fees must be paid within 30 days of billing. Any late payments will be subject to participant s removal from the program. Parent/Guardian Signature