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Required Weekly Fee $40
Field Trips (Additional/optional Fee)
YOUTH SUMMER Week 1 ● JUNE 13-17
Total: _________
Date: _____/_____/2016 Entered By:___________ Cash Credit Card Check
Office Use Only
Parent/Guardian Signature ______________________________ By signing above, I agree that I have read this form in its entirety and agree to adhere to the rules set forth by BGCTM.
Tuesday Movies 11:00am-5:00pm Angry Birds—Time TBD
$8
Wednesday Fun Quest & Laser Tag 1:00pm-5:00pm
$10
One Sign Up Sheet Per Member
Member First and Last Name ___________________________________________
Current Phone Number ________________________________________________
Date of Birth _________________________________________________________
· In consideration of my child’s membership and participation in the activities, special programs and/or special events of the Boys & Girls Club, I hereby fully waive, release, and hold harmless the Boys & Girls Club, together with all its agents, employees, representatives, officers, and directors from any and all claims, causes of actions, damages, costs, expenses, and other liabilities in any way arising out of or resulting from such membership or participation, including, but not limited to, any personal injury, accident, illness, property damages or any loss, injury or harm of any nature whatsoever. · I attest and verify that I have full knowledge of any and all risk involved in such membership and participation, and that I will, on behalf of the named member(s), assume full responsibility for such risks and pay any and all medical, emergency, and other costs and expenses in the event of injury, accident, illness, casualty or other incapacity regardless of whether I have authorized such expenses. I acknowledge that my child is in good health, physically fit, and sufficiently trained to participate in membership and in programs, activities, and events of the Boys & Girls Club.
Thursday Coconut Bowling 1:00pm-5:00pm *Lemmon & Bresson sites only*
Socks required
Summer Break 2016
Program Reminders Hours of Operation: 7:00am-6:00pm. Children must be picked up by closing time. There is no grace period. Refunds or credits will not be issued for suspensions of any kind. All field trips fees must be paid by closing on the Friday prior to the trip. Weekly fee is required; field trips are optional. Field trip box on form must be marked for child to attend the field trip. Membership cards must be presented to attend field trips. Field trip shirts must be worn for designated outings. All field trips leave after lunch and return by 5:00pm unless stated otherwise.
$6
Monday Traner Pool 1:00pm-5:00pm Swimsuit, towel, sunscreen required
$3
Expedition
Africa
Week
On Friday,
Dress as your
favorite animal
or in safari gear.
Week 1 Specialty Camps
Robotics, Swim Lessons, and Junior Giants Baseball!
See your Membership Staff or Site Coordinator for more information and to sign up!
Bresson Avenue Facility ● 229-9538 Lemmon Valley Facility ● 622-0040
Neil Road Facility ● 229-9538
Thursday Nevada Bugs & Butterflies 1:00pm-5:00pm *Neil Road site only* First come, first served. 30 max.
$3
Required Weekly Fee $40
Field Trips (Additional/optional Fee)
YOUTH SUMM
ER Week 2 ● JUN
E 20-24
Total: _________
Date: _____/_____/2016 Entered By:___________ Cash Credit Card Check
Office Use Only
Parent/Guardian Signature ______________________________ By signing above, I agree that I have read this form in its entirety and agree to adhere to the rules set forth by BGCTM.
Tuesday Movies 11:00am-5:00pm Through the Looking Glass -Time TBD
$8
Wednesday Traner Pool 1:00pm-5:00pm Swimsuit, towel, sunscreen required
$3
One Sign Up Sheet Per Member
Member First and Last Name ___________________________________________
Current Phone Number ________________________________________________
Date of Birth _________________________________________________________
· In consideration of my child’s membership and participation in the activities, special programs and/or special events of the Boys & Girls Club, I hereby fully waive, release, and hold harmless the Boys & Girls Club, together with all its agents, employees, representatives, officers, and directors from any and all claims, causes of actions, damages, costs, expenses, and other liabilities in any way arising out of or resulting from such membership or participation, including, but not limited to, any personal injury, accident, illness, property damages or any loss, injury or harm of any nature whatsoever. · I attest and verify that I have full knowledge of any and all risk involved in such membership and participation, and that I will, on behalf of the named member(s), assume full responsibility for such risks and pay any and all medical, emergency, and other costs and expenses in the event of injury, accident, illness, casualty or other incapacity regardless of whether I have authorized such expenses. I acknowledge that my child is in good health, physically fit, and sufficiently trained to participate in membership and in programs, activities, and events of the Boys & Girls Club.
