Camp Achieve Registration 2019 Forms

  • Camp Achieve Registration

     
     

     
     

     

     

    Dear Parents:

     

    Your child has been recommended to attend Camp Achieve, our extended school year program for classified students. For all students from preschool through grade 8, Camp Achieve starts on July 8th and ends on August 8th. There is no school on Fridays.

     

    If your child is a preschooler, they will attend camp from 8:30 to 11:00 a.m., Monday through Thursday. All other children in kindergarten through grade 8 will attend from 8:30 to 1:00. Transportation is provided for all of our Camp Achievers.

     

    It is now time to register your child for Camp Achieve.  Below is the registration/health form for you to complete. Kindly return it to Chester Student Services, 250 Rt. 24, Dickerson School, Chester, N.J. 07930.

     

    It is very important that you indicate whether or not your child will need transportation, so that we can plan accordingly. The registration form should be returned no later than May 1st, 2019. If you have any questions, please do not hesitate to call your child’s case manager or me at 908-879-6004.

     

     

    Sincerely,

     

    Dr. Jeanette Krone

      

    Dr. Jeanette Krone

    Director of Student Services

     

     

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    CAMP ACHIEVE

    REGISTRATION AND HEALTH INFORMATION

    SUMMER 2019

     

    Student’s Last Name_________________First Name ___________­­­­­­­­­­­­­__

     

    Current Age_______ Current Grade _____Birthdate__________

     

    Parent’s Name: _________________________________

    Address: ________________________________________________

    Home Phone#:_______________________

     

    E-mail address: _________________Cell Phone #:_______________

     

    Transportation ________ yes _________no

     

    Please list two neighbors or nearby relatives who will assume temporary care for your child if you cannot be reached:

    Name______________________Address____________Phone#__________

    Name______________________Address____________Phone#__________

     

    In case of a medical emergency, we will immediately call you and the Chester Rescue squad.

     

    To ensure the health and safety of all students, our summer school nurse, needs the following information about your child.

     

    PERMISSION FOR MEDICAL TREATMENT AND TRANSPORTATION TO THE HOSPITAL

     

    I hereby give permission for my child to be transported by emergency vehicle to a nearby hospital and given whatever aid is necessary.

     

    Signature of Parent/Guardian________________ Date: _____________

     

    Please indicate below a person to call if you cannot be reached in the event of an emergency:

     Name: ____________________ Phone #: _________________________

     

    Allergies and/or special needs: __________________________________

    Date of last tetanus booster: ___________

    List any current medication your child is prescribed: _______________

    Kindly indicate if your child will need this medication during Camp Achieve: ___yes __ no

    (Please provide the nurse with the medication and a doctor's note on the first day of Camp Achieve.) 

               

     

     

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