Winter Mini Camp 2024

Children with ASD, ADHD, ADD and learning exceptionalities welcomed.
Included: Swimming, Sports and Recreation Time.

Camp Dates: December 23, 24, 26 and 27 (No camp the 25th)

Camp Times: Half Day- 9 am - 11:30 am OR 11:30 am - 2:00 pm
Full Day- 9 am - 2 pm
Camp Fees (each week): Half Day- $200
Full Day- $250, Daily Rate- $75

Campers must bring swimming attire, change of clothes, flip flops and shoes, towel, snacks, lunch and water bottle.

* Parent's First Name

Parent's Last Name

* First Name of Participant

* Last Name of Participant

* Participant's DOB

* Email

Home Phone

* Cell Phone

* Address

* City

* State

* Zip

* Name of School:

* Any medical problems, allergies OR any situation/problem do we need to be aware of?

Diagnosis:

Referred by?

FULL DAY PROGRAM

9:00 am - 2:00 pm

Full Day- Choose your Program

All Week, Full Day - 9am - 2pm $250Monday Only, Full Day - 9am - 2pm $75Tuesday Only, Full Day - 9am - 2pm $75Thursday Only, Full Day - 9am - 2pm $75Friday Only, Full Day - 9am - 2pm $75

HALF DAY PROGRAM

9:00 am - 11:30 am OR 11:30 am - 2:00 pm

Half Day- 9am - 11:30am: Choose your Program

All Week, Half Day- 9am - 11:30am $200Monday Only, Half Day - 9am - 11:30am $60Tuesday Only, Half Day - 9am - 11:30am $60Thursday Only, Half Day - 9am - 11:30am $60Friday Only, Half Day - 9am - 11:30am $60

Half Day- 11:30pm - 2pm: Choose your Program

All Week, Half Day- 11:30am - 2pm $200Monday Only, Half Day - 11:30am - 2pm $60Tuesday Only, Half Day - 11:30am - 2pm $60Thursday Only, Half Day - 11:30am - 2pm $60Friday Only, Half Day - 11:30am - 2pm $60

Total Due

Maintain Consistency: The most important key to yours or your child's success is consistency. Regular attendance is essential. Whenever possible, take time to practice the skills we teach in class at home.

Communication: Communication is essential. If you have any concern or problem, please email Claudia immediately so we can give you the attention that you deserve. The participant's development is our top priority.

Cancelation: If you need to cancel for any reason, a 24-hour notice is required without charge. Should weather be a factor, you will be contacted at least 30 minutes prior to the start of class.

Swim Waiver

NOTICE: PLEASE READ THE FOLLOWING LANGUAGE CAREFULLY BEFORE SIGNING THIS AGREEMENT

WAIVER AND RELEASE OF LIABILITY Swimming Program

1. Assumption of Risk: I understand that swimming and/or using a pool involve certain inherent risks, including but not limited to, the risk of injury, illness, or even death. I acknowledge that I have been informed of these risks and voluntarily assume all risks associated with participating in the Swimming Program.

2. Health and Fitness: I certify that I am physically and mentally capable of participating in the Swimming Program. I have consulted with my healthcare provider and have received medical clearance to engage in swimming activities. I understand that it is my responsibility to inform the Swimming Program organizers of any changes in my health or fitness that may affect my ability to participate safely.

3. Release of Liability: I agree that TBAM, its directors, officers, employees, volunteers, and agents shall not be responsible for injury, death or property loss or damage which may directly or indirectly result from my participation in the Swimming Program or use of the pool for any reason, including negligence on the part of TBAM. I hereby expressly release, discharge, and hold harmless TBAM, its directors, officers, employees, volunteers, and agents from any and all claims, demands, causes of action, liabilities, costs, or expenses, including attorneys’ fees, arising out of or related to any injury, illness, or damage that may occur as a result of my participation in the Swimming Program and/or use of the pool, including the negligence of TBAM.

4. Indemnification: I agree to indemnify and hold harmless TBAM, its directors, officers, employees, volunteers, and agents from any and all claims, demands, causes of action, liabilities, costs, or expenses, including attorney fees, arising out of or related to my participation in the Swimming Program.

I hereby expressly agree that this Waiver and Release of Liability is intended to be as broad and inclusive as permitted by the laws of the State of Florida and that if any portion hereof is held invalid, the remainder of the Waiver and Release will continue in full force and effect. I further agree that the venue for any legal proceeding shall be Miami-Dade County, Florida.

5. Photographic Release: I grant TBAM, the right to take photographs or videos of me during the swimming program. I understand that these images may be used for promotional purposes, including but not limited to, brochures, websites, social media, and other marketing materials. 6. Emergency Medical Treatment: In the event of an emergency, I authorize TBAM and its representatives to seek and provide necessary medical treatment, including but not limited to, first aid, CPR, and calling emergency medical services. I have carefully read and fully understand the contents of this Waiver and Release of Liability. I am aware that by signing this document, I am waiving certain legal rights that I or my heirs, executors, administrators, and assigns may have against TBAM. I voluntarily sign this Waiver and Release of Liability, intending to be legally bound by its terms.

BY SIGNING BELOW, I hereby acknowledge that I am voluntarily participating in the swimming program, organized by Temple Beth Am (TBAM) and conducted by Movement Works (“Swimming Program”). In consideration of being allowed to participate in this program, I agree to the following terms and conditions.

* Full Name:

I hereby acknowledge that I am voluntarily participating in the swimming program, organized by Temple Beth Am (TBAM) and conducted by Movement Works (“Swimming Program”). In consideration of being allowed to participate in this program, I agree to the following terms and conditions.

Date:

Aquatics Program- Winter Mini Camp 2024