Thursday Roller Kingdom 1:00pm-5:00pm Socks required
Summer Break 2016
Program Reminders Hours of Operation: 7:00am-6:00pm. Children must be picked up by closing time. There is no grace period. Refunds or credits will not be issued for suspensions of any kind. All field trips fees must be paid by closing on the Friday prior to the trip. Weekly fee is required; field trips are optional. Field trip box on form must be marked for child to attend the field trip. Membership cards must be presented to attend field trips. Field trip shirts must be worn for designated outings. All field trips leave after lunch and return by 5:00pm unless stated otherwise.
$7
Monday Wild Waters- Ages 9-12 only 10:00am-5:00pm Swimsuit, towel, sunscreen required
$15
Week 2 Specialty Camps Rocket Build, Art Explorers, Science Camp, Cheerleading Camp, Swim Lessons, Pack Leaders Camp, and Junior Giants Baseball!
See your Membership Staff or Site Coordinator for more information and to sign up!
Keepin’ it Country Week
On Friday, Dress in your rodeo
gear.
Bresson Avenue Facility ● 229-9538 Lemmon Valley Facility ● 622-0040
Neil Road Facility ● 229-9538
$40
●
Total: _________
Date: _____/_____/2016 Entered By:___________ Cash Credit Card Check
Office Use Only
Parent/Guardian Signature ______________________________ By signing above, I agree that I have read this form in its entirety and agree to adhere to the rules set forth by BGCTM.
Tuesday Reno Aces Game 11:00am-5:00pm
$8
Wednesday Paradise Cove Fun Center 1:00pm-5:00pm
$14
Member First and Last Name ___________________________________________
Current Phone Number ________________________________________________
Date of Birth _________________________________________________________
· In consideration of my child’s membership and participation in the activities, special programs and/or special events of the Boys & Girls Club, I hereby fully waive, release, and hold harmless the Boys & Girls Club, together with all its agents, employees, representatives, officers, and directors from any and all claims, causes of actions, damages, costs, expenses, and other liabilities in any way arising out of or resulting from such membership or participation, including, but not limited to, any personal injury, accident, illness, property damages or any loss, injury or harm of any nature whatsoever. · I attest and verify that I have full knowledge of any and all risk involved in such membership and participation, and that I will, on behalf of the named member(s), assume full responsibility for such risks and pay any and all medical, emergency, and other costs and expenses in the event of injury, accident, illness, casualty or other incapacity regardless of whether I have authorized such expenses. I acknowledge that my child is in good health, physically fit, and sufficiently trained to participate in membership and in programs, activities, and events of the Boys & Girls Club.
Hours of Operation: 7:00am-6:00pm. Children must be picked up by closing time. There is no grace period. Refunds or credits will not be issued for suspensions of any kind. All field trips fees must be paid by closing on the Friday prior to the trip. Weekly fee is required; field trips are optional. Field trip box on form must be marked for child to attend the field trip. Membership cards must be presented to attend field trips. Field trip shirts must be worn for designated outings. All field trips leave after lunch and return by 5:00pm unless stated otherwise.
Monday Alf Sorenson Pool 1:00pm-5:00pm Swimsuit, towel, sunscreen required
$6
&Rocket Build, Art Explorers, Extreme Team Challenge, Junior Giants,
Club Kids College, Cheerleading Camp, and Swim Lessons! Family Night June 30!
See your Membership Staff or Site Coordinator for more information and to sign up!
Bresson Avenue Facility ● 229-9538 Lemmon Valley Facility ● 622-0040
Neil Road Facility ● 229-9538
Thursday Raceway & Mini Golf 1:00pm-5:00pm *Lemmon & Neil sites only* Socks required
$10
Thursday Nevada Bugs & Butterflies 1:00pm-5:00pm *Bresson site only* First come, first served. 30 max.
$3
Required Weekly Fee $32
Field Trips (Additional/Optional Fee)
Youth
Sum
mer W
eek 4 ●July 4-8
Total: _________
Date: _____/_____/2016 Entered By:___________ Cash Credit Card Check
Office Use Only
Parent/Guardian Signature ______________________________ By signing above, I agree that I have read this form in its entirety and agree to adhere to the rules set forth by BGCTM.
