Chasing the Dream CAMP INFORMATION

ELIGIBILITY: Open to students 2014 CAMP FEE: Non-refundable $250 9 to 16 years old REGISTRATION due with registration; limited CAMP DATES: July 7 – July 18, 2014 & scholarships available (see below) CAMP TIMES: 9am – 4pm PAYMENT Mail Registration & payment to: CAMP LOCATION: DEADLINE DFLI - 3301 GREEN STREET Hercules Plaza JUNE 6 CLAYMONT, DE 19703 1313 N. Market St. Checks must be made payable to DFLI. Wilmington, DE 19801 Call 302.792.1200 to pay w/ credit card.

Camp Description Interested in starting your own business and earning money? Then Chasing the Dream is for you. Learn the basics of business startup and create your own venture during the Chasing the Dream Market Day. Enjoy two weeks filled with challenging games, activities, and creative adventures including visits with entrepreneurs, a tour of local businesses, and the running of your own business. This program is for students 9 to 16 years old.

Reservations & Payments Completed and signed registration form and $250 camp payment are due by June 6th. Camp space cannot be reserved unless the form is completed and signed, and payment is received. No phone reservations will be accepted. Registrants will receive a program confirmation including directions to the site. If the camp is full, you will be notified. A waiting list will be maintained. Limited scholarships are available, please contact Kiersten Joseph, Camp Director, at 302.792.1200 or kiersten@dfli.org, for details.

Camp Times and Weather Camp runs from 9:00am to 4:00pm. Field trips and Market Day will start and end at the normal times, but transportation will be provided to and from the destination. Please drop off and pick up your child on time as there is no before or after care available. If your child will be absent or late, please notify DFLI at 302.792.1200 so that we are aware and can plan accordingly. If someone other than a parent/guardian or individual listed on the registration form will be picking up your child, we will need to be notified in writing. Programs and trips will be held rain or shine; please dress children accordingly. In case of inclement weather, activities may be modified.

Meals Lunch and snacks will be provided every day. If your child has any dietary restrictions or allergies, please note this on the program registration form.

Medical and Emergency Information So that we may obtain the best care for your child in case of an emergency, please complete all the medical information on the program registration form. Instructors will not administer medication. If your child needs routine medication, it can be held by the camp director, who can offer reminders but the student must be responsible for taking/administering the medication. All medications must be in the original bottle properly labeled for the student.

Market Day Thursday, July 17, is Market Day. Camp will begin and end at regular times at Hercules Plaza. This is your chance to showcase your business idea and sell, sell, sell! The market will be open from approximately 11:00am to 1:00pm.

Photographs Chasing the Dream Camp reserves the right to use any pictures of students to promote the Chasing the Dream program unless otherwise notified by parents. Names will not be used without parental permission.

Camp T-shirts Each student will be provided a Chasing the Dream t-shirt which MUST be worn for the tour and Market Day.

Registrant Cancellation & Refunds Cancellation requests should be made at least 14 days prior to the program start date. Any cancellation requests less than 14 days prior to the program start date will not be issued a refund. A $50 administrative fee will be charged for all cancellations.

CAMP DIRECTOR: Kiersten Joseph, 302.792.1200, or kiersten@dfli.org

3301 Green Street • Claymont, DE 19703 • 302.792.1200 • www.dfli.org

Chasing the Dream Registration & Payment CAMP REGISTRATION Deadline: June 6, 2014 CAMP DATES: July 7 – July 18, 2014 Mail Registration & payment to: CAMP FEE: Non-refundable $250 due DFLI with COMPLETED and SIGNED registration. 3301 GREEN STREET Limited scholarships available, CLAYMONT, DE 19703 contact Kiersten Joseph, Camp Director, Checks must be made payable to DFLI. at 302.792.1200 or kiersten@dfli.org Call 302.792.1200 to pay w/ credit card.

PLEASE PRINT ALL INFORMATION CLEARLY!

Camper Information – All sections MUST BE completed. (*Optional)

Name: Nickname: Birth Date:

Address: Tee Shirt : Youth: S M L XL

Adult: S M L XL XXL

City: State: Zip Code: *Email:

School: Grade Entering in the Fall of ’14:

Parent Information

Mother/Guardian Name: Email:

Employment:

Home Phone: Work Phone: Cell Phone:

Father/Guardian Name: Email:

Employment:

Home Phone: Work Phone: Cell Phone:

Emergency Information (If parents/guardians cannot be reached)

#1 Name: Relationship:

Home Number: Work Number: Cell Number:

#2 Name: Relationship:

Home Number: Work Number: Cell Number:

Authorized Pick-Up People (other than parents/guardians)

#1 Name Relationship:

Home Phone: Work Phone: Cell Phone:

#2 Name Relationship:

Home Phone: Work Phone: Cell Phone:

Medical Information:

Family Physician: Phone Number:

Family Dentist: Phone Number:

Any Known Medical Conditions or Special Needs of the Camper (asthma, diabetes, anxiety, etc):

Student Allergies (drugs, food, bees, etc.):

Medical Insurance: Insurer’s Name:

ID Number: Group Number:

YES NO In case of emergency, I give permission to have ______________ (camper’s name)

receive first aid and be transported to the nearest hospital by professional, emergency personnel. I understand I will be

financially responsible for the cost of such treatment. ________ Parent/Guardian Signature Date

Chasing the Dream Camp reserves the right to use any pictures of students to promote the Chasing the Dream program unless otherwise notified by parents. Names will not be used without parental permission.