Alper JCC Summer Camp 2016

SummerCampAt the Dave and Mary Alper JCC on the Jay Morton-Levinthal Campus

New this

year!

$99 S

ummer Ca

mp Family

Members

hip for n

ew ca

mpers.

p. 02

11155 SW 112 AvenueMiami, FL 33176

305.271.9000 x271alperjcc.org

June 20 to

August 12, 2016

For Infants

through Grade 9

NEW! $99 ALL-INCLUSIVE JCC SUMMER MEMBERSHIP*: While your kids enjoy camp, the entire family can enjoy the JCC’s sprawling 23-acre campus, including a state-of-the-art fitness center, sauna and steam room, men’s jacuzzi, women’s massage chairs, Jr. Olympic-sized pool, basketball gym, racquetball courts, tennis courts, and free childcare while using the fitness center. All Alper JCC summer camp families must have a Family Annual Membership or join the Alper JCC as a Camp Family Member through Aug. 31, 2016. *$99 offer is for new campers or those with memberships that have been inactive for 12+ months. $99 fee is non-refundable and must be paid in full at time of registration. Some facilities may have restricted hours to accommodate summer camp. In order to receive member benefits, the status of all JCC accounts must be current. Call Membership Services at 305.271.9000 x227 for more info.

JCC Membership: One Price, One Community

We are excited for your children to spend the summer with us. We've been working hard throughout the year to make sure your children have an amazing summer camp experience that they will remember for the rest of their lives!

Over the years, the Alper JCC Summer Camp has enriched the lives of thousands of children and teens guided by the principles of safety, fun, discovery, friendship and values. We are part of an all-inclusive Jewish Community Center that celebrates diversity and a place where children of all backgrounds can grow, learn and embrace the Jewish culture. We aim to impact the lives of children with quality programs in a creative, supportive, and safe atmosphere, enabling all children to reach their fullest potential.

Our staff and counselors create an environment of magical and unforgettable experiences for all campers. Staff are carefully chosen and trained in group dynamics, child development, building self-esteem and peer relationships. All staff are required to attend pre-camp trainings that emphasize children's safety and well-being and stress the importance of their role in enriching each campers experience.

We provide a community setting where children from infants through ninth grade will develop self-confidence and master new skills, while making lifelong friendships. Your children will have a summer they’ll never forget at the Alper JCC .

Shalom and Happy Camping,Elyse Molk, Camp Director

Age Groups, Weeks and Hours

Letter from the Camp Director

SeSSion 1: June 20–July 151A June 20–July 1 / 1B July 5–15

SeSSion 2: July 18–Aug. 122A July 18–29 / 2B Aug. 1–12

Full DAy CAmp HourS 9 a.m.–4 p.m.

extenDeD CAre Additional cost; not available for Tikvah/Inclusion campers. PM care closes promptly at 6 p.m.Am 7:30–9 a.m. / pm 4–6 p.m.

GenerAl CAmpSTeenokim / Infants, p. 31 yr. after 8/31 Nitzanim / Young Ones , p. 31 yr. by 8/31K’tanim / Little Ones, p. 32 yrs. by 8/31Chaverim / Friends, p. 33 yrs. old Yeladim / Children, p. 34 yrs. old Kadima / Forward, p. 4KindergartenSabra / Native Israeli, p. 4Grade 1 Jr. Maccabi / Sports Camp, p. 4Grade 1Bonim & Halutzim / Builders & Pioneers, p. 5Grades 2–3Tsofim / Scouts, p. 6Grades 4–5 Rishonim / Elders, p. 6Grades 6–9

SpeCiAlty CAmpSHabimah/Performing Arts Camp, p. 6 Grades 3–9 Maccabi/Sports Camp, p. 7Grades 2–9Camp Tikvah/Inclusion/Special Needs, p. 7Available Session 1, Session 2, or all 8 weeks.Robotics Camp, p. 8Sessions 1a and 2a only.Hadracha/Leader-in-Training, p. 8Grade 9 Madrich/Counselor-in-Training, p. 8Grade 10

15,000 ft2 gym · Age-appropriate Playgrounds · Computer Lab · Teaching Kitchen Lake with dock, paddleboats, canoes, and fishing · Indoor Racquetball Courts

Art and Ceramic Studio · Outdoor Jr. Olympic-sized Pool · Professional Theater Hard-surface Tennis Courts · Dance/Fitness Studios

Only on the Alper JCC’s Campus

Chaverim and Yeladim provides a secure and nurturing introduction to camp. Certified teachers lead each bunk. A daily instructional American Red Cross Swim Program is led by fully trained Water Safety Instructors in the in-ground Jr. Olympic size pool. All activities are educationally stimulating and age appropriate.

