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2024 Kids Camp Registration Form

Child/Children's Statement of Health Status for Enrollment in a Child Care Facility

Child #1 First Name:

Child #1 Last Name: Sex:

Address, City, Zip:

Child's Birthday: Age:

Past illness- Please check all that apply and give approximate dates.

Chicken Pox Hepatitis Rubella

Rheumatic Fever Asthma Hay Fever

Diabetes Mumps Epilepsy

Whooping Cough Poliomyelitis Other

Comments:

Surgery/Accidents/illnesses/Chronic Health Problems:

Describe any physical conditions requiring the facilities special attention:

Medication(s) prescribed:

Allergies and prescribed routine:

Are there activities that you prefer that your child NOT participate in?

Date of most recent examination of this child by a physician

Immunization Records and Dr.'s Health Note must be submitted to Impact Sports before first day of camp.

CAMP T-SHIRT SIZE

Youth Small Adult Small

Youth Medium Adult Medium

Youth Large Adult Large

Youth Extra Large

____________________________________________________________________________________________

Child #2 First Name:

Child #2 Last Name:

Sex:

Child #2 Birthday:

Age:

Child #2 Past illness- Please check all that apply and give approximate dates.

Chicken Pox Hepatitis Rubella

Rheumatic Fever Asthma Hay Fever

Diabetes Mumps Epilepsy

Whooping Cough Poliomyelitis Other

Comments:

Surgery/Accidents/illnesses/Chronic Health Problems:

Describe any physical conditions requiring the facilities special attention:

Medication(s) prescribed:

Allergies and prescribed routine:

Are there activities that you prefer that your child NOT participate in?

Child #2 Date of most recent examination of this child by a physician

Immunization Records and Dr.'s Health Note must be submitted to Impact Sports before first day of camp.

Child #2 CAMP T-SHIRT SIZE

Youth Small Adult Small

Youth Medium Adult Medium

Youth Large Adult Large

Youth Extra Large

____________________________________________________________________________________________

Child #3 First Name:

Child #3 Last Name:

Sex:

Child #3 Birthday:

Age:

Child #3 Past illness- Please check all that apply and give approximate dates.

Chicken Pox Hepatitis Rubella

Rheumatic Fever Asthma Hay Fever

Diabetes Mumps Epilepsy

Whooping Cough Poliomyelitis Other

Comments:

Surgery/Accidents/illnesses/Chronic Health Problems:

Describe any physical conditions requiring the facilities special attention:

Medication(s) prescribed:

Allergies and prescribed routine:

Are there activities that you prefer that your child NOT participate in?

Date of most recent examination of this child by a physician

Immunization Records and Dr.'s Health Note must be submitted to Impact Sports before first day of camp.

Child #3 CAMP T-SHIRT SIZE

Youth Small Adult Small

Youth Medium Adult Medium

Youth Large Adult Large

Youth Extra Large

_____________________________________________________________________________________________

Mother's Name: Address if different than child:

Cell Phone: Work Phone:

Name of Employment:

Address of Employment:

Father's Name: Address if different than child:

Cell Phone: Work Phone:

Name of Employment:

Address of Employment:

Special instructions for trying to reach parents during camp hours:

Emergency Contact (other than parent/guardian)

Emergency Contact:

Phone Number:

Work Number:

Relationship:

Primary Physician Phone Number

Address, City, Zip

Dentist Phone Number

Address, City, Zip

Preferred Hospital Phone Number

Address, City, Zip

People Allowed to sign my child out (other than parents)- Must present valid ID

Contact Person #1

First Name

Last Name

Cell Number

Relationship

Contact Person #2

First Name

Last Name

Cell Number

Relationship

For children 8+ only (optional)

I give my child special permission to sign themselves in/out of day camp. I understand that my child must arrive to camp by 9:00 am and cannot leave until 4:00 pm. Impact staff will not be responsible before my child arrives at camp or after they have signed out for the day. I will provide written permission, to the director of summer camp, if other time arrangements need to be made.

