2008 SCCC SUMMER DAY CAMP SCHEDULE
Child's name:__________________________  Parent's name: ____________________________ E-mail: ________________________
Daytime phone #:_____________________  Cell / Pager #:____________________
 Circle T-shirt size:    Youth:     S      M           Adult:   S     M      L    Child's grade:_____   Age_____
 
Dates Monday Tuesday   Swimming    Wednesday Field Trip Thursday Swimming Friday Payment           (Staff Only)
Week 1:  June 16-20 TimeIn:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out:  
Swim at Ives12-3pm Doran Beach           9:30-3:00pm $15 Swim at Ives12-3pm Wheel Day
Extended Hours?     a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.  Circle your Choice
Week 2:  June 23-27 Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out:  
Swim at Ives 12-3pm Laguna Farms                9:30-3:00pm $15                         Swim at Ives 12-3pm Wheel Day
Extended Hours?     a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.  Circle your Choice
Week 3:  June 30- July 3 Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out:                                                             
Swim at Ives12-3pm Double Decker Bowl                      9:30-2:00pm   $15     Swim at Ives12-3pm CLOSED
Extended Hours?     a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.  Circle your Choice
Week 4:  July 7-11 Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out:  
Swim at Ives 12-3pm Coast Hike                         9:30-3:00 $15 Swim at Ives 12-3pm Wheel Day
Extended Hours?     a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.  Circle your Choice
Week 5:  July 14-18 Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out:  
Swim at Ives12-3pm Cinemas                              9:30-1:00pm $10                      Swim at Ives12-3pm Wheel Day
Extended Hours?     a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.  Circle your Choice
Week 6:  July 21-25 Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out:  
Swim at Ives 12-3pm Salmon Creek                        9:30-3:00pm   $15   Swim at Ives 12-3pm Wheel Day
Extended Hours?     a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.  Circle your Choice
Week 7:  July 28-August 1 Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out:  
Swim at Ives12-3pm Roller Skating                      11:00-3:30pm $15     Swim at Ives12-3pm Wheel Day
Extended Hours?     a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.  Circle your Choice
Week 8:  August 4-8 Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out:  
Swim at Ives 12-3pm Survival Skills                    9:30-3:00 $15  Swim at Ives 12-3pm Wheel Day
Extended Hours?     a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.  Circle your Choice
Week 9: August 11-15 Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out: Time In:                                                            Time Out:  
Swim at Ives12-3pm Armstrong Woods                       9:30-3:00pm $15    Swim at Ives12-3pm Wheel Day
Extended Hours?     a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.      a.m.    p.m.  Circle your Choice
I have read and understand SCCC's Summer Camp policies, I agree to pay fees regardless of absences of any kind. As a non-refundable deposit, I have paid first and last weeks' fees $____________ Check# ____________ Further, I give consent for my child to participate in the above camps and agree to idemnify and hold the Sebastopol Community Center and the City of Sebastopol harmless and release them from any and all liability for any injury arising out of these camps.   I understand that SCC does not provide medical insurance, and I assume all risk for any injuries received.
Signature:                                                                                                            Date: