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Summer Day Camp Summer Day Camp 2018 2018 This summer send her somewhere safe, enriching, and filled with fun opportunities - give her the chance to camp #likeagirlscout! Lake Rickabear Day Camp Lake Rickabear Day Camp Kinnelon, NJ Kinnelon, NJ Jockey Hollow Day Camp Jockey Hollow Day Camp Mendham, NJ Mendham, NJ

SSummer Day Camp ummer Day Camp 22018018 - Girl … Camp... · SSummer Day Camp ummer Day Camp 22018018 This summer send her somewhere safe, enriching, and filled with fun opportunities

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Summer Day Camp Summer Day Camp

20182018

This summer send her somewhere safe, enriching, and filled with fun opportunities - give her the chance to camp #likeagirlscout!

Lake Rickabear Day CampLake Rickabear Day CampKinnelon, NJKinnelon, NJ

Jockey Hollow Day CampJockey Hollow Day CampMendham, NJMendham, NJ

Why Girl Scout Camp?Table of Table of

ContentsContentsWhy Girl Scout Camp............2

Jockey Hollow..........................3

Lake Rickabear........................3

Learn More...............................4

Safety First...............................5

Camp Extras............................6

Leadership Opportunities....7

Register Today........................8

Registration Tips....................9

FAQs..........................................10

Jockey Hollow

Transportation.......................11

Jockey Hollow Program..12-19

Lake Rickabear

Transportation................20-21

Lake Rickabear

Program............................22-26

Health Form.....................27-28

At Girl Scout camp, girls feel comfortable to acquire new skills in a safe and supportive all-girl environment. From a relaxed swim to teaming up on a project, camp offers girls a variety of opportunities to learn and grow inside and out.

• Courage. Camp is a community unlike any other. Together in an unfamiliar setting, girls find the courage within themselves to meet new people, make friends, and bond. As they make choices and direct projects, girls learn to work well with others, become self-reliant, and develop their leadership skills.

• Confidence. For many girls, camp has unlimited potential to unlock or boost a girl’s confidence. Girls have the opportunity to try new things and test their limits.

• Character. Camp is the ultimate character-building experience. It is a safe place for girls to learn individual responsibility and work as part of a team.

Page 2

Jockey Hollow CampJockey Hollow CampMendham, New Jersey

At Jockey Hollow Camp, girls have 212 pristine acres to explore, play, and learn.

Camp days are filled with swimming, hiking, outdoor cooking, arts and crafts, stream exploration, environmental education, archery (for girls entering grades 2 and up), low ropes challenge course, and zip line (for girls entering grades 4 and up). Girls can also enjoy our playing field, GaGa pit and adventurous hiking trails. Horse lovers can sign up for a special equestrian program where girls spend time at the corral with the horses or ponies. Girls receive American Red Cross swim lessons and enjoy a free swim daily in our large L-shaped swimming pool. The fun is endless!

Lake Rickabear CampLake Rickabear CampKinnelon, New Jersey

Our 332 acres at Lake Rickabear include a beautiful 40-acre, spring-fed lake, perfect for kayaking, canoeing, pedal-boating, and paddle boarding.

A long stretch of soft, sandy beach lines our swimming area, where girls not only splash and play, but also receive daily American Red Cross swim lessons from certified lifeguards, as well as free swim.

Each day is filled with activities like nature exploration, arts and crafts, boating, and archery (for girls entering grades 2 and up), as well as themed activities and special All-Camp activities. We also have a zip line (for girls entering grades 4 and up) and a low ropes challenge course to help girls learn

teamwork and self-confidence.

Our summer day camps....Our summer day camps....

“My daughter’s level of

independence always grows

when she has been to camp.” - A parent of a fifth grade camper

Page 3

Day Camp Open HouseDay Camp Open House

Find out what makes our summer camps the place to be! Take a tour, enjoy a few refreshments, and meet camp staff. Girls will leave very excited for summer camp to begin! Stop by anytime between 2:00 pm – 4:00pm and bring a friend or two!

Reservations are suggested in case of cancellation due to inclement weather, but not mandatory. Driving directions will be emailed when you register online, email to [email protected]. or call 973-248-8200.

Jockey Hollow CampJockey Hollow CampApril 8, April 29, May 20 2-4 pm

Lake Rickabear CampLake Rickabear CampApril 8, May 5, May 20 2-4 pm

Summer CampSummer CampInfo. NightsInfo. Nights

Learn about all the summer camp programs GSNNJ has to offer. Meet the directors, learn about a typical day at camp, and have all your questions answered. You can even bring a non-Girl Scout friend along who may want to join you at camp this summer. Come early to browse the GSNNJ council shop.

Registration is suggested in case of cancellation, but not required. Camp information nights are designed for new campers and parents, but returning campers are always welcome.

Register online at www.gsnnj.org>camp>summer camp by email to [email protected], or call 973-248-8200.

Dates:February 6, Randolph Service CenterFebruary 13, Paramus Service CenterFebruary 20, Riverdale Service CenterTime: 7-8 pm

Summer Camp Info. Summer Camp Info. Night WebinarNight Webinar

Did you miss the Summer Camp Information Nights at our Service Centers? This is the next best way to learn about our two great summer camps. You will see photos of the camps and learn what a typical day is like at both Lake Rickabear and Jockey Hollow Day Camps. Register online at www.gsnnj.org>camp>summer camp by email to [email protected], or call 973-248-8200.

Date: March 1Time: 7-7:30 pm

Parent Guide Parent Guide

For more information about what your daughter should bring, drop off and pick up procedures, medication policies and more, check out our Parent Guide at www.gsnnj.org>camp>summercamp.

More questions?More questions?

Please contact Rachel Jaffe, Jockey Hollow Day Camp Director, at [email protected], or Elena Morgan, Lake Rickabear Day Camp Director, at [email protected], or call 973-248-8200.

Learn more...

Page 4

Safety First!Staff

Each unit is comprised of a minimum of two counselors who are at least 18 years old, ensuring girls have mature and responsible caretakers. Each summer camp staff member completes an application with references and are individually interviewed and background checked. All staff members complete a minimum of three days of pre-camp training.

Staff Nurse & Special Needs

Jockey Hollow and Lake Rickabear have a certified nurse on staff at camp every day. In addition, all unit staff and lifeguards are certified in First Aid and CPR. Jockey Hollow Day Camp and Lake Rickabear Day Camp can provide reasonable accommodations to girls with special needs.

Please contact Rachel Jaffe, Jockey Hollow Day Camp Director, at [email protected], or Elena Morgan, Lake Rickabear Day Camp Director, at [email protected], or call 973-248-8200 to determine if we can adequately serve your camper’s needs.

All girls are welcome at Jockey Hollow and Lake Rickabear, where they will make new friends, try new things, and learn leadership skills that will last a lifetime.

We’re accredited!

The health and safety of all our campers and staff are our primary concerns. We are proud to be accredited by the American Camp Association (ACA), which reviews staff qualifications and training, emergency management, program quality, health and safety standards, and much more. Additionally, our camps comply with standards set by the New Jersey State Department of Health, American Red Cross, and Girl Scouts of the USA.

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Page 5

Camp ExtrasAdditional Services

These services are offered for an additional fee. All fees, except the lunch program fees, are due at the time of registration.

Lunch Program

An optional cold lunch program is provided by Simply Gourmet, an independent food service company. Simply Gourmet offers “kid-friendly,” nutritious, nut-free meals delivered daily and individually packaged with the camper’s name. Participate by going to www.simplygourmetlunches.com. Menus and pricing for both July and August will be available for ordering by the middle of June 2018.

Overnights

Complete the summer camp experience with an overnight at camp! During select sessions, girls can participate in an evening campfire and sing-along, and sleep in a building, tent or yurt at Lake Rickabear or in a cabin at Jockey Hollow with their unit. Three meals (Wednesday dinner, and breakfast and lunch Thursday) and a snack will be provided. Girls must pre-register for any of the overnights. Registration for overnights closes 16 days before each camp session begins. Each overnight is an additional $30. Overnights are included in the camp fees for the teen programs where specified.

AM Care

Lake Rickabear offers before care on site from 7:00 a.m. to 9:00 a.m. The fee is $50 per one-week session and $100 per two-week session. No per diem rate is available. Campers need to be dropped off at camp. AM Care is not available at Jockey Hollow.

PM Care

Extend the camp day for your camper with our after care programs held on site at Jockey Hollow and Lake Rickabear. PM care is offered from the end of the camp day until 6:00 p.m. Campers need to be picked up at camp. The fee is $50 per one-week session and $100 per two-week session. No per diem rate is available.

“This was the best two weeks

of my entire life!”- Emily, sixth grade camper

Page 6

Leadership Opportunities

Counselor in TrainingCounselor in TrainingAre you ready to step out of the camper role and begin your journey toward being a camp counselor? Girls entering grades 9 and 10 (and who are 14 years old as of 7/2/18) can register for this two-week leadership training program. During the first week, you will develop the skills needed to mentor younger girls and understand their needs in a camp setting. Use your newly-acquired skills under the guidance of camp counselors in the units during the second week. At the end of the two-week training program, you will earn your CIT pin.

* Jockey Hollow CITs: Upon completion of the program, you are encouraged to volunteer for one or more weeks during the remainder of summer camp.

Counselor in Training IICounselor in Training IIWhen you complete the CIT program, you can continue to build your camp counselor skills during this two-week session. During the first week, you will learn what goes on behind the scenes that allows camp to run safely and efficiently. You will focus on conflict management, leadership skills, unit planning and more during this leadership development experience. Use your newly-acquired skills under the guidance of camp counselors in the units during the second week. At the end of the two-week training program, you will earn your CIT II pin. Upon completion of the program, you are encouraged to volunteer for one or more weeks during the remainder of camp.

Find your spark; Become a leader

Junior CounselorJunior CounselorSpend your summer making memories, expanding your camp knowledge, and working with friends. By completing the CIT and CIT II programs, you have the opportunity to take advantage of a wonderful summer experience by becoming a paid staff member. Only girls who completed the CIT and CIT II programs and are 16 years old

by the start of the summer, may be considered for hire as a Junior Counselor.

Leadership Opportunities

Page 7

Register Today!Registration opensRegistration opens

December 5thDecember 5thVisit

www.gsnnj.org/campto register.

1. Review the program offerings section (pages 11-26) and select the sessions and programs that best fit your camper’s interests.

2. Register for the sessions your camper would like to attend!

• Go to www.gsnnj.org>Program/Camp Registration • Login under Current Member Login. Please note this is not part of the Membership Registration System and you may have a different login. (If you cannot remember your login, retrieve the login or open a Customer Care Help Desk Ticket.)• After you have logged in, search for the camp programs you would like your camper(s) to attend. • Pay a $75 non-refundable deposit per session or pay in full. If you are registering after May30, 2018, payment in full is required at time of reg-istration.

3. Look for the email confirmation

All confirmations and camp correspondence are sent via email. At the time of registration, please verify that your current email address is on file. Email confirmations are from [email protected]. Be sure to check your spam folder.

4. Submit your health form

Submit the completed health history form and immunization record as soon as possible but no later than May 30, 2018. Day Camp Health History Forms DO NOT require a doctor’s signature. Submit one of the following ways:

a. scan/email to: [email protected] b. via fax to: 973-927-7683 c. mail to:

Girl Scouts of Northern New JerseyAttn: Summer Camp1579 Sussex TurnpikeRandolph, NJ 07869

Summer Camp online registration closes 16 days before the first day of each session.

Page 8

Early Bird RegistrationEarn a $10 voucher for the summer camp Trading Post (camp store) by being one of the first 500 Early Bird campers to complete the following three steps:• Complete the online registration by February 28, 2018• Pay the remaining balance by May 30, 2018• Submit completed health history form, including immunization record by May 30, 2018

Each eligible camper will receive her voucher during her first camp session. Limit one voucher per camper. Don’t delay! Only the first 500 campers to fulfill the requirements will receive the voucher.

Changes to RegistrationThere will be an additional fee of $20 per request for any changes made after the initial registration is processed. Please submit all changes by email to [email protected].

Payment Schedule All payments are to be charged with a debit/credit card online. To pay the balance, return to the online summer camp registration website any time, but no later than May 30, 2018 and pay with your debit/credit card. All registrations submitted after May 30, 2018 must be paid in full at the time of registration.

Cancellation PolicyCamp fees will be refunded, less the $75 per session non-refundable deposit, ONLY if an email request is received by the camp director no later than May 30, 2018. (Requests received after May 30, 2018 cannot be refunded). In case of an accident, illness (verification from a doctor is required), or death of an immediate family member, a camper will be offered the next available session or a refund will be considered on a case by case basis.

GSNNJ reserves the right to cancel programs or services that do not meet our minimum enrollment. All fees will be refunded if the camper is not placed in another program. There is no refund if a camper is asked to leave camp due to behavioral problems or disobeys camp policies.

Non-member RegistrationGirls who are registered with another council or those not currently registered as a Girl Scout are welcome to attend GSNNJ summer day camps. An additional fee of $40 will be charged per session. Please contact [email protected] and we will assist you in registering your camper.

Girls who are not currently registered will become a member of GSNNJ. Girls may continue in Girl Scouts year-round by emailing [email protected].

Need help?Need assistance with summer camp registration? We’re happy to help! Please call 973-248-8200 or [email protected].

Registration Tips

Page 9

Do you offer financial assistance? Finances should never be an obstacle to a summer camp adventure! Any GSNNJ registered Girl Scout may apply for financial assistance. Each family’s request and the availability of funds determine the amount granted. Download the Girl/Adult Financial Assistance (GAFA) form from the GSNNJ website and submit it with your registration receipt. The $75 deposit is required and can be refunded if sufficient financial aid is not available. Our deadline for financial assistance applications is April 2. No applications will be accepted after that date.

What will my daughter bring home to remember her fun time at Girl Scout Camp?Each session, your daughter will come home with a free photo of her unit. She will also receive a free t-shirt the first session she attends summer camp. Our Trading Post (camp store) will be open to purchase camp memorabilia such as clothing, key chains, jewelry, stuffed animals, etc.

What if the program I want to register for is full? If a program appears full, complete the wait list form online at www.gsnnj.org>camp>summer camp. If space becomes available, girls will be placed in the session in the order their names were received. Parents/guardians will be called about any new openings. A return call to the office must be made within 24 hours to keep her space in the session.

Can my camper be in the same unit as her friend? Girls like to make new friends at camp. But we also know that some girls want to be with a particular friend, so we will try to accommodate a request to be placed with a buddy. Girls wishing to be buddies must be in the same program and cannot be more then 1 grade apart. Only one buddy can be requested and it must be reciprocal on the buddy’s registration.

If I didn’t register for an overnight at the time of registration, is it too late to sign up?If there is availability, we would be happy to add your camper. Registration for the overnight closes 16 days prior to the beginning of the camp session. Please email [email protected].

My daughter is having a great time at camp. How can I sign her up for additional sessions? If there is availability, we would be happy to register your camper for an additional session. Registration closes 16 days prior to the beginning of the camp session. Please email [email protected].

I have not received an email or a packet of information since the registration confirmation email. Is there anything I need to know before the camp session begins?The camp director will send an email 1-2 weeks prior to the start of the session with information such as Remind.com (bus delay notifications) and more. In the meantime, please view our Parent Guide which can be found at www.gsnnj.org>camp>summer camp.

Frequently Asked Questions

Goal Getters Go To Goal Getters Go To Camp For FreeCamp For Free

How can my daughter earn her free week?Earn a FREE week valued at $320 at GSNNJ Summer Camp by participating in the Fall Sale and Cookie Program! Just complete the following three steps to qualify:1. Sell 6 Magazine Items and 30 Nut/Candy items between October 1 and October 22 during the 2017 Fall Sale Program2. Sell 175 Boxes of Girl Scout Cookies during the initial order period in 2018 (January 13-February 11). If not participating in the Fall Sale, girls must sell 550 packages of cookies during the initial order. Digital Cookie and traditional orders count!3. Do a service project in your community with a minimum of 3 hours of service time and submit the summary form that can be found on our website. Service projects must be completed by February 1st; summary form must be received by February 5th.

Service projects can be done as a troop, however each girl must complete the sales requirements and service hours individually.

My daughter is working towards earning the Goal Getter incentive. How do I register her for camp?You will receive an email in February with directions to help you with the registration process. If you want to reserve your spot in a specific session, you can register online and pay your $75 deposit. Your deposit will be refunded if she earns Goal Getter status.

Page 10

Jockey Hollow Day CampTRANSPORTATION

Bus transportation to and from camp is included in the camp fee. Buses arrive at camp between 8:50 and 9:00 a.m. and leave camp at approximately 3:45 p.m. A bus stop (or parent transport) must be selected at the time of registration. Bus times may vary due to traffic and weather conditions. An email will be sent with directions on how to register for remind.com (bus delay notifications) prior to the start of each session. A bus counselor is present on each bus.

Buses cannot wait beyond the scheduled times, so please arrive at the bus stop 10 minutes prior to pick-up and drop-off times. For the safety of our campers, an authorized adult must present a photo ID when picking up a camper each day.

Arriving and Departing by Car: Campers transported to camp by a parent/guardian should arrive between 8:30 and 8:45 a.m. and should be picked up at 3:35 p.m. For campers being transported by a parent/guardian, select Parent Transport during online registration. Select PM Care for those staying for extended care.

JOCKEY HOLLOW BUS ROUTE SCHEDULE

Town Stop Location AM PMBus 1 Oakland 1A ShopRite, 14 Post Rd. 7:45 4:45 Towaco 1B Train Station, 632 Main St. 8:10 4:20 Boonton 1C Boonton High School, Front Lot, 306 Lathrop Ave. 8:25 4:05

Bus 2 Whippany 2A Pine Plaza, The Melting Pot, 831 Route 10 8:00 4:35 Florham Park 2B Florham Park Plaza, Trader Joe’s, 176 Columbia Tpke. 8:15 4:15 Madison 2C Hartley Dodge Memorial Bldg. Parking Lot, Maple Ave. 8:30 4:00

Bus 3 Mt. Arlington 3A Lee’s County Park Marina, 443 Howard Blvd. 7:50 4:40 Rockaway 3B Dennis B. O’Brien School cul-de-sac, Mineral Springs Dr. 8:05 4:20 Dover 3C St. John’s Episcopal Church, 11 South Bergen St. 8:20 4:05 Brookside 3D Brookside Community Club, 1 East Main St. 8:45 3:45

Bus 4 Wayne 4A Ramapo Plaza, Valley Health Medical, 759 Hamburg Tpke. 7:45 4:50 Parsippany 4B St. Peters. Church, 179 Baldwin Rd. 8:15 4:20 Morristown 4C Thomas Jefferson School, 120 James St. 8:40 3:55

Bus 5 Landing 5A Former Fresh Imperium Food Market, 175 Lakeside Blvd. 7:55 4:35 Flanders 5B Tinc Road School, 24 Tinc Rd. 8:15 4:15 Chester 5C West Morris Central High School, 259 Bartley Rd. 8:25 4:05 Chester 5D Municipal Parking Lot, Collis Lane 8:35 3:55

Bus 6 Chatham 6A Lafayette School, 221 Lafayette Ave. 8:00 4:25 Chatham 6B Fairmount Country Store, 765 Fairmount Ave. 8:10 4:15 Stirling 6C Central School, 90 Central Ave. 8:25 4:00

Bus 7 Denville 7A St. Mary’s Church, 15 Meyers Ave. 7:55 4:40 Parsippany 7B St. Christopher’s Church, 1050 Littleton Rd. 8:15 4:20 Morris Plains 7C Simons Memorial Park, Mountain Way/Hillview Ave. 8:35 4:00

Bus 8 Hackettstown 8A Target, 68 Route 46 7:45 4:50 Succasunna 8B Horseshoe Lake, Imagination Parking Lot, 72 Eyland Ave. 8:15 4:20 Randolph 8C Randolph High School, 511 Millbrook Ave. 8:30 4:05 Mendham 8D Mendham High School, 65 East Main St. 8:45 3:50

Page 11

Session 1: July 2-6 (No July 4)

Jockey Hollow Summer Fun

Join us for a jam-packed week of exciting activities! Cool off in our beautiful pool each day (weather permitting) during your combined swim lesson and free swim period. Cook lunch over an open fire on Thursday, learn crazy camp songs, play field games, and get creative during arts & crafts. Strengthen your self-esteem and practice teamwork at the Low Ropes Challenge Course. Explore the Jockey Hollow forest with the Environmental Education Specialist and work on badges. Girls in 2nd grade and up can try their hand at archery and girls in 4th grade and up can take a ride on the zipline. Other Jockey Hollow Summer Fun activities may include hiking the trails, stream exploration, playing in our GaGa pit, participating in camp-wide service projects, and so much more. Weekly theme activities make each session unique. Themes are announced on the first day of each session. End the week at Friday Fest which will include a theme-based activity. Girls will be grouped in units of 16-20 girls according to grade level. New fun and friendships await you at camp this summer!

Session 1: July 2-6 (no camp July 4) Fee: $260 Entering Grades: 1-9

Pony Pals

Giddy up! Hang out at the horse corral for 1 1/2 hours each day, Monday through Friday, (except Wednesday 7/4) learning horsemanship basics from trained professionals in a safe, non-threatening environment. This hands-on program will teach you about grooming, leading, and the basic care of your pony. Mount up for basic riding in the ring or hand-walking on trails (weather permitting). Spend the remainder of each day participating in the great Jockey Hollow Summer Fun activities listed above.

Session 1: July 2-6 (no camp July 4) Fee: $415 Entering Grades: 1-3

Horsemanship

Fulfill your love of horses at Jockey Hollow’s corral this summer! Spend two fun-filled hours a day, Monday through Friday (except Wednesday 7/4), at the corral, grooming, tacking, and learning trail etiquette. Saddle up for a daily 25-30 minute riding session or enjoy a trail ride through our majestic woodlands. Fill the remainder of each day participating in the Jockey Hollow Summer Fun activities listed above.

Session 1: July 2-6 (no camp July 4) Fee: $455 Entering Grades: 4-8

Engineer Sampler

Do you have what it takes to be an engineer? An engineer is an originator, a designer, an architect, an inventor, a developer, a creator. During this 4 day session, get involved designing and building various structures and learn through hands on activities. Become the architect of your own future!

Session 1: July 2-6 (no camp July 4) Fee: $305 Entering Grades: 6-9

JOCKEY HOLLOW DAY CAMP 2018 PROGRAM OFFERINGS

Page 12

JOCKEY HOLLOW DAY CAMP 2018 PROGRAM OFFERINGS

Counselor in Training (2 week session)

Please see page 7 for program description.

Sessions 1 & 2: July 2-6 & July 9-13 (no camp July 4) Fee: $435 Entering Grades: 9-10 (must by 14 yrs. old by 7/2/2018)

Counselor in Training II (2 week session)

Please see page 7 for program description.

Sessions 1 & 2: July 2-6 & July 9-13 (no camp July 4) Fee: $435 Entering Grades: 10-11 (Pre-requisite - completion of CIT)

Session 2: July 9-13

Jockey Hollow Summer Fun

See Jockey Hollow Summer Fun Session 1 for description.

Pre-register for our awesome optional overnight for girls entering grades 3 to 9 on Wednesday, July 11 for an additional $30. See page 6 for details.

Session 2: July 9-13 Fee: $320 Entering Grades: 1-9

Pony Pals

See Jockey Hollow Session 1 Pony Pals for description. Session 2 equestrian days are Tuesday through Friday. Monday is a regular Jockey Hollow Summer Fun day.

Pre-register for our awesome optional overnight for girls entering grades 3 to 9 on Wednesday, July 11 for an additional $30. See page 6 for details.

Session 2: July 9-13 Fee: $475 Entering Grades: 1-3

Horsemanship

See Jockey Hollow Session 1 Horsemanship for description. Session 2 equestrian days are Tuesday through Friday. Monday is a regular Jockey Hollow Summer Fun day.

Pre-register for our awesome optional overnight for girls entering grades 3 to 9 on Wednesday, July 11 for an additional $30. See page 6 for details.

Session 2: July 9-13Fee: $490 Entering Grades: 4-8

Page 13

JOCKEY HOLLOW DAY CAMP 2018 PROGRAM OFFERINGS

NYC Eats

Do you enjoying eating while traveling around New York City? Join us for this food tour around NYC without even leaving camp! Make and sample food from Chinatown, Little Italy, Brooklyn and the Upper East Side.

Pre-register for our awesome optional overnight for girls entering grades 3 to 9 on Wednesday, July 11 for an additional $30. See page 6 for details.

Session 2: July 9-13 Fee: $345 Entering Grades: 4-5

Animal Lover

Do you have a passion for animals? Are you thinking about a future career with animals? Join us for this fun and interactive week learning about different animal occupations. Enjoy presentations from The Seeing Eye, the Morris County Sheriff K9 unit, and much more!

Enjoy an overnight on Wednesday, July 11 (included in price). See page 6 for details.

Session 2: July 9-13 Fee: $370 Entering Grades: 6-9

Session 3: July 16-20

Jockey Hollow Summer Fun

See Jockey Hollow Summer Fun Session 1 for description.

Session 3: July 16-20 Fee: $320 Entering Grades: 1-9

Pony Pals

See Jockey Hollow Session 1 Pony Pals for description. Session 3 equestrian days are Tuesday through Friday. Monday is a regular Jockey Hollow Summer Fun day.

Session 3: July 16-20 Fee: $475 Entering Grades: 1-3

Page 14

JOCKEY HOLLOW DAY CAMP 2018 PROGRAM OFFERINGS

Horsemanship

See Jockey Hollow Session 1 Horsemanship for description. Session 3 equestrian days are Tuesday through Friday. Monday is a regular Jockey Hollow Summer Fun day.

Session 3: July 16-20Fee: $490 Entering Grades: 4-8

Jewels & Gems (2 week session)

Show your creative side by designing and creating pieces of jewelry using a variety of materials. Learn jewelry making techniques and construct your own designs. At the end of this two-week session, take home some of your masterpieces and donate one of your hand made pieces!

Enjoy an overnight on Wednesday, July 25 (included in price). See page 6 for details.

Session 3 & 4: July 16-20 & July 23-27 Fee: $695 Entering Grades: 6-9

Session 4: July 23-27

Jockey Hollow Summer Fun

See Jockey Hollow Summer Fun Session 1 for description.

Pre-register for our awesome optional overnight for girls entering grades 3 to 9 on Wednesday, July 25 for an additional $30. See page 6 for details.

Session 4: July 23-27 Fee: $320 Entering Grades: 1-9

Pony Pals

See Jockey Hollow Session 1 Pony Pals for description. Session 4 equestrian days are Tuesday through Friday. Monday is a regular Jockey Hollow Summer Fun day.