If you are currently enrolled in our ECD Preschool, monthly camp fees will be the same as your monthly school tuition. For details, call the ECD at 305.271.9000 x301.

Experienced certified teachers lead each Teenokim, Nitzanim, and K’tanim camp group. Together they create an environment specifically designed to promote socialization, language development and creativity for our youngest campers. All activities are educationally stimulating and age appropriate.

Chaverim and Yeladim

New for ECD Campers!

Teenokim, Nitzanim, and K’tanim

Activities Include

Age Groups

•Arts&Crafts•Cooking•CreativeMovement•Gymnastics•Judaicactivities•Music&Rhythm•Science&Nature•Water/Splashactivities

(Teenokim, Nitzanim & K’tanim)•DailySwim (Chaverim & Yeladim)•OutdoorandIndoorPlay•Soccer•Storytelling•ThemeDays•Specialevents,shows,charactervisits,andmore!

Teenokim/“Infants”1 yr. after Aug. 31 Nitzanim/“YoungOnes”1 yr. by Aug. 31K’tanim/“LittleOnes”2 yrs. by Aug. 31Chaverim/“Friends”3 yrs. old

Yeladim/“Children”4 years old

Teenokim, Nitzanim, K’tanim, Chaverim,

and Yeladim

3

Sabra provides a supportive and encouraging camp experience that promotes independence and offers new challenges. Hobby Hours are twice a week, field trips once a week and every session there is an optional late night.

The Jr. Maccabi Sabra Sports Camp offers a more challenging, age-appropriate sports experience for the budding athlete. Specialists and counselors lead activities including football, basketball, field games, field hockey, baseball, swimming, gymnastics and martial arts. Hobby Hours are twice a week, field trips once a week and every session there is an optional late night.

Kadima is designed especially for children moving “forward” to kindergarten. Twice a week campers have Hobby Hour activities and enjoy field trips twice each session.

Sabra

Jr. Maccabi Sabra Sports Camp

Kadima

Activities Include

Age Groups

• InstructionalAmericanRedCrossSwimProgram

•Arts&Crafts•HobbyHour•Cooking•Drama•Fieldtrips•Gymnastics•Judaicactivities•Music•Nature•PhysicalEducationprogramisskill-orientedandincludeskickball,basketball,outdoorgames,andmartialarts

•SoccerprogramrunbySuperSoccerStars

•Ruach (Jewish spirit)•Specialevents•Costumedays

Kadima/“Forward”Campers entering Kindergarten Sabra/“NativeIsraeli”Campers entering Grade 1

Kadima and Sabra4

Bonim and Halutzim challenge the seasoned camper and offer an independent camping experience filled with a real spirit of adventure. Through the expanded Hobby Hour elective program, campers have the opportunity to venture into new and exciting territory with advanced specialty activities including ceramics, chess, hip-hop, and grossology to name a few.

Activities Include

Age Groups

Bonim & Halutzim “Builders and Pioneers”Grades 2–3

•Daily instructional American Red Cross Swim Program led by fully trained Water Safety Instructors in Jr. Olympic-size pool

•Arts & Crafts•Boating program

(canoes and pedal boat)•Computers•Cooking•Drama•Field trips•Fishing•Hobby Hour •Late Nights (optional)•Music•Nature programs

featuring hands-on discovery•Physical Education program

includes football, kickball, basketball, and outdoor games

•Soccer program run by Super Soccer Stars

•Robotics•Rocketry•Ruach (Jewish spirit)

Bonim and Halutzim5

Tsofim and Rishonim campers travel twice a week to exciting destinations in the Miami-Dade, Broward, and Palm Beach Counties. They meet new challenges, gain independence, and have FUN! While at the JCC, campers are encouraged to pursue individual interests through the Hobby Hour program and to participate in scheduled camp activities.

Habimah campers expand their horizons and artistic potential in dance, drama, art and music. Campers are immersed in a high-level, four-week production schedule filled with rehearsals and set design. At the end of each camp session, a musical performance is held in the magnificent Robert Russell Theater. Habimah campers travel on several field trips throughout the summer and participate in many JCC camp special events, including late nights. In addition to the arts, campers participate in fitness activities, an instructional water games program and an expanded Hobby Hour program including Hip-Hop, cheerleading, jazz and more. Habimah campers must attend a minimum of a four-week session of camp. Contact Camp Director for special situations.

