Summer Programs Registration 2013

Welcome to Girls Inc. of Worcester's Super Camp 2013! This promises to be a great summer filled with new friends, fun programs and awesome field trips. At Girls Inc. we encourage girls to learn, explore, make friends, and most of all have fun! All girls will have a safe, nurturing environment where they feel comfortable to be who they are and to discover the world around them with the support of other girls and women. Girls Inc. of Worcester is a place that inspires all girls to be strong, smart, and bold. sm

We are running a "9" themed week summer camp for girls and teens; girls will enjoy both urban and city settings; 2 days a week at our intown facility - Winthrop House and 2 days a week at Camp Kinneywood and 1 day will be a wild card (field trip or a special project).

We’re all looking forward to another amazing summer. See you soon!

Girls Inc. Summer Staff

Child's Information

First Name: *

Last Name: *

Address:

City:

State:

ZIP:

Home Phone:

Cell Phone:

Date of Birth: *

Age:

Grade in Fall:

School:

E-mail:

Indicate your child's special needs and medication concerns:

Physician’s Name:

Physician’s Phone:

Allergies:

Family Information

Parent / Guardian's Name: *

Address:

City:

State:

ZIP:

Home Phone:

Work Phone:

Cell Phone:

E-mail: *

Emergency Contact: *

Emergency Contact Phone: *

Alternate Pick-up Person:

Parental Permission

Medical: * Initial:

I give permission for my child to participate in Girls Incorporated activities and for my child to receive emergency treatment to be hospitalized, at my expense, if necessary. I understand the Director may dismiss my child from the program if in her/his opinion the conduct of my child is not in the best interest of the total program.

Photo Release: * Initial:

I give permission for photographs and videos in print and electronic form taken of my child during programs at Girls Incorporated to be used for public relations purposes, publicly and privately for newsletters, brochures, annual reports, website, radio, television, and newspapers.

Transportation: * Initial:

I give permission for my child to be transported by Girls Inc. of Worcester either by bus or van with Girls Inc. of Worcester staff to/from Camp Kinneywood and Winthrop House.

Deposit: * Initial:

I understand there is a Non-Refundable/Non-Transferrable $50 required deposit per each week registered.

Weeks: *

Week 1 - 6/24/2013 "Imaginarium" - The Sky's The Limit!

Week 2 - 7/1/2013 “Snap, Crackle, Pop” - Calling All Future Physicists! (closed 7/4)

Week 3 - 7/8/2013 “Where The Wild Things Are” - Animal Adventure

Week 4 - 7/15/2013 “Mad Scientists” - Slime, Goop, and Gunk

Week 5 - 7/22/2013 “Eco Explorers” - Green Energy

Week 6 - 7/29/2013 “H20” - Water, Water, Everywhere

Week 7 - 8/5/2013 “Energize” Yourself - Cooking and Nutrition

Week 8 - 8/12/2013 “Moving' and Groovin'” - Sports and Fitness

Week 9 - 8/19/2013 “I'm A Girls Inc. Girl” - Expressive Arts

Please select the weeks you are interested in. A Non-Refundable/Non-Transferable deposit of $50 per registered week is required.

Summer Programs Registration 2013

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