Tuesday Movies 11:00am-5:00pm Finding Dory—Time TBD
$8
Wednesday High Ballocity 1:00pm-5:00pm Socks required
$6
One Sign Up Sheet Per Member
Member First and Last Name ___________________________________________
Current Phone Number ________________________________________________
Date of Birth _________________________________________________________
· In consideration of my child’s membership and participation in the activities, special programs and/or special events of the Boys & Girls Club, I hereby fully waive, release, and hold harmless the Boys & Girls Club, together with all its agents, employees, representatives, officers, and directors from any and all claims, causes of actions, damages, costs, expenses, and other liabilities in any way arising out of or resulting from such membership or participation, including, but not limited to, any personal injury, accident, illness, property damages or any loss, injury or harm of any nature whatsoever. · I attest and verify that I have full knowledge of any and all risk involved in such membership and participation, and that I will, on behalf of the named member(s), assume full responsibility for such risks and pay any and all medical, emergency, and other costs and expenses in the event of injury, accident, illness, casualty or other incapacity regardless of whether I have authorized such expenses. I acknowledge that my child is in good health, physically fit, and sufficiently trained to participate in membership and in programs, activities, and events of the Boys & Girls Club.
Thursday Fun Quest and Laser Tag 1:00pm-5:00pm
Summer Break 2016
Program Reminders Hours of Operation: 7:00am-6:00pm. Children must be picked up by closing time. There is no grace period. Refunds or credits will not be issued for suspensions of any kind. All field trips fees must be paid by closing on the Friday prior to the trip. Weekly fee is required; field trips are optional. Field trip box on form must be marked for child to attend the field trip. Membership cards must be presented to attend field trips. Field trip shirts must be worn for designated outings. All field trips leave after lunch and return by 5:00pm unless stated otherwise.
$10
Monday Closed Happy Independence Day
Week 4 Specialty Camps Swim Lessons
See your Membership Staff or Site Coordinator for more information and to sign up!
Party in the USA Week
On Friday, dress in red, white and blue.
Bresson Avenue Facility ● 229-9538 Lemmon Valley Facility ● 622-0040
Neil Road Facility ● 229-9538
Required Weekly Fee $40
Field Trips (Additional/optional Fee)
Youth Summer Week 5 ●July 11
15
Total: _________
Date: _____/_____/2016 Entered By:___________ Cash Credit Card Check
Office Use Only
Parent/Guardian Signature ______________________________ By signing above, I agree that I have read this form in its entirety and agree to adhere to the rules set forth by BGCTM.
Tuesday Movies 11:00am-5:00pm The BFG—Time TBD
$8
Wednesday Paradise Cove Fun Center 1:00pm-5:00pm
$14
One Sign Up Sheet Per Member
Member First and Last Name ___________________________________________
Current Phone Number ________________________________________________
Date of Birth _________________________________________________________
Program Reminders Hours of Operation: 7:00am-6:00pm. Children must be picked up by closing time. There is no grace period. Refunds or credits will not be issued for suspensions of any kind. All field trips fees must be paid by closing on the Friday prior to the trip. Weekly fee is required; field trips are optional. Field trip box on form must be marked for child to attend the field trip. Membership cards must be presented to attend field trips. Field trip shirts must be worn for designated outings. All field trips leave after lunch and return by 5:00pm unless stated otherwise.
Monday Wild Waters- Ages 9-12 only 10:00am-5:00pm Swimsuit, towel, sunscreen required
$15
Week 5 Specialty Camps & Info Robotics, Skate Camp, Equestrian (Horse Riding), Science Camp,
Tennis Camp, and Swim Lessons! Talent show July 15th!
See your Membership Staff or Site Coordinator for more information and to sign up!
Rollin’ Out the Red Carpet Week
Pajama day on
Friday!
· In consideration of my child’s membership and participation in the activities, special programs and/or special events of the Boys & Girls Club, I hereby fully waive, release, and hold harmless the Boys & Girls Club, together with all its agents, employees, representatives, officers, and directors from any and all claims, causes of actions, damages, costs, expenses, and other liabilities in any way arising out of or resulting from such membership or participation, including, but not limited to, any personal injury, accident, illness, property damages or any loss, injury or harm of any nature whatsoever. · I attest and verify that I have full knowledge of any and all risk involved in such membership and participation, and that I will, on behalf of the named member(s), assume full responsibility for such risks and pay any and all medical, emergency, and other costs and expenses in the event of injury, accident, illness, casualty or other incapacity regardless of whether I have authorized such expenses. I acknowledge that my child is in good health, physically fit, and sufficiently trained to participate in membership and in programs, activities, and events of the Boys & Girls Club.