Tsofim and Rishonim

Activities Include

•SignLanguage•Ballet(lyrical)•Drama•Jazz•Make-upArtistry&SetDesign•MusicalTheater•Art•Tap•Hip-Hop•Swim(instructional and recreational)

HabimahPerforming

Arts Camp

6

Activities Include

Age Groups

•DailyinstructionalAmericanRedCrossSwimProgramledbyfullytrainedWaterSafetyInstructors

•Fieldtripsinthetri-countyarea•Basketball&Football•Canoeing•Ceramics,Jewelry-making•Chess•Circuittraining/IndoorCycling®(Rishonim only)

•Computers&WebDesign•Overnighttrips

(Rishonim session 2 trip optional)•Rocketry•GarageBandVideo/MusicProduction

Tsofim/“Scouts”Campers entering Grades 4–5 Rishonim/“Elders”Campers entering Grades 6–9

7

Maccabi Sports Camp is an in-depth, state-of-the-art athletic experience designed for boys and girls. Under the guidance of our certified, professional staff, campers participate in a wide variety of sports using the Alper JCC’s outstanding facilities. Campers are grouped according to age and participate in activities with their bunkmates.

Maccabi Sports Camp

High-functioning special needs campers in grades K–9 have an inclusion counselor to guide them throughout the day and are a part of a general camp bunk. Eligibility screening is required. Fees are the same as Camp Tikvah. Tsofim and Rishonim inclusion campers add $50 per week to camp fee.

Inclusion Program

A stimulating, hands-on environment for campers with cognitive disabilities. Goals include instilling confidence, developing social and life skills, increasing attention span, and improving fine and gross motor abilities. Campers participate in general camp activities when appropriate. Yearly evaluation and current IEP required; campers must be registered in school to participate. Runs from 8:30 a.m. to 3:30 p.m. Questions? Contact Program Director Johana

Sarmiento at 305.271.9000 x273 or [email protected].

Camp Tikvah

Age Groups

Kinderlach Tikvah 1Ages 3–5 Kinderlach Tikvah 2Ages 5–8Chai Tikvah 2Ages 9–12 Clayton Feig TikvahAges 12–21

Activities Include

Age Groups

•Daily instructional American Red Cross Swim Program led by fully trained Water Safety Instructors in Jr. Olympic-size pool

•Baseball, basketball & football•Canoeing, fishing, pedal boating•Fitness, cardiovascular, and

strength training (Grades 6–9)•Hobby Hour •Late night

(optional each session)•Martial Arts•Rocketry•Soccer program run by Super

Soccer Stars•Indoor Cycling® (Grades 6–9)•Garage Band video/music

production

Maccabi / “Sports Camp”Campers entering Grades 2–9

8

For Campers entering Grades 1–5Session 1a, June 20–July 1 / Session 2a, July 18–29 Campers are engaged through science, engineering, technology, creativity, imagination and design, learning to prepare for the future. Campers build their own LEGO robots and then use a computer to program instructions for the robot to accomplish a pre-determined mission. DPB Robotics’ program offers hands-on project-based learning approach to teaching STEM (Science, Technology, Engineering and Math).

Robotics Camp

For Campers entering Grade 9LITs work with campers three days a week, go on field trips, and develop leadership and team-building skills. 80 community service hours are given for each 4-week session. An interview is required and space is very limited. Camp options are available if not admitted into the program.

For Campers entering Grade 10CITs assist in camp groups, learn hands-on skills, and attend leadership training sessions. A $100 stipend is given and 160 community service hours are given for each 4-week session. Must work session 1, session 2, or all eight weeks of camp. No exceptions. An interview is required; contact Lene Saeger x271 to schedule. Priority given to those who commit to 8 weeks.

Hadracha / Leader-in-Training (LIT)

Madrich / Counselor-in-Training (CIT)

Robotics, LIT and CIT

• AllrefundandcancellationrequestsmustbemadeinwritingandgiventothecampofficepriortoJune17.

• PriortoJune17,ifyouneedtocancelanyweek(s)ofcampbutnotcampinitsentiretytherewillbea$100cancellationfeeperchild.Ifyoucancelcampinitsentiretytherewillbea$250cancellationfeeperchild.

• AllCampfeesareNON-REFUNDABLEafterJune17,including,butnotlimitedtoabsences,withdrawalsandinclementweather.

• $250depositperchild• Noregistrationfee• Camppricesandfeesaresubjecttochange• IfyoutookadvantageofEarlyBirdRegistration,youreceivedanadditional5%discountonyourcampfees!PleasecontactJacqueCovasat305.271.9000x270withquestions.

• AllcampfeesmustbepaidinfullbyMonday,May2.• Apaymentauthorizationformmustbefilledout,signedandreturnedalongwithcampregistrationformanddeposit.

• EnrollmentafterMay1mustbepaidinfullattimeofregistration.

