Summer Camp CalABASAS TEEN CAMP 2018

Teen _____________________________________________Age_______ Date of Birth________________ Gender______

Father First Name__________________________________ Last Name______________________________ Lives with: Both Parents

Shared
Mother First Name__________________________________ Last Name______________________________ Mother
Father
Home Phone__________________________________ Mother Work___________________________

Mother Cell___________________ Father Cell ____________________________ Father Work Number___________________________

E-Mail 1__________________________________________________ E-Mail 2_________________________________________________

Campers Cell (if applicable)___________________________________ School Camper Attends____________________________

Address__________________________________________________ Grade of Camper (Starting in September)_______________

City______________________________________ Zip_____________

Allergies/Medical Conditions/Current Medication:

____________________________________________________________________________________________________

AUTHORIZED PERSONS TO CONTACT IN CASE OF EMERGENCY AND TO PICK-UP YOUR CHILD FROM CAMP

Name:________________________________________ Phone:___________________________

Name:________________________________________ Phone:___________________________

FREE EXTENDED CARE BEGINNING AT 7am AND AS LATE AS 6:30pm FOR TRIPS THAT DON’T RUN THE ENTIRE DAY

Mark the box of the days your teen will attend camp.
JUNE/JULY
Space is limited and if you don’t pre-pay or pre-register we might Full Time Mon Tue Wed Thu Fri
not have room to accommodate all that show up as $280.00 18 $65 19 $40 20 $65 21 $65 22 $65
drop-in’s. The full weeks payment will be due upon arrival.
Parents will be charged based on days marked/registered. $340.00 25 $125 26 $40 27 $65 28 $65 29 $65

ADDITIONAL DAYS CAN BE ADDED BASED ON AVAILABILITY. FIVE DAYS $215.00 July 2 $65 3 $40 4 OFF 5 $65 6 $65
WRITTEN NOTICE IS REQUIRED FOR ANY CHANGE IN
$280.00 9 $65 10 $40 11 $65 12 $65 13 $65
ATTENDANCE. IF YOU EMAIL YOUR NOTICE YOU MUST GET A
REPLY FROM CAMP ACKNOWLEDGING THE NOTICE/IF CALLING YOU $280.00 16 $65 17 $40 18 $65 19 $65 20 $65
MUST SPEAK TO A CAMP DIRECTOR TO MAKE CHANGES!
$340.00 23 $125 24 $40 25 $125 26 $65 27 $65
Make up days not permitted regardless of the reason.
AUGUST
Please initial here __________ indicating that you understand that you Full Time Mon Tue Wed Thu Fri
will be charged for days you register your child to attend.
$340.00 30 $125 31 $40 1 $65 2 $65 3 $65
FOR MORE INFORMATION OR TO REGISTER PLEASE $280.00 6 $125 7 $40 8 $65 9 $65 10 $65
CONTACT US AT 818-878-0162 FAX 818-878-0195
Email campcalabasas@gmail.com $280.00 13 $65 14 $40 15 $65 16 $65 17 $65
Visit us at www.campcalabasas.org
Reg Fee $25.00
 Camp Calabasas Teen Camp
2018 Trip Calendar
Times/Trips subject to change with notice based on circumstances beyond our control.
If a trip is changed we will notify participants immediately and will update this calendar.

Week Full Time Mondays Tuesdays Wednesdays Thursdays Fridays

June 18 June 19 June 20 June 21 June 22
Knott’s Berry Farm Zuma Raging Waters -Mountasia and Bowling Movie & Lunch
1 $280.00 8:00am-6:30pm 10am-5pm 7:30am-6:30pm 10:00am-6:00pm 10:00am-5:00pm
$65.00 $40.00 $65.00 $65.00 $65.00

June 25 June 26 June 27 June 28 June 29

Universal Studios Zuma Pacific Park Dodgers vs. Cubs Neon Arcade
2 $340.00 8:00am-6:30pm 10am-5pm 9:00am-6:00pm 10:00am-5:00pm 9:00am-6:00pm
$125.00 $40.00 $65.00 $65.00 $65.00

July 2 July 3 July 4 July 5 July 6

Observatory, Guinness Rec- Zuma Long Beach Aquarium Movie and Lunch
3 $215.00 ord & Wax Museum 10am-5pm
CLOSED 9:00am-6:00pm 10:00am-6:00pm
9:00am-5:30pm $40.00 $65.00 $65.00
$65.00

