Christmas Break Camp - Rocket Skating Plus LLC

Join us Monday and Tuesday as we make 6 wonderful Christmas gifts for our family and friends. We will be skating and playing games. On Tuesday: Wear your Christmas PJs and bring your favorite Christmas snack for a fun Christmas Party and a Black light skate. Please pre-register and pre-pay on or before December 15th so we can get all the supplies ordered.

Nerf Wars Day Camp May 3rd

Student's name & age

Student's name & age (optional)

Parent's names & cell phone numbers

Parent's name & cell phone numbers (optional)

Emergency Contact Information – Alternate Pickup/Release Name & cell number (optional)

What is your email?

I understand that I will be notified in the case of a medical emergency involving my child. In the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event my child is injured or becomes ill.

I understand that Rocket Skating Plus LLC it’s owners and it’s employees and volunteers will not be responsible for any medical expenses that may be incurred, but that such expenses will be my responsibility as parent/guardian.

My student agrees to follow The camper Code of Conduct which is designed to ensure that all of the participants in the camp program have a safe and happy camp experience.

My student and I have read and agree to follow the the camp handbook

Medical Release Information

Primary Physician & phone #

Hospital Preference

Please list any medical concerns, including any requiring maintenance medication

Any conditions require us to call a paramedic?

Are there any food or environmental allergies that we need to be aware of?

Is your child presently being treated for an injury or sickness, or taking any form of medication for any reason?

Is your child allergic to any type of food or medication?

Does your child require a special diet?

The purpose of the above listed information is to ensure that medical personnel have details of any medical problem which may interfere with or alter treatment. Is there any additional medical information that we may need to be aware of?

Rocket Skating Plus LLC Camp, and its co-organizers are not responsible for lost or damaged personal property. All scheduled events are subject to change. Children’s’ photos and quotes may be used for publicity purposes. In case of an emergency, and if a family physician cannot be reached, I hereby authorize my child to be treated by Certified Emergency Personnel (i.e. EMT, First Responder, and/or Physician).

Photo Release – I hereby give permission for my child to be photographed during the Rocket Skating Plus Camp. I understand the photos will be used to keep a journal of activities, to share during power point presentations and/or reports to our donors and for promotional purposes including flyers, brochures, newspaper and on the internet. I understand that although my child’s photograph may be used for advertising, his or her identity will not be disclosed, I do not expect compensation and that all photos are the property of Rocket Skating Plus Camp and its affiliates.

Please comment how you will be making your payment. If your camper is an Epic Charter student and you would like for me to submit their invoice please comment their student id # and grade level. All please note if we will be sending in an invoice to Respite. If you prefer to pay through paypal there is a link below.

Please note any Early Drop off or Late pickups needed. $10 per family, per date, per arrangement.

How did you hear about our Camp?