Pre-register for our awesome optional overnight for girls entering grades 3 to 9 on Wednesday, July 25 for an additional $30. See page 6 for details.

Session 4: July 23-27 Fee: $475 Entering Grades: 1-3

Horsemanship

See Jockey Hollow Session 1 Horsemanship for description. Session 4 equestrian days are Tuesday through Friday. Monday is a regular Jockey Hollow Summer Fun day.

Pre-register for our awesome optional overnight for girls entering grades 3 to 9 on Wednesday, July 25 for an additional $30. See page 6 for details.

Session 4: July 23-27Fee: $490 Entering Grades: 4-8

Page 15

JOCKEY HOLLOW DAY CAMP 2018 PROGRAM OFFERINGS

Beaded Bling

Join us for this intro to jewelry making session where you will get to know the tools of the trade, turn everyday objects into jewelry, create a piece of jewelry inspired by other cultures and make a sparkling gift for a friend.

Pre-register for our awesome optional overnight for girls entering grades 3 to 9 on Wednesday, July 25 for an additional $30. See page 6 for details.

Session 4: July 23-27Fee: $345 Entering Grades: 4-5

Jewels & Gems (2 week session)

See page 15 for description.

Enjoy an overnight on Wednesday, July 25 (included in price). See page 6 for details.

Session 3 & 4: July 16-20 & July 23-27 Fee: $695 Entering Grades: 6-9

Session 5: July 30-August 3

Jockey Hollow Summer Fun

See Jockey Hollow Summer Fun Session 1 for description.

Session 5: July 30-August 3 Fee: $320 Entering Grades: 1-9

Pony Pals

See Jockey Hollow Session 1 Pony Pals for description. Session 5 equestrian days are Tuesday through Friday. Monday is a regular Jockey Hollow Summer Fun day.

Session 5: July 30-August 3 Fee: $475 Entering Grades: 1-3

Horsemanship

See Jockey Hollow Session 1 Horsemanship for description. Session 5 equestrian days are Tuesday through Friday. Monday is a regular Jockey Hollow Summer Fun day.

Session 5: July 30-August 3Fee: $490 Entering Grades: 4-8

Page 16

JOCKEY HOLLOW DAY CAMP 2018 PROGRAM OFFERINGS

Day & Away (2 week session)

Love day camp, but want to experience sleep-away camp, too? Experience the best of both camp worlds in a special two-week session for girls entering grades 4-5! Spend the first week, Monday through Friday, at Jockey Hollow forming friendships with fellow campers and counselors in your unit and participating in all the great day camp activities. The next week, Sunday through Saturday, venture off with the same unit and counselors to experience resident camp at its best at Camp Lou Henry Hoover in Middleville, NJ, our sister camp operated by Girl Scouts Heart of New Jersey. Parents provide transportation to and from Camp Hoover and get a chance to meet the staff and the director, visit the Trading Post, and tour the camp at drop-off.

Save the date! Join us for a recommended Day & Away Orientation on Thursday, May 17, 2018 at the Riverdale Service Center. An email will be sent to registered campers prior to the event with more information.

Session 5 & 6: July 30-August 3 (Mon.-Fri.) at Jockey Hollow Day Camp &August 5-August 11 (Sun.-Sat.) at Camp Hoover Resident CampFee: $790 Entering Grades: 4-5

World Cuisine (2 week session)

Travel around the world as you create recipes from other countries. Girls will create French pastries, Italian specialties and Asian delicacies. Prepare and sample additional recipes from at least 5 other cuisines including Mexican, Caribbean, German, African, Indian, and more. Go home at the end of the session with a great cookbook! Bon Appétit!

Enjoy an overnight on Wednesday, August 8 (included in price). See page 6 for details.

Session 5 & 6: July 30-August 3 & August 6-10 Fee: $695 Entering Grades: 6-9

Session 6: August 6-10

Jockey Hollow Summer Fun

See Jockey Hollow Summer Fun Session 1 for description.

Pre-register for our awesome optional overnight for girls entering grades 3 to 9 on Wednesday, August 8 for an additional $30. See page 6 for details.

Session 6: August 6-10 Fee: $320 Entering Grades: 1-9

Pony Pals

See Jockey Hollow Session 1 Pony Pals for description. Session 6 equestrian days are Tuesday through Friday. Monday is a regular Jockey Hollow Summer Fun day.

Pre-register for our awesome optional overnight for girls entering grades 3 to 9 on Wednesday, August 8 for an additional $30. See page 6 for details.

Session 6: August 6-10 Fee: $475 Entering Grades: 1-3

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JOCKEY HOLLOW DAY CAMP 2018 PROGRAM OFFERINGS

Horsemanship

See Jockey Hollow Session 1 Horsemanship for description. Session 6 equestrian days are Tuesday through Friday. Monday is a regular Jockey Hollow Summer Fun day.

Pre-register for our awesome optional overnight for girls entering grades 3 to 9 on Wednesday, August 8 for an additional $30. See page 6 for details.

Session 6: August 6-10Fee: $490 Entering Grades: 4-8

Magical World of Wizardry

Enter the wizarding world of Hogwarts! Attend a potions and herbology class, play a round of Quidditch, and even make and enjoy a glass of butterbeer! Indulge in a true Hogwarts feast for Thursday’s cookout.

Pre-register for our awesome optional overnight for girls entering grades 3 to 9 on Wednesday, August 8 for an additional $30. See page 6 for details.

Session 6: August 6-10 Fee: $345 Entering Grades: 4-5

Day & Away (2 week session)

See page 17 for description.

Save the date! Join us for a recommended Day & Away Orientation on Thursday, May 17, 2018 at the Riverdale Service Center. An email will be sent to registered campers prior to the event with more information.

Session 5 & 6: July 30-August 3 (Mon.-Fri.) at Jockey Hollow Day Camp &August 5-11 (Sun.-Sat.) at Camp Hoover Resident CampFee: $790 Entering Grades: 4-5

World Cuisine (2 week session)

See page 17 for description.

Enjoy an overnight on Wednesday, August 8 (included in price). See page 6 for details.

Session 5 & 6: July 30-August 3 & August 6-10 Fee: $695 Entering Grades: 6-9

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JOCKEY HOLLOW DAY CAMP 2018 PROGRAM OFFERINGS

Session 7: August 13-17

Jockey Hollow Summer Fun

See Jockey Hollow Summer Fun Session 1 for description.

Session 7: August 13-17 Fee: $320 Entering Grades: 1-9

Pony Pals

See Jockey Hollow Session 1 Pony Pals for description. Session 7 equestrian days are Tuesday through Friday. Monday is a regular Jockey Hollow Summer Fun day.

