No School Day Camp Registration for Alchemy Academy

Open to students in 5th - 8th grade
Date: May 10, 2024
Serving: St. Mary's and ECC Schools
Location: St. Mary's - Community Education Center
Time: 8 am - 3 pm
Camp Description: Alchemy Academy is a thrilling one-day adventure designed to ignite curiosity and foster a love for chemistry! This immersive day camp is perfect for aspiring chemists eager to dive into the world of atoms, reactions, and scientific discovery. During this one day camp we will be doing different hands-on chemistry experiments!


Cost: $20 per camper
Note: Scholarships are available, please contact Kaitlyn Goode (kaitlyn@communityedcenter.com) for more info.
Please send a bagged lunch with your child!

Questions, contact:
Kaitlyn Goode
kaitlyn@communityedcenter.com
814-781-3437

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* 1. Child's Name

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* 2. Child's Age

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* 3. Child's Grade

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* 4. Parent/Guardian's Name

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* 6. Parent/Guardian's Phone Number

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* 7. Address

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* 8. Emergency Contact One: Name

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* 9. Emergency Contact One: Phone Number

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* 10. Emergency Contact One: Relation to Child

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* 11. Emergency Contact Two: Name

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* 12. Emergency Contact Two: Phone Number

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* 13. Emergency Contact Two: Relation to Child

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* 14. Please list any medical problems, including any requiring maintenance medication (i.e. Diabetic, Asthma, Seizures).

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* 15. Is your child presently being treated for an injury or sickness, or taking any form of medication for any reason?

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* 16. Is your child allergic to any type of food or medication?

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* 17. Photo Release Consent

I hereby give permission for my child to be photographed during the Summer MINI STEM Camp. I understand the photos will be used to keep a journal of activities, to share during power point presentations and/or reports and for promotional purposes including flyers, brochures, newspaper and on the internet.  I understand that although my child’s photograph may be used for advertising, his or her identity will not be disclosed, I do not expect compensation and that all photos are the property of the Community Education Center for Elk and Cameron Counties.

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* 18. Participation Consent

I, the parent/guardian, herby release discharge, indemnify, hold harmless and defend The Community Education Center for Elk and Cameron Counties, officers, employees and servants from any and all liability (claims, demands, losses, causes of action, suits, judgements) of any kind that I or my family may have against The Community Education Center for Elk and Cameron Counties due to death, personal injury or illness, loss or damage to property, or future causes that occur during the 2023 Summer Camp Program.  In the event of any medical emergency, I authorize and consent for The Community Education Center for Elk and Cameron Counties and co-organizers to act on my behalf for medical care deemed necessary for the participant.

I understand The Community Education Center for Elk and Cameron Counties is not responsible for lost or damaged personal property, all scheduled events are subject to change and children's photos and quotes may be used for publicity purposes.

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* 19. Rules and Regulations      

  • Campers must be at camp from designated time unless the program manager is instructed by the parent.
  • Campers are expected to be respectful and courteous to all campers, staff, speakers and guests.
  • Absolutely no physical or verbal altercations with fellow campers or staff. Fighting, the use of offensive language or any other inappropriate behavior will not be tolerated, and the camper’s parent will be notified immediately.
  • Bullying of any kind will not be tolerated. This includes any intentional written, verbal, or physical act intended to harm another camper.
  • Shorts must be an appropriate length, and shirts or tank tops must be modest. Activities will be held both indoor and outdoor (if weather permits). It is recommended that your child dress appropriately.
  • All apparel may not have inappropriate language or graphics on them.
  • All campers must sign in and out with a counselor before leaving.
  • Cell phones, I-Pods, I-Pads, or other electronic devices are not allowed during camp hours, but may be used during breaks, lunch and bus rides. Use of cell phones during manufacturing tours is strictly prohibited.  The Community Education Center for Elk and Cameron Counties are not responsible for lost or stolen electronics.
  • The Community Education Center for Elk and Cameron Counties is not responsible for any lost or stolen items.
Consequences:

A zero tolerance policy is enforced in regard to bullying as well as other acts of aggression. Fighting, hitting, or physical altercations of any kind will result in the camper/campers being separated and removed from the camp group until a parent or guardian can pick them up, a refund will not be given.

I realize that the staff in charge will exercise precaution for the safety of youth involved in these events, and I agree to assume full responsibility for any unforeseen accident which might occur during travel or while participating in this program. I further assure that my son/daughter has been instructed to comply with the regulations of the camp and/or chaperones who are in charge of the activity.

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* 20. Please pay $20 cash or check to the Community Education Center.

You may drop it off at the Community Education Center at 4 Erie Ave St. Mary's, PA or you may send payment with your child on the day of camp.

If you would like to pay online, please follow the link below [Please note online payments are subjected to a 3% surcharge!]:

St. Mary's Payment Link: https://link.clover.com/urlshortener/bKcK3v

Johnsonburg Payment Link: https://link.clover.com/urlshortener/NXGGjJ

Please let me know if you are paying with cash/check or online for reimbursement reasons?

Paying Cash/Check or Online?

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