PANTHERS “ALL SPORTS” CAMP

2010

Founded:
Panthers Camp, founded in 1995, is designed exclusively for youth, 6 – 12 years of age
(campers younger than 6 must be entering 1st grade to be eligible to attend camp). Panthers
Camp is located at Corte Madera School in Portola Valley and is directed by Dan Flahavan, CMS
Athletic Director and physical education instructor. Dan has over 22 years experience
developing and directing camps including Nike Mountain Air All Sports Camp and Nike Lake
Tahoe Tennis Camp.

Camp Curriculum:
Campers participate in a core group of physical activities, which enhance self-confidence,
cooperation, sportsmanship, lifelong fitness, and an appreciation for a wide variety of sports.
Core activities include:

Team Challenge Basketball Capture the Flag Ping Pong Frisbee

Field Games Risk Adventure Cooperatives Volleyball Soccer
Tumbling Track & Field Combatives Lacrosse Badminton
Obstacle Course Pickle-ball Flag Football Ultimate Camp Olympics
American Gladiators Archery/Air-soft Hockey Softball and more…

Typical Day*
Panthers Camp is held Monday through Thursday, 9 am – 3 pm
9:00 Campers Arrive
9:15 All Camp Meeting and Warm-up
9:30 Morning Activities (Indoor Soccer, Team Challenge, Risk Adventure)
12:00 Lunch (Optional Tournament)
12:45 Afternoon Activities (Lacrosse, Archery, & Ping Pong)
2:45 Daily Highlights, Awards, Snacks
2:55 Slide show
3:00 Campers Depart
*Activities change daily - Thursday is Camp Olympics & awards ceremony

Enrollment:
Panthers Camp is enrolled on a first-come, first-serve basis. To e nro ll, p lea se c om plete
the ap p lic at ion , wh ich is loca ted on t he back of t his fo rm an d su bm it w it h
full pa ym ent (Checks should be made payable to Panthers Camp). Send registration form &
payment to:

Panthers Camp
Attn: Dan Flahavan
796 Campbell Ave.
Los Altos, CA. 94024

***Please call or email Dan Flahavan if you have any questions (851-1777 x2255 or
dflahavan@pvsd.net).

(Continued on Back)
Please Circle the Session & Enclose Amount: Multiple session discount:

Session 1: 6/14 – 6/17/10 ($290) or Two Sessions = $540

*Sessions___&___
Session 2: 6/21 – 6/24/10 ($290)
or Three Sessions = $780
Session 3: 6/28 – 7/01/10 ($290) **Sessions___, ____, &___

Session 4: 7/06 – 7/09/10 ($290) or All 4 sessions = $1000

(Tuesday-Friday due to July 4th holiday)

(Registration is non-refundable and non-transferable after 4/1/10. Cancellations made prior to

4/1/10 will be charged a $100 cancellation fee.)

REGISTRATION:
CAMPER:_______________________ GENDER: ________ AGE: _________

GRADE: (entering Sept. 2010) ______

ADDRESS:___________________________________________________

MEDICAL INSURANCE PROVIDER: ____________ ID #: _________

PARENT/GUARDIAN: _______________________ PHONE: _______

EMERGENCY CONTACT: ____________________ PHONE: _______

Parent email ______________________________________________

T-Shirt Size: (Circle) YouthS, YM, YL, YXL, AdultS, AM, AL, AXL
DISTRICT RELEASE: With my signature below, I acknowledge that the Panthers Camp (Camp) is neither sponsored nor
endorsed by the Portola Valley Elementary School District (District) and I hereby release the District from any potential liability
emanating from the programmatic operation of the Camp.

HOLD HARMLESS: I, the undersigned, parent or guardian, do hereby agree to allow the individual(s) named herein to participate
in Panthers Camp and I further agree to indemnify and hold harmless Dan Flahavan and the Panthers Camp Staff from and against
any and all liability for any injury which may be suffered by the aforementioned individuals arising out of or in any way connected
with participation in this camp program.

MEDICAL RELEASE: In the case of a medical emergency, I give permission to Dan Flahavan and the Panthers Camp Staff to
order treatment for my child. This includes any medical treatment or x-rays.

Photo Consent:
I give consent for photos/videos of my child to be used in promotional materials, camp publications, & website postings. I
understand campers will not be identified by name on any promotional materials or photos unless additional permission has been
granted by the parent/guardian.

Your Signature below authorizes the aforementioned Camp & District Release, Hold Harmless, Medical Release, and photo consent:

PARENT/GUARDIAN SIGNATURE: _______________________ DATE: _________________