Bresson Avenue Facility ● 229-9538 Lemmon Valley Facility ● 622-0040
Neil Road Facility ● 229-9538
Summer Break 2016
Thursday Discovery Museum 1:00pm-5:00pm *Bresson & Neil sites only* Socks required
$8
Thursday Nevada Bugs & Butterflies 1:00pm-5:00pm *Lemmon Valley site only* First come, first served. 30 max.
$3
Required Weekly Fee $40
Field Trips (Additional/Optional Fee)
Youth
Summer W
eek 6
●Ju
ly 18-
22
Total: _________
Date: _____/_____/2016 Entered By:___________ Cash Credit Card Check
Office Use Only
Parent/Guardian Signature ______________________________ By signing above, I agree that I have read this form in its entirety and agree to adhere to the rules set forth by BGCTM.
Tuesday Roller Kingdom 1:00pm-5:00pm Socks required
$7
Wednesday Alice in Wonderland 11:00am-5:00pm Play for Artown First come, first served. 45 max.
$8
One Sign Up Sheet Per Member
Member First and Last Name ___________________________________________
Current Phone Number ________________________________________________
Date of Birth _________________________________________________________
Thursday Bowling @ GSR 1:00pm-5:00pm Socks required
Summer Break 2016
Program Reminders Hours of Operation: 7:00am-6:00pm. Children must be picked up by closing time. There is no grace period. Refunds or credits will not be issued for suspensions of any kind. All field trips fees must be paid by closing on the Friday prior to the trip. Weekly fee is required; field trips are optional. Field trip box on form must be marked for child to attend the field trip. Membership cards must be presented to attend field trips. Field trip shirts must be worn for designated outings. All field trips leave after lunch and return by 5:00pm unless stated otherwise.
$6
Monday Traner Pool 1:00pm-5:00pm Swimsuit, towel, sunscreen required
$3
Week 6 Specialty Camps Club Kids College, Tennis Camp and Swim Lessons!
See your Membership Staff or Site Coordinator for more information and to sign up!
Nautical by Nature Week On Friday, wear
your flip-flops and
shorts.
· In consideration of my child’s membership and participation in the activities, special programs and/or special events of the Boys & Girls Club, I hereby fully waive, release, and hold harmless the Boys & Girls Club, together with all its agents, employees, representatives, officers, and directors from any and all claims, causes of actions, damages, costs, expenses, and other liabilities in any way arising out of or resulting from such membership or participation, including, but not limited to, any personal injury, accident, illness, property damages or any loss, injury or harm of any nature whatsoever. · I attest and verify that I have full knowledge of any and all risk involved in such membership and participation, and that I will, on behalf of the named member(s), assume full responsibility for such risks and pay any and all medical, emergency, and other costs and expenses in the event of injury, accident, illness, casualty or other incapacity regardless of whether I have authorized such expenses. I acknowledge that my child is in good health, physically fit, and sufficiently trained to participate in membership and in programs, activities, and events of the Boys & Girls Club.
Bresson Avenue Facility ● 229-9538 Lemmon Valley Facility ● 622-0040
Neil Road Facility ● 229-9538
Required Weekly Fee $40
Field Trips (Additional/optional Fee)
Yo
ut
h S
um
me
r W
ee
k 7 ●
Ju
ly
25-
29
Total: _________
Date: _____/_____/2016 Entered By:___________ Cash Credit Card Check
Office Use Only
Parent/Guardian Signature ______________________________ By signing above, I agree that I have read this form in its entirety and agree to adhere to the rules set forth by BGCTM.
Tuesday Movies 11:00am-5:00pm Secret Life of Pets—Time TBD
$8
Wednesday Raceway & Mini Golf 1:00pm-5:00pm
$10
One Sign Up Sheet Per Member
Member First and Last Name ___________________________________________
Current Phone Number ________________________________________________
Date of Birth _________________________________________________________
Thursday High Ballocity 1:00pm-5:00pm Socks required
Summer Break 2016
Program Reminders Hours of Operation: 7:00am-6:00pm. Children must be picked up by closing time. There is no grace period. Refunds or credits will not be issued for suspensions of any kind. All field trips fees must be paid by closing on the Friday prior to the trip. Weekly fee is required; field trips are optional. Field trip box on form must be marked for child to attend the field trip. Membership cards must be presented to attend field trips. Field trip shirts must be worn for designated outings. All field trips leave after lunch and return by 5:00pm unless stated otherwise.
