Medford Community Schools is offering their popular summer vacation camp at the Columbus Elementary School with Director

Anthony Petrelis and Staff. Your child will participate in a number of activities from Sports, Games, Arts & Crafts, Movies, Swimming, and much more! Doors Open/Drop-Off at 7:30 Doors Close/Pick-Up at 4:30 Now offering extended day hour till 5:30 - $15/hour or $50 for whole week
Campers Need: Sneakers Sandals (for pool only) Towel Bathing Suit Sunscreen Snack Lunch Water Bottle Any medications - to be given by licensed EMT

***Breakfast is provided everyday and Pizza Day is every Friday for lunch***

Summer Schedule
Week 1: June 30 July 3 Week 2: July7 11 Week 3: July14 18 Week 4: July 21 25 Week 5: July 28 Aug 1 Week6: Aug 4-8 Week 7: Aug 11 15 Week 8: Aug 18 22

EVENT DATES TBD Curious Creatures Magic Jim Rainho Police k-9 Unit Annual Noreen Oconnor Dodgeball Game Tie-Dye T-Shirts End of Yr. Carnival

Schedule subject to change Every Friday Weekly group Talent Show after Pizza and DJ Party.For
further information or to enroll, contact the Medford Community Schools office at 781-393-2380 or email summerfun@medford.k12.ma.us

****Price $135 per week**** For further information or to enroll, contact the Medford Community Schools office at 781-393-2380 or email summerfun@medford.k12.ma.us), or send check or money order to: Medford Community Schools, 489 Winthrop Street, Medford, MA 02155

Child's Name

Age

Child's Name

Age

Street Address City, State, Zip

Home Phone

Cell Phone

Parent's Name

Emergency Contact Phone

Email Address: Check which week(s) you would like your child to attend:

Payment (s)Received Week 1: June 30- Jul 3 Week 2: July 7-11 Week 3: July 14-18 Week 4: July 21-25 Week 5: Jul 28-Aug 1 Week 6: Aug 4-8 Week 7: Aug 11 - 15 Week 8: Aug 18 -22

Date

I/We ___________________________________________________________________________ parent/guardian o f_________________________________________________________________, minor, do hereby consent to his/her participation in the Medford Community School Program and do forever release, acquit, discharge and covenant to hold harmless the City of Medford and its successors, employees, servants, and officers from any and all actions, causes of actions, and claims, demands, damages, costs, on account of, or in any way growing out of, directly or indirectly, all known and unknown personal injuries or property damage which I/We may have now or hereafter may have, including all claims or right of action for damages which said minor has or hereafter may acquire, either before or after reaching majority resulting from his/her participation in the Medford Community School Program and/or receiving medical attention as provided herein. Furthermore, I/We hereby agree to indemnify, reimburse or make good to the City of Medford or its successors, employees, agents, servants, and officers any loss or damage or costs, including attorneys fees the city or its representatives may incur if any litigation arises from said minors intentional, gross negligent, or reckless acts or omissions while participating in said programs. I/We understand that this program involves physical activity and hereby state that to my/our knowledge such minor is in proper physical condition for participation in said program. I/We also agree to provide such minor with all the proper and required equipment to participate in such programs. In the event of an emergency requiring medical attention beyond first aid, I/We hereby grant permission to a physician or hospital personnel designated by the Medford Community Schools Program to attend to such minor. I have fully read and understand the terms of this release and waiver. Signature __________________________________________________ Date ____________________________

Must be signed by a parent/guardian to participate