Session 7: August 13-17 Fee: $475 Entering Grades: 1-3

Horsemanship

See Jockey Hollow Session 1 Horsemanship for description. Session 7 equestrian days are Tuesday through Friday. Monday is a regular Jockey Hollow Summer Fun day.

Session 7: August 13-17 Fee: $490 Entering Grades: 4-8

Jockey Hollow STOMP

Back by popular demand! Move to the beat of the drum and rock the camp! Under the direction of a musical professional, construct trash can instruments and perform in a junk band ensemble. Get in tune with yourself and others by participating in a drum circle. Recognize drumming as a spiritual art form and learn basic Afro-Cuban drum patterns and invocations. You will experience instruments from other cultures, such as a didgeridoo, congas, shakers and an agogo bell. Be a part of the Stomp!

Session 7: August 13-17 Fee: $350 Entering Grades: 6-9

Lake Rickabear Day CampTRANSPORTATION

Bus transportation to and from camp is included in the camp fee. Buses arrive at camp at approximately 9:00 a.m. and leave camp at approximately 4:00 p.m. A bus stop or parent transport must be selected at the time of registration. Bus times may vary due to traffic and weather conditions. An email will be sent with directions on how to register for remind.com (bus delay notifications) prior to the start of each session. A bus counselor is present on each bus.

Buses cannot wait beyond the scheduled times. Please arrive at the bus stop 10 minutes prior to pick-up and drop-off times. An adult must stay with the camper until the bus arrives. For the safety of our campers, an authorized adult must present a photo ID when picking up a camper each day.

Arriving and Departing by Car: Campers transported to camp by a parent/guardian should arrive between 8:45 a.m. and 9:00 a.m. and should be picked up between 3:45 p.m. and 4:00 p.m. For campers being transported by a parent/guardian, select Parent Transport during online registration. Select AM or PM Care for those staying for extended care.

LAKE RICKABEAR BUS ROUTE SCHEDULE

Town Stop Location AM PMBus A Rutherford A1 Felician University 7:15 5:40

Passaic A2 Burger King, 22 Gregory Dr. 7:30 5:25

Clifton A3 Richfield Shopping Center, Dunkin’ Donuts, 1372 Clifton Ave. 7:45 5:10

Clifton A4 St. Philip the Apostle Church, 797 Valley Rd. 7:55 5:00

Woodland Park A5 Kiddie University, 224 Lackawanna Ave. 8:05 4:50

Totowa A6 Valley National Bank, 55 Union Blvd. 8:15 4:40

Kinnelon A7 Borough Hall, 130 Kinnelon Rd. 8:50 4:10

Bus B Mahwah B1 Ramapo Reformed Church, 100 Island Rd. 7:45 5:10

Ramsey B2 Interstate Shopping Center, TD Bank, 1 Interstate Shop Center 7:55 5:00

Wyckoff B3 Boulder Run Shopping Ctr, Capital One Bank, 840 Franklin Ave. 8:15 4:40

Midland Park B4 Godwin Ave & Paterson Rd. 8:25 4:30

Bus C Paramus C1 Paramus Council Service Center, 300 Forest Ave. 7:40 5:10

Fair Lawn C2 Radburn Rd. & Fair Lawn Ave. 8:00 4:55

Glen Rock C3 Kilroy’s Wonder Market, 288 Rock Rd. 8:10 4:45

Hawthorne C4 Rea Mansion, Former Boys’ and Girls’ Club, 675 Goffle Rd. 8:25 4:30

Bus D Hackensack D1 Stop and Shop, 380 W. Pleasantview Ave. 7:20 5:45

Elmwood Park D2 Elmwood Park Rec Dept, 500 Blvd. (Senior Center lot) 7:35 5:25

Wayne D3 Former A&P, 560 Valley Rd. 8:00 5:00

Wayne D4 Packanack Elementary School, 190 Oakwood Dr. 8:15 4:45

Wayne D5 Preakness Shopping Center (Macy’s side lot & Alps Rd.) 8:30 4:30

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All new bus routes!

LAKE RICKABEAR BUS ROUTE SCHEDULE

Town Stop Location AM PMBus E Sussex E1 Sussex Middle School, 10 Loomis Ave. (front parking lot) 7:10 5:30

Vernon E2 Acme, 530 Route 515 7:30 5:10

West Milford E3 ShopRite, 23 Marshall Hill Rd. 8:00 4:55

Ringwood E4 CVS, 115 Skyline Dr. 8:20 4:35

Wanaque E5 Haskell Elementary School, 973 Ringwood Ave. 8:35 4:25

Bus F Franklin Lakes F1 Franklin Crossing Shopping Ctr, Capital One Bank, 840 Franklin Ave. 7:40 5:20

Oakland F2 Our Lady of Perpetual Hope, 117 Franklin Ave. 7:50 5:10

Oakland F3 Copper Tree Mall, Dunkin’ Donuts, 338 Ramapo Valley Rd. 8:00 5:00

Riverdale F4 Riverdale Council Service Center, 95 Newark Pompton Tpke. 8:15 4:45

Pompton Plains F5 Pequannock Borough Hall, 530 Newark Pompton Tpke. 8:25 4:35

Bloomingdale F6 Delazier Field, 52 Balston St. 8:40 4:20

Bus G Sparta G1 Sparta Town Shopping Center, Stop & Shop, 5 Town Center Dr. 7:15 5:40

Lake Hopatcong G2 Jefferson Dairy, 741 Route 15 South 7:30 5:25

Denville G3 Community Church of Denville, 190 Diamond Spring Rd. 8:05 4:55

Mountain Lakes G4 Mountain Lakes High School, 96 Powerville Rd. (back lot) 8:20 4:40

Montville G5 Community Park, 130 Changebridge Rd. 8:40 4:20

Bus H Park Ridge H1 Ridgemont Shopping Center, 177 Kinderkamack Rd. 7:30 5:25

Emerson H2 Stop & Shop Shopping Center, 354 Kinderkamack Rd. (near Quick Check) 7:45 5:10

Oradell H3 Oradell Health Care Center, 600 Kinderkamack Rd. 7:55 5:00

River Edge H4 River Edge Town Mall, 645 Kinderkamack Rd. 8:10 4:45

Lake Rickabear Day Camp

“Bus drop off,

pick up, and bus

counselors were efficient

and effective”

- Parent of a third grade camper

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All new bus routes!

LAKE RICKABEAR DAY CAMP 2018 PROGRAM OFFERINGS

Session 1: July 2-6 (No July 4)

Sweet Summer

Bring your sweet tooth! Create your own candy and other delicious confections. Enjoy all our regular camp activities with a yummy twist! Cool off in the lake each day (weather permitting) for swim. Learn camp songs, play field games, and get creative during arts & crafts. Strengthen your self-esteem and practice teamwork at the Low Ropes Challenge Course. Girls in 2nd grade and up can try their hand at archery and girls in 4th grade and up can take a ride on the zipline.