(Please initial):Optional

General Release and Liability Waiver

I the participant or legal parent/guardian hereby agrees to, or grants permission for my child to, participate in Impact Sports Performance LLC training sessions, rental sessions and or events. I understand that sports/athletics is inherently vigorous and involves numerous physical demands and may involve contact, and therefore may cause injury. I furthermore certify and understand that I am, or my child is, physically fit and in good physical health and able to participate in these events. I understand that all attempts will be made to contact me or my emergency contact; however, in the event that either cannot be reached I hereby authorize the staff and/or trainers of Impact Sports Performance, LLC to secure any and all medical treatment for me or my child. I further authorize any attending physician to render any and all medical care which may be deemed necessary. I do hereby release and forever discharge and agree to indemnify Impact Sports Performance, LLC, their directors, coaches, staff and the owners of any fields, facilities and equipment suppliers used, from liability for any personal injury or illness, damage, or loss incurred while participating in Impact Sports Performance LLC, training sessions, rental sessions, and/or events. I understand that I will be financially responsible for any and all damages to Impact Sports Performance LLC facility and equipment that are determined to be my fault.

I have read, and understand, and acknowledge the above General Release & Liability Waiver as stated above.

(Please initial):

2024 Summer Day Camp Handbook

PHILOSOPHY

At Impact, we have a unique opportunity to provide your child with; an introduction to a variety of sports, with highly qualified instructors, in a state of the art facility. Each week of camp we will feature a two sport theme. During that week, campers will learn the basic skills and rules of various sports, while making friends and working on team building skills. Campers will have the opportunity for “free time”, chances for arts and crafts, enjoying downtime playing board games and participating in organized activities. Campers will also enjoy off site field trips and weekly swimming. The staff at Impact’s main goal is for each camper to have a fun, active and safe summer vacation!

AGE REQUIREMENTS

Children participating in Summer Day Camp must be enrolled in school K-7 grade during the 2024-2025 school year. NO EXCEPTIONS. If your child will not be entering Kindergarten we have a preschool camp as well.

SERVICES OFFERED FOR CHILDREN WITH SPECIAL NEEDS

Impact Sports Summer Day Camp does not discriminate on the basis of race, color, national origin, sex, or disability. We are dedicated to supporting the Americans with Disabilities Act. Impact is not required to provide individuals with disabilities personal devices. Any personal nature services including assistance in eating, toileting, or dressing is not provided by our staff. If your child is unable to perform activities of personal care, you may provide a personal care assistant at your own cost. (35.135 Personal devices and services)

Before enrollment, we encourage you to talk with our Director about your child’s needs and we can tell you more about our camp setting and structure to see if it would be a good fit. Some things to consider before enrollment into camp; camp will be highly stimulating, loud and campers will need to be in control with minimal intervention or prompting. Campers will be gathered in large groups of 40-60 and smaller groups of 10-15. The day will include many transitions in a structured and semi-structured environment. The campers will be participating in various sports and remain active most of the day.

DATES AND HOURS OF OPERATION

Impact Summer Day Camp will run for 11 weeks including a short week starting on May 28th and running through August 9th.

Day Camp hours are Monday-Friday 8:00 a.m-5:00 p.m.

Check-in time will be from 8:00-9:00 (there will be no supervision for your child before 8:00) If you arrive after 9:00 a.m, it makes our grouping very difficult. We ask if you need to come after 9:00 please notify Danielle Reed in advance.

Children must be picked up no later than 5:00p.m. Your card on file will be charged $5.00, per every 5 minutes past the 5:00 p.m. pickup time.

If the Camper is not picked up within 10 minutes of the designated pickup time, the director will notify everyone on the emergency contact list. If the director has not received a call back within 30 minutes an additional call to will be made to all emergency contacts to pick up the child. If a child has not been picked up after 1 hour of the designated pickup time, the director will contact Superior Police department. This will be reported to the Social worker on duty to file an abandoned child report.