July 9 July 10 July 11 July 12 July 13

Soak City Zuma Hurricane Harbor LA Sparks Game Mountasia
4 $280.00 8:00am-6:30pm 10am-5pm 9:00am-6:30pm 10:30am-5:30pm 9:30am-5:30pm
$65.00 $40.00 $65.00 $65.00 $65.00

July 16 July 17 July 18 July 19 July 20

Magic Mountain Zuma Movie and Lunch Roller Skating/Bowling Sky High & Aquatic Center
5 $280.00 9:00am-6:30pm 10am-5pm 9:30am-5:30pm 9:00am-5:00pm 9:30am-5:30pm
$65.00 $40.00 $65.00 $65.00 $65.00

July 23 July 24 July 25 July 26 July 27

Raging Waters Zuma Universal Studios Lazer Tag and Mini Golf Parkour/Big Z Pizza & Arcade
6 $340.00 7:00am-6:30pm 10am-5pm 8:30am-6:30pm 9:00am-5:30pm 9:00am-5:00pm
$65.00 $40.00 $125.00 $65.00 $65.00

July 30 July 31 August 1 August 2 August 3

California Adventure Zuma Scooters Jungle/Lunch Ventura County Fair Movie & Lunch
7 $340.00 7:00am-6:30pm 10am-5pm 9:30am-6:30pm 10:00am-5:00pm 10:00am-6:00pm
$125.00 $40.00 $65.00 $65.00 $65.00

August 6 August 7 August 8 August 9 August 10

Soak City Zuma Knott’s Berry Farm Neon Arcade Pacific Park
8 $280.00 8:00am-6:30pm 10am-5pm 8:00am-6:30pm 9:30am-5:00pm 9:00am-6:00pm
$65.00 $40.00 $65.00 $65.00 $65.00

August 13 August 14 August 15 August 16 August 17

Paddle Boats & Dojo Boom Zuma Golf-N-Stuff & Bowling Sky Zone/Bowling Movie & Lunch
9 $280.00 9:00am-5:30pm 10am-5pm 9:00am-5:30pm 9:30am-5:30pm 10:00am-6:00pm
$65.00 $40.00 $65.00 $65.00 $65.00

PLEASE ARRIVE AT CAMP 15-30 MINUTES BEFORE THE DEPARTURE TIME LISTED ON THE CALENDAR
TO ENSURE A SPOT FOR THE DAY AND TO REGISTER FOR THE DAY. WE OFFER FREE EXTENDED
CARE BEGINNING AT 7am AND AS LATE AS 6:30pm. SPACE IS LIMITED SO WE RECOMMEND
PRE-REGISTERING FOR TEEN CAMP AS WE HAVE A SPECIFIC TICKET COUNT FOR CERTAIN TRIPS AND
CAN’T ADD ONTO OUR RESERVAIONS FOR ADDITIONAL TEENS TO ATTEND.

CAMP CALABASAS 818-878-0162/De Anza Park 818-880-6461/Fax 818-878-0195

~ email: campcalabasas@gmail.com ~www.campcalabasas.org ~
TEEN CAMP CELL PHONE: 818-224-0810 (ONLY ANSWERED DURING SUMMER CAMP)
SUMMER CAMP CELL: 818-447-9469 (ONLY ANSWERED DURING SUMMER CAMP)
 SUMMER CAMP CALABASAS 2018
CAMP AGREEMENT