The Dave and Mary Alper JCC aims to keep fees as low as possible in an effort to foster community participation in our programs. However, anyone wishing to apply for financial aid must be an Alper JCC Member and submit a fee adjustment application by March 18 to the membership office. All inquiries and applications are confidential.• Applicationsmaybeobtainedbycalling305.271.9000x262.• Applicationsarenotcompleteandwillnotbeevaluatedwithoutacopyofyour2015taxreturn.

• Campdepositsmustbemadeinfullbeforeapplyingforfinancialaid.• Scholarshipfundsareallocatedonafirstcome,firstservedbasis.• Ifthefeeadjustmentawardedisnotsufficientandtheenrollmentiswithdrawn,alldepositswillbecreditedtoyouraccount,exceptfora$25processingfee.

Refund & Cancellation Policies

Deposit, Fees & Payment

Fee Adjustment

Registration & General Information

•BuildingJewishidentity• Jewishvalues•Hands-onJudaismthroughart,•music,dance,anddrama•Ruach -ExtraordinaryspiritledbyIsraelicounselor

•Shlichim,Israelicounselors•WeeklyShabbatprograms•Mitzvah (“gooddeeds”) program

• Full-timeCampNurse• Fitnessprofessionals• Excellentstaff-to-camperratio• Specialistsandsupervisorsoverseeeachprogram

• Staffaretrainedingroupdynamics,childdevelopment,buildingself-esteem,andpeerrelationships

• StaffmembershavecompletedLevel2DCFbackgroundscreenings

• AquaticsprogramrunbySwimGym• SoccerprogramrunbySuperSoccerStars• RoboticsprogramrunbyD.B.P.Robotics

Important Dates

FLEX Scheduling

Staff

Jewish Heritage

Parent Information Night for parents of registered campersThursday,May26,7:30p.m.Y&ABuildingCamper OrientationSunday,June19,9:30a.m.See inside back cover for more general information.

• Campprogramoperatesontwo-weekintervals

• Youmayaddonadditionalweeksofcamp,space-permitting

•One-weekregistrationofferedbasedonavailability

Every summer Israeli shlichim (emissaries) infuse camp with Israeli culture and tradition. It’s an amazing experience for campers, staff, and the families who host these individuals. The JCC is looking for families to open their homes to host one of these shlichim. It’s an opportunity to create lifelong friendships and grow closer to Israel. For info, contact Elyse Molk, Camp Director at 305.271.9000 x263 or [email protected].

Bring Israel to Miami: Summer Shlichim Program

Medical & General Information, cont’d

Medical Forms

Sick Policy

No camper will be allowed to begin camp without complete medical forms as required by the Department of Children and Families (formerly HRS). These forms include the Student Health Form (HRS-H FORM 3040) and the Florida Certificate of Immunization (HRS 680 PART A). Both of these forms are approved by the Department of Children and Families and available through your pediatrician’s office.

If your child is ill, please exercise good judgment when sending him/her to camp. Children evaluated to be ill by the nurse will be sent home. Regarding head lice, the JCC has a “NIT FREE” policy. If lice or nits are found in your child’s head, he/she will be sent home and will not be permitted to return to camp for 24 hours. Upon the camper’s return, he/she must be checked by the camp nurse.

Special Programs & Camp Sponsorship

Make a Difference: Become a Camp Sponsor!

Inclusion Program

Your tax-deductible contribution allows deserving children the opportunity to attend camp. Sponsorship privileges include your company name appearing on signage during camp season at the three pick-up and drop-off locations and recognition on our website and in Alper JCC publications. For more info, contact Ann Horenstein at 305.271.9000 x253.

Our Inclusion Camp program provides an opportunity for children ages 3+ with special needs to participate in mainstream camp programs. Children in the program may have accommodations made or receive special assistance from a facilitator. For more info, contact Johana Sarmiento at 305.271.9000 x273 or [email protected].

Stamford, CT | July 31–August 12The second largest Jewish teen event in the world, the JCC Maccabi Games and ArtsFest bring together 1500+ artists and athletes from around the globe for an Olympic-style event. Team Miami will include boys and girls competing in basketball, baseball, and flag football (St. Louis, MO). New this year: Team Miami will also compete in ArtsFest for teens excelling in performing & visual arts. Open to Jewish Teens (must be ages 13–16 by July 31).For tryouts and more info, contact Athletic Director Doug Buckley, 305.271.9000, x292 or [email protected]

Campers must bring their own lunches daily, clearly marked with their name. The Alper JCC provides non-dairy drinks and snacks. An optional Kosher lunch program is available for purchase. More info will be made available before camp begins.

One camp T-shirt is included in the camp fee. Additional T-shirts may be purchased in the Camp Office in Y&A Building #5.

