February 2011 School-Age Vacation Day Schedule

Monday, February 21^st – Mr. Twisty Magic Show – See this wonderful magician at the JCC who has been wowing audiences for years!

Tuesday, February 22^nd – Indoor Water Park – Have a great time at this awesome indoor water park, which includes a lazy river and a water slide.

Wednesday, February 23^rd – Gnomeo & Juliet  See this wonderful cartoon remake of the classic play, Romeo & Juliet.

Thursday, February 24^th – Empire State Aerosciences Museum - Have a great time seeing all the amazing airplanes, and then ride the spectacular simulator ride.

Friday, February 25^th – Bouncy Bounce Day - Have a blast bouncing with your friends in the Gym on some super cool bouncy bounces!

*Travel time is included in the trip times listed*

Please be sure to pack a lunch (that does not need to be heated) for your child, a swimsuit & towel, and appropriate clothing for outside.  Cost for the program is $49 per day/per child. The program will run each day from 7:00 am to 6:00 pm.

Children are not allowed to use the vending machines or purchase any items on the trips.  Please submit this form to your site director or to the JCC by Wednesday, February 16^th.

Any late registrations will only be accepted at the discretion of the School Age Director.  There will be an extra $8 fee per day, per child for any late registrants.  Please call Andy Katz at the JCC with any questions at 377-8803.

There will be no refunds given for unused vacation days.

February 2011 School-Age Vacation Days

Child's Name __________________________________________

Parent's Name _________________________________________

Days Attending:

Mon 21^st  ___   Tue 22^nd ____

Wed 23^rd ____  Thur 24^th ____    Fri 25^th ____

ADDRESS: ___________________________________________________

GENDER: ______GRADE:_____ BIRTH DATE:___/___/____

HOME PHONE: __________________ CELL PHONE: ______________

PLEASE LIST, IN ORDER, ALL PEOPLE TO CALL IN CASE OF EMERGENCY (STARTING WITH YOURSELF):

1.___________________________________            ________________      

            NAME                                                      DAY PHONE                   RELATIONSHIP_______________________________

2.____________________________________           _______________      

         NAME                                                         DAY PHONE             

 RELATIONSHIP ______________________________

3.____________________________________            _______________        

         NAME                                                          DAY PHONE                   RELATIONSHIP________________________________

THE PEOPLE LISTED ABOVE MAY PICK UP YOUR CHILD

PHYSICIAN'S NAME: ____________________ PHONE: ___________

MEDICAL PROBLEMS/ALLERGIES/SPECIAL INFO:

__________________________________________________

Estimated Drop-0ff Time: _________

Estimated Pick-Up Time: _________

I GIVE PERMISSION FOR MY CHILD TO ATTEND THE ABOVE TRIPS.  IN CASE OF ACCIDENT OR INJURY, EMERGENCY CARE MAY BE GIVEN.

_____________   ______________________        _______

Printed Name            Signature of person legally responsible   Date