Camp fees will not be prorated or refunded for children missing camp due to vacations, illness or any other reason.

REGISTRATION, FEES AND CANCELLATIONS

Registration can be done online at www.myimpactsports.com. Fees will depend on how many days/weeks/months children are registered for. All fees may be found online.

Parents must sign all appropriate waivers, permission slips; submit health records and emergency forms provided by Impact Sports before registration is considered complete. YOUR CHILD MAY NOT ATTEND CAMP UNTIL ALL FORMS ARE COMPLETED! PLEASE UPLOAD ALL DOCUMENTS TO YOUR CHILD"S ACCOUNT.

1. Childs current vaccinations

2 Childs most current doctor visit (must be within 1 year)

You can access camp fees via the website. All sessions must be paid in full when registering.

********IMPORTANT INFORMATION*******

Due to our Summer Camps increasing popularity, NO REFUNDS will be given AFTER PURCHASE

In the event a child becomes injured, or does not possess the necessary skills to participate in camp, a pro-rated refund may be given upon request. Proper documentation may be requested (doctor’s note).
There will be NO TRANSFER OF DAYS WILL BE AVAILABLE FOR THE 2024 SUMMER CAMP. ONCE YOUR DAYS HAVE BEEN CHOSEN, YOU CANNOT CHANGE THEM. Camp days MUST be used by August 9th.
Non-payment or return payments may result in permanent dismissal of child from camp.

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TRACKING CAMPER

During our morning meeting, campers will receive a bracelet which corresponds with their specific counselor for the day. Our staff will also perform several head counting, face to name checks, roll calls and communication using walkie-talkies with other counselors and the director for that day. Again, your child’s safety is our number one concern!

LOST CHILD ON-SITE OR ON A FIELD TRIP

In the event that a camper becomes missing during our care, all available camp staff will immediately begin a search. We will determine where and when the camper was last seen. If the camper is not found within 10 minutes, the local police department will be notified as well as the parent/guardian. When the police arrive, the search and rescue will be turned over entirely to them.

EMERGENCY PROCEDURES

Day camp staff are CPR/First Aid certified. In the event of an emergency, staff will respond to the best of their ability. Every effort will be made to provide appropriate care.

If a child is injured, first aid will be administered and staff will let the parent/guardian know if their child needs to be picked up. In the case of a severe injury, 911 will be called and parents will be notified that their child was transported by emergency vehicle to the hospital. Minor injuries will be reported to the parent/guardian when they arrive to pick-up their child. An Impact Summer Camp staff member will fill out a complete incident report.

Please be considerate to other families and if your child is demonstrating any sign or symptoms of illness, please keep your child at home. If your child is contagious, allow the recommended time pass by a physician before they return to camp. If your child becomes ill at camp, a parent/guardian will be notified to come and pick them up. Until a parent arrives, they will be separated from other children and provided assistance from a staff member. Any contagious illnesses will be communicated to parents via email and the identity of the child will be kept confidential.

As required by the Colorado Department of Human Services Rules Regulating Child Care Centers, certain illnesses and accidents requiring medical treatment will be reported to the State.

NATURAL DISASTERS

In the event of a natural disaster such as severe weather, fire or flood or a lockdown, the safety of our campers and staff is our number one priority! All staff members are properly trained on all of the above safety and evacuation procedures. Drills are held to familiarize staff and children on those specific emergencies. Camp staff will also be trained on the City’s lightening procedures. Remain in a safe area for 30 minutes after the last lightning strike was heard or seen, before resuming outdoor activities.

EVACUATION PLAN

In the event of an evacuation of the Sports Stable in the case of a fire, earthquake, bomb threat or other unforeseen emergencies, we will evacuate to the north of the facility. Depending on circumstances, parents may be notified to pick up their children. Modified evacuation plans may be created depending on the child’s ability.