Each camper is assigned to a bunk. We make every effort to honor bunk requests. Only two requests will be accepted and they must be reciprocal, age-appropriate, attending the same camp, and both families as well as the Camp Director must agree on each request.

All campers (including LITs) being dropped off at the JCC before 8:45 a.m. or picked up after 4 p.m. must be enrolled in AM or PM care. No camper will be allowed to roam or be unsupervised before or after camp.

Lunches

Camp Tees

Camp Group Requests

Dropoff/Pickup Policy

Race (optional) [ ] White [ ] Multi Racial [ ] Asian [ ] Black or African American [ ] Other Ethnicity (optional) [ ] Hispanic [ ] Haitian [ ] Other

Last Name First Name Age by 9/1/16 Grade entering 8/16DOB

Gender [ ] M [ ] F

2016 | Alper JCC Camp Registration Form

T-shirt size (Child) [ ] YXS [ ] YS [ ] YM [ ] YL (Adult) [ ] S [ ] M [ ] L [ ] XL (Shirts may run small)School

Bunk Mates (must be reciprocal, same camp unit and dismissal time) 1 2

[ ] All 8 wks. (6/20-8/12) [ ] 1st Session (6/20-7/15) [ ] 1A (6/20-7/1) [ ] 1B (7/5-15) [ ] 2nd Session (7/18-8/12) [ ] 2A (7/18-29) [ ] 2B (8/1-12)

[ ] Inclusion Program Must be a JCC Family Member. To enroll, contact Johana Sarmiento at 305.271.9000 x273 for an interview before your registration is accepted.

Camp Unit

AM/PM CARE Not available for Tikvah or Inclusion campers. All campers being dropped off at the JCC before 8:45 a.m. or picked up after 4 p.m., including LITs, MUST be enrolled in AM/PM care. No camper will be allowed to roam or be unsupervised before or after camp at the JCC. No exceptions.[ ] AM Care (7:30-9 a.m.) [ ] PM Care (4-6 p.m.)

Does child have a documented disability? [ ] Yes [ ] No (If yes, please specify.)

Allergies/Medical Issues

Medications

A JCC Annual Family or Summer Camp Membership is required to register for camp. Call 305.271.9000 x235 for info. Member #

CAMPER #1 (ReqUIRed: Attach a current school photo of camper. Please write name on back of photo.)



Last Name

Last Name

First Name

First Name

Age by 9/1/16

Age by 9/1/16

Grade entering 8/16

Grade entering 8/16

DOB

DOB

Gender [ ] M [ ] F

Gender [ ] M [ ] F

T-shirt size (Child) [ ] YXS [ ] YS [ ] YM [ ] YL (Adult) [ ] S [ ] M [ ] L [ ] XL (Shirts may run small)

T-shirt size (Child) [ ] YXS [ ] YS [ ] YM [ ] YL (Adult) [ ] S [ ] M [ ] L [ ] XL (Shirts may run small)

School

School







Camp Unit

Camp Unit

AM/PM CARE Not available for Tikvah or Inclusion campers. All campers being dropped off at the JCC before 8:45 a.m. or picked up after 4 p.m., including LITs, MUST be enrolled in AM/PM care. No camper will be allowed to roam or be unsupervised before or after camp at the JCC. No exceptions.

AM/PM CARE Not available for Tikvah or Inclusion campers. All campers being dropped off at the JCC before 8:45 a.m. or picked up after 4 p.m., including LITs, MUST be enrolled in AM/PM care. No camper will be allowed to roam or be unsupervised before or after camp at the JCC. No exceptions.

[ ] AM Care (7:30-9 a.m.) [ ] PM Care (4-6 p.m.)

[ ] AM Care (7:30-9 a.m.) [ ] PM Care (4-6 p.m.)





Medications

Medications



FAMILY INFORMATION

AuThORIzATION FOR EMERgENcY MEdIcAL/SuRgIcAL TREATMENT

TRANSpORTATION

cAMp REFuNd, cANcELLATION ANd chANgE pOLIcIES

Parent/Guardian #1’s Name DOB

Parent/Guardian Signature

Business #

Business #

Phone (day)

Phone (day)

Home #

Home #

Cell #

Date

Cell #

Who has custody of child?