Session 1: July 2-6 (no camp July 4)Fee: $260 Entering Grades: 1-7

Sweet Summer Teen

Enjoy all the fun from Sweet Summer, but also participate in a two-hour professional cooking class where you’ll make treats which may include strawberry shortcake, blueberry tarts with homemade piecrust, summer rolls with sweet chili sauce, fireworks salad, summer corn chowder, and fruit infused lemonade.

Session 1: July 2-6 (no camp July 4)Fee: $290 Entering Grades: 8-12

Session 2: July 9-13

Out of This World

Blast off to an action packed week at Lake Rickabear! Build your own rocket and learn about everything outer space. Break out your creativity for an alien themed dress up day!

Campers can enjoy star gazing and a sleepover on July 11 for an additional $30. See page 6 for more overnight information.

Session 2: July 9-13 Fee: $320 Entering Grades: 1-5

Out of This World Plus

Out of this World PLUS campers will enjoy all the fun from Out of This World, but will also go on a field trip to a planetarium to experience a live tour of the night sky by an astronomer and a featured presentation. PLUS campers can add an overnight and stargazing on July 11 for $30. See page 6 for more overnight information.

Session 2: July 9-13 Fee: $345 Entering Grades: 6-7

Out of This World Teen

Out of this World TEEN campers will enjoy all the fun from Out of this World, but will also go on a field trip to a planetarium and enjoy star gazing and an overnight on July 11. See page 6 for more overnight information. The cost of the field trip and the overnight are included in the camp fee.

Session 2: July 9-13Fee: $375 Entering Grades: 8-12

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LAKE RICKABEAR DAY CAMP 2018 PROGRAM OFFERINGS

Counselor in Training II (2 week session)

Learn more about our Leadership Development programs on pg 7.

Session 2 & 3: July 9-13 & July 16-20Fee: $435 Entering Grades: 10-11 (pre-requisite completion of CIT)

Day and Away Camp for Girl Scout Juniors (2 week session)

Love day camp, but want to experience sleep-away camp too? Encounter the best of two worlds in this special 2 week session. Spend the first week at Lake Rickabear forming friendships with fellow campers and counselors and participating in “Out of This World” activities. The next week, venture off with the same unit counselors to experience resident camp at Camp Lou Henry Hoover, our sister camp operated by Girl Scouts Heart of NJ. Parents get the chance to meet the staff and director, visit the Trading Post, and tour the camp when they drop the girls off at Camp Hoover in Middleville on Sunday.

Save the date! Join us for a recommended Day & Away Orientation on Thursday, May 17, 2018 at the Riverdale Service Center. An email will be sent to registered campers prior to the event with more information.

Session 2 & 3: July 9-13 (Mon.-Fri.) at Lake Rickabear Day Camp & July 15-21 (Sun.-Sat.) at Camp Hoover Resident CampFee: $790 Entering Grades: 4-5

Session 3: July 16-20

Under the Big Top

Join us for a Ricka-Circus! Play classic carnival games, learn to juggle, and enjoy a snow cone. Two circus artists will visit camp to provide a spectacular performance and hands-on workshops.

Session 3: July 16-20 Fee: $320 Entering Grades: 1-7

Under the Big Top Teen

Under the Big Top TEEN campers will enjoy all of the fun from Under the Big Top. In addition, you will travel to the School of Circus Arts on July 18 where you can try tight wire walking, swinging on a trapeze, climbing the silks, plate spinning, and building a human pyramid. You will return to camp for a special Teen-only overnight. See page 6 for more overnight information. The cost of the field trip and the overnight are included in the camp fee.

Session 3: July 16-20 Fee: $395 Entering Grades: 8-12

LAKE RICKABEAR DAY CAMP 2018 PROGRAM OFFERINGS

Session 4: July 23-27

Camp Like A Girl Scout

Follow in the footsteps of Juliette Gordon Low as you learn how to make a sit-upon, cook over a campfire, and sing campfire songs. Campers can add an exciting sleepover on July 25 for an additional $30. See page 6 for more overnight details.

Session 4: July 23-27Fee: $320 Entering Grades: 1-7

Camp Like A Girl Scout Teen

You’ll enjoy everything from Camp Like a Girl Scout plus go on a relaxing tube float down the Delaware River on July 25. Then return to Lake Rickabear for a great overnight with your camp friends. See page 6 for more overnight information. The cost of the field trip and the overnight are included in the camp fee.

Session 4: July 23-27Fee: $395 Entering Grades: 8-12

Day and Away Camp for Girl Scout Cadettes (2 week session)

See Day and Away Camp for Girl Scout Juniors on page 23 for description. Spend the first week at Lake Rickabear participating in “Camp Like a Girl Scout” activities. The next week, venture off with the same unit counselors to experience resident camp at Camp Lou Henry Hoover.

Save the date! Join us for a recommended optional Day & Away Orientation on Thursday, May 17, 2018 at the Riverdale Service Center. An email will be sent to registered campers prior to the event with more information.

Session 4 & 5: July 23-27 (Mon.-Fri.) at Lake Rickabear Day Camp & July 29-August 4 (Sun.-Sat.) at Camp Hoover Resident Camp Fee: $790 Entering Grades: 6-8

Session 5: July 30-August 3

Time Traveler

Past, present, or future? Who knows! Join us for a time traveling week filled with fun from the past and dreaming about the future. Session 5: July 30-August 3 Fee: $320 Entering Grades: 1-7

Time Traveler Teen

Our time traveling TEENS will enjoy everything from Time Travelers, but will also travel to Medieval Times on August 1. You will enjoy lunch fit for a king while watching a live show featuring knights, jousting, hand-to-hand combat, and extraordinary horsemanship. The cost of the field trip is included in the camp fee.

Session 5: July 30-August 3Fee: $380 Entering Grades: 8-12

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LAKE RICKABEAR DAY CAMP 2018 PROGRAM OFFERINGS

Session 6: August 6-10

Get Wild

Let your imagination run wild as we explore animals from near and far. You’re sure to have an exciting animal filled week!

Girls can spend the night at camp on August 8 for an additional $30. See page 6 for overnight details.

Session 6: August 6-10Fee: $320 Entering Grades: 1-5

Get Wild Plus

Get Wild PLUS campers will enjoy everything from Get Wild, and will also go on an exciting field trip to Turtle Back Zoo on August 8. At the zoo, you’ll attend a special program where you will meet some of the zoo’s animal ambassadors up close and learn about and create enrichment items.

Girls can spend the night at camp on August 8 for an additional $30. See page 6 for overnight details.