Campers Name

LITTLE LEARNERS, LLC

RELEASE, ASSUMPTION OF RISK, AND INDEMNITY
RELEASE: The undersigned is the parent or legal guardian of the minor camper, identified above. In consideration
for Little Learners providing to the camper identified above a camp Experience at Camp Calabasas, I HEREBY, ON MY
OWN BEHALF AND ON BEHALF OF THE CAMPER, RELEASE AND DISCHARGE LITTLE LEARNERS, LLC, THE OWNER
AND OPERATOR OF CAMP, AND THE CITY OF CALABASAS AND BOTH OF THEIR OFFICERS, DIRECTORS, EMPLOYEES,
VOLUNTEERS AND AGENTS (called herein the “Releasees”) FOR AND FROM ANY AND ALL CLAIMS ARISING OUT OF
THE CAMPER’S PARTICIPATION IN THE CAMP, INCLUDING CLAIMS ARISING OUT OF THE NEGLIGENCE OF THE
RELEASEES OR ANY OTHER CAMPER THAT CAUSES, OR IS CLAIMED TO CAUSE, INJURY OR DEATH TO THE CAMPER
IDENTIFIED ABOVE, PROPERTY DAMAGE, OR OTHER DAMAGES. I ALSO PROMISE NOT TO SUE ANY OF THE RE-
LEASEES FOR ANY OF THE CLAIMS BEING RELEASED.
ASSUMPTION OF RISK: I understand and acknowledge that participation in camp activities
involves risk of injury. I fully appreciate the risks involved in my camper’s participation in these
activities and voluntarily assume, on the camper’s behalf, those risks.
PROMISE TO DEFEND, IDEMNIFY, AND HOLD HARMLESS: In consideration of the above camper being
permitted to participate in Little Learners camp, I agree to defend, indemnify, and hold harmless the Releasees
from and against all claims arising out of the camper’s participation in the camp.
EMERGENCY TREATMENT: I hereby consent to allowing emergency medical personnel to be summoned for the
camper if needed and consent to emergency treatment of the camper as may be required as the result of accidental
injury or otherwise. I further agree to pay any and all costs incurred for such treatment.
PHOTOGRAPHS: I agree to allow the camper to be photographed while participating in camp
activities and understand that Little Learners and the City retain the right to use any photographs taken during camp
activities for promotional and other purposes.

I HAVE READ THIS AGREEMENT AND UNDERSTAND IT INCLUDES A RELEASE OF ALL CLAIMS, VOLUNTARY
ASSUMPTION OF ALL RISKS INVOLVED IN CAMP ATTENDANCE AND AN AGREEMENT TO DEFEND, INDEMNIFY AND
HOLD HARMLESS THE RELEASEES. BY SIGNING THIS AGREEMENT I VOLUNTARILLY ACCEPT ALL OF THE TERMS AND
CONDITIONS OF THIS AGREEMENT.

PARENT OR LEGAL GUARDIANS SIGNATURE

PARENT OR LEGAL GUARDIANS PRINTED NAME

RELATIONSHIP TO CAMPER

DATE
 Camp Calabasas Teen Camp 2018 Waivers

Water Waiver/Permission Form

The Teen Program will be going to the beach and swimming along with taking trips to water parks on specific
trip days. Transportation will be provided by the City of Calabasas. I understand that there will be a
lifeguard on duty at all times at the water parks and at the beach. I hereby give permission for my child to
swim and participate in water activities. I also understand that if I wish for my child not to swim that I will
verbally notify the staff in charge and indicate their ability below. If I wish for my child to
participate I understand that they will need to bring their own swimsuit, towel, and sunscreen.

____________________________________________ ___________ Knows how to swim?

Teens Name Age Y N

City of Calabasas Indemnification

The undersigned hereby agrees to defend, indemnify, and hold harmless the City of Calabasas and its
officers, employees and agents against any loss, liability charges and expenses (including
attorneys’ fees) and costs which may arise by reason of participation in any program. (The City does not
provide accidents, medical, liability, workers’ compensation insurance for program participants). As parent/
guardian, I hereby consent to emergency treatment of my minor child as a result of accident or injury. I
further agree to pay any and all costs incurred as a result of said treatment. I agree to carefully inspect and
satisfy for me that the facilities provided are reasonably safe for their use. Once having conducted the in-
spection, I agree to expressly assume the risk of participating at the premises. I understand the City retains
the right to use photos taken during activities for public purposes.

Parent Signature:_________________________________________ Date:_____________

MOVIE RATING WAIVER

By initialing next to the rating I give my child permission to see the movies with a rating of:

G_________ PG_________ PG-13_________

Please call me once the movie is decided upon to give verbal permission for the said movie.__________

Parent Signature:_________________________________________ Date:_____________

PERMISSION TO APPLY SUNSCREEN

By initialing below I give permission to Little Learners/Camp Calabasas Staff to
apply SUNSCREEN to my CAMPER as needed.

YES____________ NO___________
 TEEN CAMP 2018 ADMISSION AGREEMENT AND IMPORTANT INFORMATION

Registration: There are three easy ways to register. You can mail-in, walk-in or fax-in the registration forms.
Payments are to be made out to LITTLE LEARNERS

Fees: Includes field trips admission, transportation, and activities listed on the calendar. Lunch is not provided unless stated on
the calendar. If going to a shopping center teens may bring money to shop and for additional food.

Payments: All payments to Little Learners must be made by credit card, by check: payable to Little Learners, money order or
cash. Checks returned to us for NSF or any other reason will be required to replaced with cash or a credit card. A fee of $25 will
also be charged for any returned check.