Parent/Guardian #2’s Name DOB

Email address (required) Parent/Guardian 1 Parent/Guardian 2

Name

Name

Relationship

Relationship

IN cASE OF EMERgENcY cALL (other than parents)

The following people have permission to pick up my child(ren) from camp

The following people DO NOT have permission to pick up my child(ren) from camp (must provide legal documentation)

(Check one option) [ ] My child is participating in PM Care [ ] I plan to transport my child at 2:30 or 4 p.m. [ ] I plan to carpool (see below)

Dismissal Time

Dismissal Time

Child’s Name

Child’s Name

**Initial I have read the Dave and Mary Alper JCC Summer NEW Camp Refund, Cancellation and Change Policy

Camp Unit (must be filled in)

Camp Unit (must be filled in)

cARpOOLINg (if your are carpooling please list each child in your group)

phOTO ANd INTERNET/SOcIAL NETWORKINg RELEASE**[ ] Yes [ ] No I hereby give the Dave and Mary Alper Jewish Community Center and all persons acting with its permission the absolute right and unrestricted permission to obtain, use, copyright and/or publish photographic portraits or pictures of the above named registrant, in conjunction with the registrant’s own name or another fictitious name whether such are still, moving, single, multiple, or with others. It is my understanding that such picture(s) are for the purpose of art, advertising, trade, inclusion in social media and any other lawful purpose whatsoever. I understand further that I will not have any opportunity to approve or review the finished product that may be used in connection there with or the use to which it may be applied. I understand that if I check NO, my child will be asked to step out of group photographs and will not be included in any weekly camp photograph emails.

WAIVER ANd RELEASE**Initial I on behalf of myself and my family (“I”), the undersigned, upon registration for the Summer Camp at the Dave and Mary Alper Jewish Community Center, Inc. (”Alper JCC”) agree to abide by the policies, rules, and by-laws of the Alper JCC. I understand that services may be limited or terminated upon violation of these rules. I understand that engaging in the different activities and programs at the Alper JCC, or otherwise connected with the Alper JCC, are done at my own volition, and that it is my sole responsibility to ensure that I am in the proper physical condition to engage in such activities or programs. I understand and acknowledge that participation in the programs offered by the Alper JCC, or otherwise connected with the Alper JCC, involve risks which could, in some circumstances, result in physical injury, including death, despite all safety precautions, and that I assume all risks and responsibilities for such losses and damages. I hereby agree not to sue and to release, indemnify and hold harmless the Alper JCC and any and all of its servants, agents, contractors or employees, including but not limited to any and all of the instructors of any and all programs offered by the Alper JCC or connected with the Alper JCC, from and for any and all actions or causes of actions, claims, damages, demands by the registrants heirs/executors, administrators or assigns, for, upon, or by reason of any damage, loss or injury (including death) to the registrant or their property which may be sustained as a consequence of the registrant attending at or participating in any and all of the programs, or any other activity connected with the Alper JCC, including use of the facilities and equipment and transportation to and from these programs, notwithstanding any such damage, loss or injury (including death) may have arisen out of the negligent acts or omissions or the negligence of the Alper JCC, and any and all of its servants, agents, contractors or employees, including but not limited to any and all of the instructors of the programs. I understand that this WAIVER is intended to be as broad and inclusive as permitted by the laws of Florida and agree that if any portion is held invalid, the remainder of the WAIVER will continue in full legal force and effect. I have read this Form and fully understand that by signing this, I am giving up legal rights and/or remedies which may be available to me for the ordinary negligence of the ALPER JCC. I understand and acknowledge that the Alper JCC is not liable for any loss, damage or theft of personal property wheresoever’s located, and not limited to personal property left

Signature of Parent/Guardian (required) Date

[ ] Married [ ] Single [ ] Widowed [ ] Separated [ ] Divorced [ ] Life Partner Parent’s Marital Status

PhoneCamper’s Physician

Mailing Address City State Zip**A CoPy oF EACh PAREnt/guARDIAn’S DRIVER’S LICEnSE IS REquIRED In oRDER to REgIStER FoR CAMP AnD MuSt bE SubMIttED WIth REgIStRAtIon FoRM.**

It is the firm hope that the authorization granted on this form will never have to be used. For the safety of your child, however, sound medical practice calls for such authorization. In emergency situations where, for some reason, the parent of the child cannot be contacted immediately, this form may become extremely important. the authorization granted by this form will be used only where absolutely necessary and only after every attempt has been made to contact the parent. Doctors and hospitals refuse to give any treatment, regardless of how minor, unless they have authorization from the parent.I unDERStAnD thAt In thE EVEnt I CAnnot bE REAChED, I hEREby gRAnt PERMISSIon to thE PhySICIAn oR hoSPItAL SELECtED by thE CAMP ADMInIStRAtIon to SECuRE PRoPER tREAtMEnt FoR, oRDER InJECtIon, AnESthEtIC, oR PERFoRM SuRgERy on My ChILD. I hEREby gIVE PERMISSIon oR ARRAngE nECESSARy tRAnSPoRtAtIon to A hoSPItAL.