$6
Monday Wild Waters- Ages 9-12 only 10:00am-5:00pm Swimsuit, towel, sunscreen required
$15
Week 7 Specialty Camps Streams & Trails, SMART Girls Camp, and Swim Lessons!
See your Membership Staff or Site Coordinator for more information and to sign up!
Rev Your Engine Week
Crazy hair day on
Friday!
· In consideration of my child’s membership and participation in the activities, special programs and/or special events of the Boys & Girls Club, I hereby fully waive, release, and hold harmless the Boys & Girls Club, together with all its agents, employees, representatives, officers, and directors from any and all claims, causes of actions, damages, costs, expenses, and other liabilities in any way arising out of or resulting from such membership or participation, including, but not limited to, any personal injury, accident, illness, property damages or any loss, injury or harm of any nature whatsoever. · I attest and verify that I have full knowledge of any and all risk involved in such membership and participation, and that I will, on behalf of the named member(s), assume full responsibility for such risks and pay any and all medical, emergency, and other costs and expenses in the event of injury, accident, illness, casualty or other incapacity regardless of whether I have authorized such expenses. I acknowledge that my child is in good health, physically fit, and sufficiently trained to participate in membership and in programs, activities, and events of the Boys & Girls Club.
Bresson Avenue Facility ● 229-9538 Lemmon Valley Facility ● 622-0040
Neil Road Facility ● 229-9538
Required Weekly Fee $40
Field Trips (Additional/Optional Fee)
Youth Sum
mer W
eek 8 ●A
ugust 1-5
Total: _________
Date: _____/_____/2016 Entered By:___________ Cash Credit Card Check
Office Use Only
Parent/Guardian Signature ______________________________ By signing above, I agree that I have read this form in its entirety and agree to adhere to the rules set forth by BGCTM.
Tuesday Movies 11:00am-5:00pm Ice Age: Collison Course—Time TBD
$8
Wednesday Coconut Bowling 1:00pm-5:00pm Socks required
$6
One Sign Up Sheet Per Member
Member First and Last Name ___________________________________________
Current Phone Number ________________________________________________
Date of Birth _________________________________________________________
Thursday Discovery Museum 1:00pm-5:00pm
Summer Break 2016
Program Reminders Hours of Operation: 7:00am-6:00pm. Children must be picked up by closing time. There is no grace period. Refunds or credits will not be issued for suspensions of any kind. All field trips fees must be paid by closing on the Friday prior to the trip. Weekly fee is required; field trips are optional. Field trip box on form must be marked for child to attend the field trip. Membership cards must be presented to attend field trips. Field trip shirts must be worn for designated outings. All field trips leave after lunch and return by 5:00pm unless stated otherwise.
$8
Monday Traner Pool 1:00pm-5:00pm Swimsuit, towel, sunscreen required
$3
Week 8 Specialty Camps Swim Lessons
See your Membership Staff or Site Coordinator for more information and to sign up!
Let the Games Begin...Rio 2016 On Friday, represent your
favorite Olympic country.
· In consideration of my child’s membership and participation in the activities, special programs and/or special events of the Boys & Girls Club, I hereby fully waive, release, and hold harmless the Boys & Girls Club, together with all its agents, employees, representatives, officers, and directors from any and all claims, causes of actions, damages, costs, expenses, and other liabilities in any way arising out of or resulting from such membership or participation, including, but not limited to, any personal injury, accident, illness, property damages or any loss, injury or harm of any nature whatsoever. · I attest and verify that I have full knowledge of any and all risk involved in such membership and participation, and that I will, on behalf of the named member(s), assume full responsibility for such risks and pay any and all medical, emergency, and other costs and expenses in the event of injury, accident, illness, casualty or other incapacity regardless of whether I have authorized such expenses. I acknowledge that my child is in good health, physically fit, and sufficiently trained to participate in membership and in programs, activities, and events of the Boys & Girls Club.
Bresson Avenue Facility ● 229-9538 Lemmon Valley Facility ● 622-0040
Neil Road Facility ● 229-9538