Camp Times: Teen Camp times are listed on the calendar. They will be departing very close to the time listed. For the movie
days the time of departure might vary weekly as we don’t know movie show times until the week before. There is free early care
starting at 7am and late care until 6:30pm for those needing their children to be on the premises for a full day. Parents running
late will be charged $1.00/minute and it must be paid to the supervising counselor, for every minute that you are late and for
every child.

What to Bring: Teens may bring a sack lunch with a drink each day they attend camp unless they plan on purchasing lunch at
their specific destination. Specific water and amusement parks do not permit outside food/drink unless a doctors note is given to
the head of security stating what the restrictions are and why outside food needs to be brought in. Magic Mountain, Hurricane
Harbor, Knott’s Berry Farm, Soak City, Raging Waters and Universal Studios are just a few that give us warning in advance that no
outside food/beverage is permitted. We recommend packing water and sunscreen for your child on a daily basis. BEACH DAYS:
Please send SPRAY sun screen for your camper as it is easier to apply when they are wet or have sand on their bodies. Sack lunch-
es and snacks can be sent or food can be purchased at the snack shack. Camp will send a snack and water to the beach for each
camper but please pack additional beverages.

Info: All refunds and cancellations of days must have FIVE BUSINESS DAYS NOTICE prior to the sessions start date. Excessive
changes will result in an administrative fee of $10.00. There will be no refunds and transfers due to illness or non-attendance for
registered days. You are financially responsible for all days registered unless we are notified via email or in writing about such
changes. If you email us we will respond letting you know we received your notice. Everything must be put in writing to make
changes and all of our staff and park staff know this policy so you won’t be told differently by asking a different staff member. For
those who do not register in advance please be advised that we might not have spots for all of the drop-in’s. If you know your
child wants to attend a specific trip you must pre-pay to hold your spot. Due to the nature of our reservations and transportation
only being able to take a certain number of campers. Making-up or transferring missing days is not permitted regardless of the
circumstances (including illness).

Space: We have limited space for this program. If a camper isn’t on our shuttle/bus they are not considered part of the teen
program. Campers may not be dropped off at the field trip site to meet up with or hang out with camp as we would not be
responsible for them in case of emergency/evacuation. Please make responsible choices for your child as we can not anticipate
emergency situations and are not able to take action for those who are not properly registered. Campers who do not arrive on
time also may not be driven to the camp location to meet up with camp even if there is space still available.

Sign In/Out: Teens arriving and departing camp must be signed in and out on a daily basis

Discipline: We strive to provide a well-rounded and safe program for all participants. Discipline will be handled in the following
manner and depending on the infraction: (1) Child will be spoken to and will be given a warning (2) Child will be suspended from
the program (3) Child won’t be permitted to enroll in the program.

Dismissal Policy: Expulsion from the Camp Calabasas and Little Learners Program results from one or more of the following
situations or at for any other reason at the digression of the camp director: (1) Physically or verbally abusing another participant
(including using inappropriate language), (2) Refusal to correct documented problematic behavior, (3) Theft, (4) Parent Payment
Negligence, (5) Excessive late pick-up from camp past closing time, (6) Misusing technology (texting people inappropriate sayings,
etc.), (7) Disturbing drivers of busses by not following rules set by driver and bus company (8) Bullying or making threats to
another camper on social media sites that stems from interactions at camp (9) Using of social media to bully or rally in a negative
manner against another participant or one of our camp staff members. (10) Being talked to by security or personnel at one at one
of our trip sites.
 TEEN CAMP 2018 ADMISSION AGREEMENT AND IMPORTANT INFORMATION

TEEN CAMP 2018 ADMISSION AGREEMENT ACKNOWLEDGEMENT SIGNATURE PORTION MUST BE RETURNED TO
CAMP CALABASAS PRIOR TO YOUR CHILD ATTENDING. I HAVE READ AND AGREE TO ABIDE BY THE ADMISSION
AGREEMENT POLICIES STATED ABOVE AND OTHER PROCEDURES SET FORTH BY THE CITY OF CALABASAS AND LITTLE
LEARNERS, LLC AND UNDERSTAND THE PAYMENT/CANCELLATION POLICIES.