It is the policy of the JCC to release a child only to a parent or legal guardian. In the event a parent or legal guardian is not authorized to pick up a child, the JCC must have a current court restraining order or injunction on file. Every person who comes to pick up a child before carpool will be asked to show a picture ID before the child is released. Please advise your child’s counselor with a written note if there is a carpool change or an early pick up.

1. All refund and cancellation requests must be made in writing and given to the Camp office prior to June 17, 2016.2. Early bird Registrants only, if you need to cancel any week(s) of camp but not camp in its entirety there will be a $25 cancellation fee per child. If you cancel camp in its entirety there will be a $100 cancellation fee

per child.3. Prior to June 17, 2016, if you need to cancel any week(s) of camp but not camp in its entirety there will be a $100 cancellation fee per child. If you cancel camp in its entirety there will be a $250 cancellation fee per child.4. All Camp fees are non REFunDAbLE after June 17, 2016, including, but not limited to absences, withdrawals, changes in camp group and inclement weather.5. Changes: All camp week changes or camp unit changes must be submitted in writing and are subject to a $20 change fee. Changes are made according to availability in each camp unit.6. Dismissal: the Camp Director reserves the right to terminate or suspend any camper/LIt or deny his/her participation in any activity including off-campus fieldtrips, if his/her mental condition, conduct, influence

or behavior is deemed unsatisfactory and not in the best interest of the camp. no REFunDS will be given if a camper/LIt is asked to leave.

**Initial I acknowledge that my JCC Membership must stay active until August 31, 2016.

Member # Date

Parent’s First Name Parent’s Last Name

Child’s Name Camp Fees AM/PM Care Total Fees

Deposit DUE NOW

($250/child)

Balance(Total Fees-deposit)

1. $ $ $ $ $

2. $ $ $ $ $

3. $ $ $ $ $

4. $ $ $ $ $

5. $ $ $ $ $

**Yes, (initial) I would like to help send another child to camp and donate money towards the JCC Camp Scholarship Fund (optional). Please add the following amount to my camp balance. $

TOTALS $ $ $

Payment Worksheet

I have read the above and I promise to pay the Alper JCC Camp Program as per my choice indicated above. The Alper JCC reserves the right to collect late charges and late payment fees. Notice of default is waived. I understand that in the event of default I will be responsible for the cost of collec-tion/attorney fees by the Alper JCC, and that my child will be removed from the program and membership privileges will be suspended until such time as I rectify the situation. Venue for suit will be Miami-Dade County, Florida.

[ ] Check # [ ] Credit Card* [ ] Debit Credit Card

See “Payment Plan Authorization Form.”

[ ] Check # [ ] Credit Card* [ ] Debit Credit Card

PRINT NAME

PAYMENT oPTIoNsDeposit (required)

[ ] I will pay my camp fees IN FULL now.

[ ]

[ ] I will pay (# of payments) of

[ ] Charge my credit card in full for the balance of camp on Monday, May 2, 2016.

sIgNATuRE (required)

PlEAsE REAd cAREfullY•All participants must have NO OUTSTANDING BALANCES with the Alper JCC. •All monthly payments must be made by monthly Credit Card Debits or Electronic Fund Transfer from your checking account.•All camp balances must be paid in full by Monday, May 2, 2016. •Any payment that is delinquent may result in your child(ren) being withdrawn or participation being disrupted until the account is made current.•Any payment that is returned from the bank will be charged with a $25 bank fee. This will be added to your account. •DEPOSIT IS NON-rEFUNDABLE.

I am applying for fee adjustment. It will be my responsibility to have the completed Financial Aide Application, including my most recent tax return submitted to the JCC Membership Office no later than friday, March 18, 2016. full dEPosIT of $250 PER chIld ANd PAYMENT INfoRMATIoN Is sTIll REquIREd whEN APPlYINg foR fINANcIAl AIdE.

*See “Payment Plan Authorization Form” to pay by AMEX/MC/VISA or for automatic Credit Card Debit or Electronic Transfer from your checking account.

Camp must be paid in full by Monday, May 2, 2016.$

$

$

$

2016 | Payment Plan Authorization Form

Name Membership #

Please select a camp payment plan from the options below and return this form promptly. Questions about your payment? Call 305.271.9000 x270 or email [email protected].

Call the accounting office at x228 if there is a change with your credit card or checking account.

Name of Child(ren)

Cell #Home # Work # Email

ONE-TIME PAYMENTS

Please attach a VOIDED check from your account. All debits will be made on the 3rd of every month.

CREDIT CARD

DAVE AND MARY ALPER JCC MONTHLY ACH ELECTRONIC DEBIT AUTHORIZATION FORM

MONTHLY PAYMENTS These payments will be charged on the 5th of every month.

