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MIAMI BEACH JCC

201 9

-2020

SCHOOL DAYS OUT

School Days Out are offered with Miami-Dade County public school closings. K - 5th grade students will enjoy activities such as art, cooking, science, sports, games, swim and more!

WHAT TO BRING:

Fun Programing from 9 am- 4 pm.

Kosher lunch and snacks will be provided daily.

Pre-care is available at 8 am and Post-care is available until 5 pm for an additional fee.

SCHEDULE

Friday, October 25 • Teacher Work Day Monday, November 4 • Teacher Work Day Monday, November 11 • Veteran’s Day Monday, January 21 • Martin Luther King, Jr. Day Monday, February 17 • Presidents Day Friday, April 10 • Teacher Work Day FOR MORE INFORMATION: JENNY MERMELSZTEYN Director of Camping & Children/Family Programs  jenny@mbjcc.org | x210

NICOLE GOLDSTEIN After-School Program Coordinator  nicole@mbjcc.org | x204

Send your child with a swimsuit, towel, flip-flops and sunscreen.

FOOD PROVIDED: GENERAL CAMP FEES: Pre-registration: $65 | Members: $50 Day of: $70 | Members: $55 SPORTS CAMP FEES: Pre-registration: $75 | Members: $60 Day of: $80 | Members: $65 PRE-CARE: $10 | Members: $5

POST-CARE: $10 | Members: $5

No refunds or credits for missed days. Cancellations required 24 hours in advance for a refund.

 TO REGISTER GO TO MBJCC.ORG OR CONTACT REGISTER@MBJCC.ORG

 4221 Pine Tree Drive, Miami Beach FL 33140 |  (305) 534-3206 |  mbjcc.org Updated 9/5/19


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SCHOOL DAYS OUT 2019- 2020 Registration Form

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MEMBER*:  Yes

REGISTRATION DATE:_____________

 No

PARTICIPANT INFORMATION Last Name _________________________

First Name ___________________

School _____________________________

Gender_____

Birthday (Mo/Day/Yr) ___/___/___

Grade ________________________

Allergies or Diet Restriction ___________________________________________

Medications ______________________________________

FAMILY INFORMATION  Address__________________________________________________

City, State, Zip __________________________________________

 Cell _______________________________________

 Home/Work Phone ___________________________________

Parent/Guardian Information 1  Full Name __________________________________________________

 Email ________________________________________________

 Cell ________________________________________________________

 Home/Work Phone ___________________________________

Parent/Guardian Information 2  Full Name __________________________________________________

 Email ___________________________________________

 Cell ________________________________________________________

 Home/Work Phone ___________________________________

EMERGENCY & PICKUP AUTHORIZATION CONTACTS Please provide three additional people who have authority to make all decisions regarding your child(ren) if we are unable to reach a parent/guardian as well as a list of people who are authorized to pick up your child(ren) from the MBJCC. In the event of an emergency, we will attempt to contact a parent/ guardian first. Please notify the MBJCC of any pick-up changes for the day if applicable. Please note proper identification will be required for anyone picking up your child(ren).

 Full Name ___________________________________________

Relation __________________________________

 Cell _________________________________________________

 Other Phone ____________________________

 Full Name ___________________________________________

Relation __________________________________

 Cell _________________________________________________

 Other Phone ____________________________

EMERGENCY PICKUP









DAYS  October 25

 November 4

 November 11

 Pre-care |  Post-care

 Pre-care |  Post-care

 Pre-care |  Post-care

 January 21  Pre-care |  Post-care

 February 17  Pre-care |  Post-care

 April 1  Pre-care |  Post-care

PAYMENT INFORMATION School Days Out Daily Fee Total: __________________________

GENERAL CAMP - Daily Fee: $65 | Member: $50 | Day of Fee: $70 | Member: $55

School Days Out Pre- Care Daily Fee Total: ________________

SPORTS CAMP - Daily Fee: $75 | Member: $60 | Day of Fee: $80 | Member: $65

School Days Out Post- Care Daily Fee Total: ________________

(8 - 9 am) Daily Rate: $10 | Members: $5 | (4 - 5 pm) Daily Rate: $10 | Members: $5

Total: ________________ Payment Type:



Credit Card Type:  









(Payable to MBJCC)

 Card on File

Name on Card __________________________________________  Authorized Signature __________________________________

Credit Card # ______________________________________________ CVV # _____________

Exp. Date ____________

PARENT/GUARDIAN ACKNOWLEDGMENTS DISCIPLINE & CHILD BEHAVIOR: The MBJCC should be made aware in writing of any special needs or limitations a child may have. In the event our staff sees your child is having difficulty with the structure that we provide, we will notify you and discuss the implementation of behavior modification programs with staff and your child. After implementing behavioral programs, if your child continues to experience difficulty, we will recommend other appropriate alternatives. HEALTH AND SAFETY: The Parent or Guardian certifies that the child is healthy and able to participate in all School Days Out activities at the time of application. Updated school health forms are required prior to the start of the program. Parent/guardian gives permission to secure proper medical treatment in case of an emergency, when parent/guardian can not be reached. FIELD TRIPS AND ACTIVITIES: Permission is hereby granted for the child to participate in all field trips and activities. The MBJCC has the right to change the dates and locations of field trips as necessary. PUBLICITY: The MBJCC reserves the right to use photographs and/or videos of my child for publicity purposes in all media including the MBJCC website and all social media.

 Parent/Guardian Signature ______________________________________________________

Date _________________

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