****************************************************************************************************

Child’s Name:_______________________________________________________________________

Parent’s Signature :___________________________________________________________________Date:_______________

Parents Printed Name:_______________________________________________________________________

 Summer 2018 Swimming/Water Field Trip
Permission Slip & Waiver and Release

Name of Child (please print): ___________________________________________________

Name of Parent/Guardian: _____________________________________________________

Swimming and/or water related activities are one of the optional activities available to campers enrolled in our summer camp programs.
Certain field trips (dependent on age group) also include outings to water parks and the beach. Each location has lifeguards and/or other safety
personnel on duty provided by the facilities. Example facilities include but are not limited to:
the Calabasas Tennis and Swim Center, Lake Casitas Water Park, Soak City Water Park, Hurricane Harbor Water Park, Raging Waters, LA
County Beaches and in water play during campers’ time at DeAnza Park.

Before the child of whom you are the parent/guardian can participate in these types of field trips involving swimming and/or water related
activities, you, the parent/guardian, must complete and sign this Summer 2018 Field Trip Permission Slip & Waiver and Release. This form
must be completed, signed, and returned to Little Learners before the day of the field trip. Failure to complete this form before the day of the
field trip, will result in the child of whom you are the parent/guardian to remain onsite at camp where they will join a group close to his/her age
for an alternate activity if that is an option/or else they will need to be picked up before such excursions.

WAIVER AND RELEASE

By indicating your acceptance, you understand, agree, warrant and covenant as follows: In consideration of the opportunity for the child of
whom I am the parent/guardian to be a participant in Little Learners’ swimming/water related field trips, I hereby freely and voluntarily agree
to the following representations, waivers, and agreements:

I do hereby for myself and my dependents, heirs, executors, administrators, agents and assigns, agree to waive, hold harmless, indemnify,
covenant not to sue, release and forever discharge Little Learners and its officers, employees, members, agents, successors and assigns
(“Releasees”) for and from any and all responsibility, liability, and causes of actions, claims, and/or damages whatsoever which I or the child
of whom I am the parent/guardian or those claiming under may have, suffer, or incur now or in the future resulting from or arising out of
participation in said trip/activity/outing and any direct or indirect event and occurrences in connection therewith occurring before, during and/
or after said trip/activity/outing, including but not limited to claims for death, personal injury, property damage, or loss.

I further agree to indemnify and hold harmless said Releasees of and from all liabilities described about, arising out of or connected with the
participation of the child of whom I am the parent/guardian in said swimming and/or water related field trips, including any claims of third
persons, relating to the matters, whether by subrogation, right of recovery or otherwise.

Severability. I further expressly agree that this Waiver and Release is intended to be as broad and inclusive as is permitted by the laws of the
State of California and that if any provision of this Waiver and Release shall be found to be unlawful, void, or for any reason unenforceable,
then that provision shall be deemed severable from this Waiver and Release and shall not affect the validity and enforceability of any
remaining provisions.

By indicating your acceptance and grant of permission for the child of whom you are the parent/guardian to participate in swimming and/or
water related field trips, you are affirming that you have read and understand this document. You understand that you are giving up substantial
rights, including the right to sue and any rights of recovery and/or subrogation.

Please read any waiver carefully. It includes a release of liability and waiver of legal rights and deprives you of the ability to sue certain
parties and/or for third party recovery of amounts paid on your behalf. Do not sign this document unless you have read and understood it in its
entirety.. You also understand and agree that swimming and/or water related activities carry certain inherent dangers and risks which may or
may not be readily foreseeable, including without limitation personal injury, property damage or death. Your child’s ability to participate in the
activities is/are subject to your agreement to waiving such rights.

Swim/Water Activities Permission – I understand that swimming and/or water activities are a part of the field trip. My child’s swimming
ability is (check one): Beginner _____ Intermediate _____ Advanced _____

By signing below, I, the undersigned, acknowledge that I have read the above and willingly consent to allow participation of the child of whom
I am the parent/guardian under the above stated conditions.

Signature of Parent/Guardian: _____________________________________________________________________________

Date of Signature: ____________________________________________________________

 LITTLE LEARNERS/CAMP CALABASAS
SUMMER CAMP 2018 CREDIT CARD FORM

I, __________________________________________, hereby authorize

Little Learners to automatically charge my Credit Card/Process for Summer Camp fees.

Participants Name:___________________________________

Fees: (Please circle one) $________________ (one time use) OR

_______By initialing I’m authorizing reoccurring camp fees based on registration

Card Number:___________________________________________________

Expiration Date: _________________________ CVV:________________

Name that appears on card: ________________________________________

Billing Address: _________________________________________________

_________________________________________________

Authorized Signature: __________________________Date ______________