CREDIT CARD INFORMATION

[ ] $ deposit now.

[ ] $ Debit my account in full for the balance of camp on May 3, 2016.

I authorize the Dave and Mary Alper Jewish Community Center, Inc. hereinafter named (“Alper JCC”) to ACH/electronically debit my account (and if necessary, electronically credit my account to correct erroneous debits) as follows:

[ ] $ Charge my credit card in full now.

[ ] $ Charge my credit card in full for the balance of camp on Monday, May 2, 2016.

[ ] I wish to arrange for the Alper JCC to charge my credit card (# of payments) pre-authorized monthly charges of $ per month.

[ ] Checking Account [ ] Savings account (select one) at the depository financial institution named below (“DEPOsITOry”)

Card # Exp. date / CVV

Starting date Ending date

SIGNATURE

SIGNATURE

Name(s)/Title(s) (please print)

Date

Date

Depository Name

PLEASE CHOOSE ONE OPTION BELOW

[ ] I wish to arrange for the Alper JCC to charge my credit card (# of payments) pre-authorized monthly charges of $ per month.

Starting date Ending date

I understand that this authorization will remain in full force and effect until I notify the Alper JCC in writing that I wish to revoke this authorization. I understand that the Alper JCC requires 30 days prior notice in order to cancel this authorization. I understand that a sufficient balance and/or credit line must be maintained in my account to fulfill my monthly obligation. I understand that insufficient funds and/or denial of payment to the the Alper JCC will result in a $25 service charge for each case of insufficient funds and/or denial of payment to the the Alper JCC, which will be deducted from my credit card or checking account.

Billing Address City State Zip

All payment plan charges will be made on the 5th of each month.

Charge my [ ] Visa [ ] MasterCard [ ] AMEX [ ] Check here if your credit card is a debit card.

ABA/Routing # Bank Account #

I agree that ACH transactions I authorize comply with all law.

Camp Fees

2 weeks 4 weeks 6 weeks 8 weeks

Teenokin, Nitzanim, and K’tanim (1–2 yrs.)

9 a.m.–4 p.m. $535 $1,000 $1,500 $1,800

9 a.m.–2:30 p.m. $455 $840 $1,260 $1,530

Chaverim and Yeladim (3–4 yrs.)

9 a.m.–4 p.m. $535 $1,000 $1,500 $1,800

9 a.m.–2:30 p.m. $455 $840 $1,260 $1,530

Kadima (Kindergarten) $535 $1,000 $1,500 $1,800

Sabra and Jr. Maccabi (Grade 1) $560 $1,050 $1,575 $1,900

Bonim and Halutzim (Grades 2–3) $560 $1,050 $1,575 $1,900

Tsofim (Grades 4–5) $582.50 $1,095 $1,642.50 $1,990

Rishonim (Grades 6–9) $635 $1,200 $1,800 $2,200

Maccabi (Grades 2–9) $582.50 $1,095 $1,642.50 $1,990

Habimah (Grades 3–9 yrs.) n/a $1,095 n/a $1,990

Hadracha/LIT (Interview required; Grade 9) $392.50 $715 $1,072.50 $1,230

Robotics (Grades 1–5) $600 n/a n/a n/a

Tikvah n/a $1,175 n/a $2,350

Kadima/Sabra/Bonim & Halutzim Inclusion n/a $1,175 n/a $2,350

Tsofim & Rishonim Inclusion n/a $1,325 n/a $2,650

AM Care $70 $120 $180 $240

PM Care $70 $120 $180 $240

AM and PM Care $140 $240 $360 $480

Requires JCC Membership.

Special Needs and Inclusion Program FeesRequires JCC Membership.

AM/PM Care Fees

live up™ this summer at the Alper JCC’s Summer Camp 2016!

11155 SW 112 Avenue, Miami, FL 33176

Dave and Mary Alper JCCon the Jay Morton-Levinthal Campus

Phone 305.271.9000 | Fax 305.275.1391 [email protected] | alperjcc.org

Elyse MolkSummer Camp Director

Joshua RaderPresident,The Alper JCC

Steve TepperExecutive Director,The Alper JCC

2016 Camp SupervisorsKadima/SabraJenine Simonbonim/HalutzimMichelle Appelrouth RadertSofimRodolfo AmaralriSHonimFelix CardenasHabimaH Perfoming artS CamPAlina PreshongmaCCabi SPortS CamPBrett SpenceCamP tiKvaHJohana Sarmiento, Directorlit SuPerviSorNicole Fernandez

Documents

Alper JCC Summer Camp 2016