HomeMy WebLinkAbout2020 Green Explorers Spring Break Camp Registration - Fillable Final -sm
GREEN EXPLORERS
SPRING BREAK CAMP
MARCH 16-20, 2020
Check-In and Check-Out at:
The Park Lodge at Terry Trueblood Recreation Area
579 McCollister Blvd.
Iowa City, IA 52240
Activities and field trips are held from 9 a.m. - 4 p.m.
Pre-camp and post-camp supervised play from
7:30-9 a.m. & 4-5:30 p.m. at no additional fee.
Registration Forms Available Online at: icgov.org/camps
or In-Person at:
Mercer Park Aquatic Center
2701 Bradford Dr.
Iowa City, IA 52240
Robert A. Lee Recreation Center
220 S Gilbert St.
Iowa City, IA 52240
Every camper will need to bring the following:
-Sack Lunch -Athletic Shoes
-Water Bottle -Boots
-Backpack -Socks
-Swimsuit & Towel (T&TH)-Clothes for Outdoor Activities
Morning and afternoon snacks will be provided. If your child has
special dietary needs, please list on the consent form and provide
them with a suitable snack for each day.
Spring Break Camp Produced by the City of Iowa City Parks and
Recreation Department in Partnership with Green Iowa Americorps.
@ I C P A R K S A N D R E C
GREEN EXPLORERS
SPRING BREAK CAMP
MARCH 16-20, 2020
Camp Schedule
Monday, March 16, 2020
Planet Earth
- Paper Mache Planets - Earth Day Slime - Planet Earth from Pole to Pole -
Explore Terry Trueblood Recreation Area
Wear clothes that can get dirty for outdoor activities
Tuesday, March 17, 2020
Robot Recycle
- Recycle Relay - Robotics - Planet Earth and Fresh Water - Swimming -
Bring swimsuit and towel for the pool at Robert A. Lee Recreation Center
Wednesday, March 18, 2020
Wildlife Wednesday
- Day Trip to Kent Park - Camouflage - Bird Identifications - Outdoor Exploring -
Wear clothes that can get dirty for outdoor activities
Thursday, March 19, 2020
H2Ocean
- The Water Cycle - Ocean in a Bottle - Planet Earth's Shallow Seas - Swimming -
Bring swimsuit and towel for the pool at Robert A. Lee Recreation Center
Friday, March 20, 2020
Predators
- Blind Mice and Owls - Scavenger Hunt - Wolf Masks - Planet Earth's Seasonal Forests -
Wear clothes that can get dirty for outdoor activities
Spring Break Camp Produced by the City of Iowa City Parks and
Recreation Department in Partnership with Green Iowa Americorps.
@ I C P A R K S A N D R E C
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Camp Consent Form
Separate forms must be completed for each participant.
Parent/Guardian Name:
First: _____________________________ Last: _____________________________ DOB:____________________
Address: _______________________________________________________________________________________
Email: ________________________________________________ Phone # :_______________________________
Emergency Contact : ___________________________ Emergency #: ______________________________
Participant Name:
First: _____________________________ Last: _____________________________ DOB:____________________
Age: ______________________ Gender: ___________________________________________________________
School: _________________________________________________ Grade :_______________________________
Health Information/Special Accommodations:
Please indicate any health information that would be important for staff to know (i.e.
asthma, allergies, medications, physical, mental, or emotional disabilities). Also note if
English is not the child’s primary language. Should your child require special
accommodations in order to participate, please contact Joyce Carroll at the Recreation
Division (319-356-5100) as soon as possible. Insufficient notice may result in a delay of
your child’s participation.
Transportation:
I give permission for my child, _________________________________________, to participate in the
Iowa City Recreation Program for which I have registered him/her. I give permission for
my child to leave the Robert A. Lee Community Recreation Center for trips by bus, car,
public transportation, or foot to local parks and other program destinations. I
understand that some of these field trips may occur outside the city limits of Iowa City
and that I will be notified by hand-out and/or posted message.
Signature of Parent/Guardian: ___________________________________________ Date____________
Every camper will need to bring the following:
Morning and afternoon snacks will - Sack Lunch & Water Bottle
be provided. If your child has special - Backpack
dietary needs, please list above and - Swimsuit & Towel (T&TH)
provide them with a suitable snack - Athletic Shoes, Boots & Socks
for each day. - Clothes for Outdoor Activities GREEN EXPLORERS SPRING BREAK CAMP
GREEN EXPLORERS SPRING BREAK CAMP Camp Payment Form
3 Ways to Register
Email: Completed 2-page registration and payment to Joyce Carroll at
joyce-carroll@iowa-city.org.
Walk-In: Register in person at Mercer Park Aquatic Center or Robert A. Lee Recreation Center
customer service desks.
Mail: Please mail completed 2-page registration to:
Joyce Carroll - Recreation Program Supervisor
220 S. Gilbert St.
Iowa City, IA 52240
Low Income Discount: A reduced rate is available for those who qualify, but registration must be
completed at a customer service desk.
Refunds: Only available with 3 business days' notice. No refunds due to weather. In cases of
inclement weather, alternative programs will be held inside the Lodge at Terry Trueblood Recreation
Area.
Receipt: Please confirm a current email address on the Parent/Guardian section of the camp consent
form.
$40
$40
$40
$40
$40
$45
$45
$45
$45
$45
Resident Non-
Resident
Daily
Totals
Day of the week
Total Amount Due:
Non-Resident = Person who does not reside within the corporate limits of Iowa City.
Monday, March 16
Planet Earth - 13853
Tuesday, March 17
Robot Recycle - 13854
Wednesday, March 18
Wildlife Wednesday - 13855
Thursday, March 19
H2Ocean - 13856
Friday, March 20
Predators - 13857
FOR OFFICE USE ONLY:
Method of Payment
Cash _____ Cash _____ Discover Card _____ Master Card _____ Visa _____
Credit Card Information
Credit Card #: ______________ - ______________ - ______________ - ______________
Expiration Date: ___________________________ CVC: ___________________________
Authorized Signature: ________________________________________________________
Receipt # _________________________________________
Clerk's Initials____________ Date Sent ____________