Session 6: August 6-10Fee: $350 Entering Grades: 6-7

Get Wild Teen

Get Wild TEEN campers will enjoy everything from Get Wild, and will also go on a VIP field trip to the Maritime Aquarium on August 8. You will explore the exhibits and see an IMAX movie. To top it off, you will go on a special behind the scenes tour and learn about the careers that are involved in making the Maritime Aquarium a great place for visitors and animals alike. You will return to camp for a fun camp overnight. See page 6 for more overnight information. The cost of the field trip and the overnight are included in the camp fee.

Session 6: August 6-10 Fee: $395 Entering Grades: 8-12

Counselor in Training (2 week session)

Learn more about our Leadership Development programs on pg 7. In addition, you’ll enjoy a fun overnight with your CIT friends on August 8. See page 6 for more overnight information. The cost of the the overnight is included in the camp fee.

Session 6 & 7: August 6-10 & August 13-17Fee: $465 Entering Grades: 9-10 (must be 14 years old by 7/2/2018)

LAKE RICKABEAR DAY CAMP 2018 PROGRAM OFFERINGS

Session 7: August 13-17

Mystery Mania

Sharpen your detective skills as we figure out this mystery-filled week! Learn about fingerprinting and how to be a secret agent. Try to solve a camp-wide conundrum! Session 7: August 13-17Fee: $320 Entering Grades: 1-5

Mystery Mania Plus

Mystery Mania PLUS campers will enjoy all of the fun from Mystery Mania plus go on a field trip to Liberty Science Center on August 15. At the science center, you will explore the exhibits, enjoy an IMAX movie, and participate in a hands-on workshop where you will discover how to investigate a crime scene and collect evidence through real forensic techniques.

Session 7: August 13-17Fee: $375 Entering Grades: 6-7

Mystery Mania Teen

Mystery Mania TEEN campers will enjoy all of the fun from Mystery Mania plus go on a field trip to an escape room on August 15. You will need teamwork, problem solving, keen observation, and clear communication to beat the clock. The cost of the field trip is included in the camp fee.

Session 7: August 13-17 Fee: $365 Entering Grades: 8-12

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Fo

Summer Day Camp Health History Form 2018Camp Attending: Jockey Hollow Lake Rickabear

THIS HEALTH HISTORY FORM MUST BE COMPLETED BY MAY 30, 2018.The form is to be completed and signed by the camper’s parent/guardian.

A doctor’s signature is NOT required for this health form.

Girl Name: Date of Birth: Age: Address: Grade in Sept. 2018: City: State: Zip:

Parent/Guardian 1 Name: Home Phone: Email (REQUIRED): Work Phone: Cell Phone: Parent/Guardian 2 Name: Home Phone: Email (REQUIRED): Work Phone: Cell Phone: Do both parents have custody? Yes No If no, who is the custodial parent/guardian? If a non-custodial parent is denied access to a child by a court order, you must provide camp with a copy of the documentation.

Emergency Contact (Will only be contacted if the parents/guardians are not available).Name: Primary Phone: Relationship to Child: Seconday Phone:

Name of Family Physician: Phone: Primary Insurance Carrier: Policy or Group #:

General Health Date of last health examination: Date of last tetanus shot: REQUIRED:

I have attached a copy of my child’s current immunization record. My child is not immunized; I have attached the GSNNJ waiver (Email [email protected] for waiver).

Provide Most Recent Dates for All That Apply:

Allergies: Describe reaction, if known.REQUIRED: ATTACH A COPY OF ANY ALLERGY OR ASTHMA ACTION PLAN(S) SPECIFIC TO YOUR CHILD.

Medication taken routinely (prescription and OTC):

Cam

per Nam

e:

D

ate Rec’d:

Session(s):

Frequent Ear Infections Heart Defect/Disease Convulsions Blood Disorders Hypertension Psychiatric Treatment Mononucleosis ADHD Autism Spectrum Disorder

Sickle Cell Trait/Disease Musculoskeletal Disorder Chronic or Recurrent Illness Diabetes: 1) Glucose Testing? No Yes 2) On Insulin? No Yes 3) Pump or Injection? No Yes Asthma 1) Use of Inhaler? No Yes 2) Self Administer? No Yes Seizures 1) Most recent: 2) Medications:

Insect Stings: Food Allergies: Penicillin: Other Drugs:

Poison Ivy: Hay Fever: Other Allergies: Prescribed Epipen? No YesCan Self Administer Epipen? No Yes

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Can your child participate in all camp activities as described in the camp brochure? Yes, she is in good health and can participate without any accommodations. Yes, she can participate with reasonable accommodations in respect to health or physical special needs.

Describe: No, she needs to be exempt from the following activities:

Hospitalization / Operations / Injuries:

Is the camper currently under the care of a physician or psychologist? No Yes, please specify:

Has she started menstruation? No Yes

Any additional information we should know about your child:

Please feel free to attach any additional signifi cant information that will assist us in providing an enriching day camp experience for your camper.

EMERGENCY MEDICAL AUTHORIZATION

I give consent for my child, , to receive medical treatment according to camp protocol written by standing orders by the camp doctor, or otherwise directed in writing by the child’s physician. In the event of a known severe allergy, camp staff as per physician’s instructions to prevent life-threatening conditions, will administer medication. In the event of an emergency, I give my consent for the administration of emergency medical treatment and to transport the child to hospital facilities if necessary. I understand that a reasonable attempt to contact me will be made.

I understand that part of the camp healthcare supervisor’s role at camp is to dispense medication and that this will not occur unless she/he has written authorization and instructions from the child’s doctor to dispense non-prescription and/or prescription medication (including vitamins, nutritional supplements, etc.). All medications must be in their original pharmacy containers, with an intact current prescription label. No exceptions will be made.

Please send all medications, including Epi Pens and inhalers, with your child on the fi rst day of camp.

I also give permission for my child to receive the following non-prescription medications that I have checked below if the nurse deems it necessary. Dosages will be administered according to directions on the bottle unless a physician directs otherwise.

Child’s weight: lbs. Antacid Advil Benadryl Tylenol Cough drop Topical creams/lotions

HIPAA Privacy Rule: I authorize the use of information to promote and monitor well-being while in camp, and as necessary, provision of fi rst aid/emergency care as best as possible, according and not limited to certifi cations, training, and availability.

This health history is complete and accurate. I know of no reason(s), other than the information indicated on this form, why my daughter should not participate in prescribed camp activities except as noted. I understand that willful omission of information that prevents GSNNJ staff from providing adequate care of my child may potentially result in dismissal of my child from camp.

Signature of parent/guardian: Date:

Completed Health History Forms are due by May 30, 2018 or immediately upon registration if registering after that date. Submit the completed form via fax to 973-927-7683, scan/email to [email protected], or by mail to Girl Scouts of Northern New Jersey, attn: Summer Camp, 1579 Sussex Turnpike, Randolph, NJ 07869.

If scanning/emailing, please use a PDF format. Photos will not be accepted. Please use a smartphone scan app in lieu of taking a photo of the Health History Form. Please retain a copy for your records.Page 28