WEEKLY FIELD TRIPS

We will be taking two field trips per week, one to an assigned destination and the other to the Louisville Rec center. Each group will be checked in and out by the camp coordinator or director. All field trips will be approved by Impact and camp administration to ensure safety and age appropriateness. If the departure of the field trip is before the usual time of your drop off, we ask that you please arrive a minimum of 15 minutes before the estimated departure time. This ensures your child can be assigned to a group for the day and a smooth transition for your child and counselors that morning.

Camp T-shirt (which must be worn on field trip days) are included in the registration fees. Camp counselors will also wear t-shirts on field trip days to make it easy for kids to recognize an Impact Staff member.

Field trips are not required to attend but are encouraged and parents must note that there will be no supervision at Impact Sports for you child during field trip times. Some locations may require an additional permission slip that must be signed by a parent/guardian. before the child can attend.

Impact Kids Club Vans will be providing transportation for field trips. Children and staff will observe all safety precautions as dictated by the Department staff.

Swimming Requirements: Swimming days will be on each Thursday of the week. These days, campers are required to bring an additional $5.00 to camp for entrance fee to the Louisville Rec Center.

By signing below, I give my child permission to attend all Summer Camp Field trips. When needed, I will apply sunscreen to my child in the morning and also provide sunscreen in a plastic bag for use throughout the day. If I don not provide sunscreen, I give Impact Sports Summer Camp staff permisson to use Rocky Mountain SPF 50 sunscreen on my child.

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CAMP ACTIVTIES

A detailed weekly calendar will be available at www.myimpactsports.com. The camp curriculum is designed to introduce children to a variety of sports and games. Campers will be encouraged to participate in all sports and activities but reading and board games will always be an option. The days will consist of a combination of small nontraditional games (kickball, dodgeball etc.), with one of our featured sports in the morning and one in the afternoon. The times during the day we are engaged with our highly qualified Sports Performance Coach wlll be a more structured setting. For the weekly scheduled activity, all campers are asked to participate. We strive to have a balance between structured and youth directed time during camp. During drop-off, pick-up and snack times, the camp will be together as a whole and campers can choose to utilize board games, crafts, visit with friends, and spend time in the reading area or watching a movie. At Impact, our staff will encourage new experiences and friendships. If your child is having a difficult time making friends at camp, please do not hesitate to contact a camp counselor or director. We will do our best to introduce them to other children to ensure they have the best summer possible!

If campers arrive after 9:00 am please go to Impact’s front desk and a staff member will direct them to their counselor for the day and at that point the child will receive their wristband. However, children who arrive late on a field trip day will not be allowed to attend. There will be no supervision available, at Impact, for campers who arrive after the bus departs the facility.

Please send a leak proof water bottle, campers will have access to cool water during all camp activities and camp staff will be encouraging them to drink plenty of water during the day. most of our activities will be held inside but if we happen to be outside and there is inclement or excessively hot weather, camp activities modified and moved indoors.

When camp activities take us away from our main sign-in and out location, a notice will be posted on the table indicating how and where you can locate your child.

MOVIES/VIRTUAL GAMES

Movies will be shown during the summer. Movies and video games will be rated G or PG. Within the Sport Stable, there is a golf simulators which may be utilized during the week. The simulators can be used to hit golf balls on various virtual courses, show movies, play video games. Please inform Impact staff if you prefer that your child does not watch a movie or play in the golf simulators. During this time, we will find an alternative activity for those children. The activities may include reading quietly, coloring, crafting, board games or another quiet activity.

Due to Covid we have implemented a Curbside checkin and checkout. This will be done on the Northside of the building (in between the medical office building). You will pull through all the way to the front, drop your child off and check them in. During pickup, you will drive all the way through the same area, tell the staff member your child's name and we will bring them out to you. YOU MUST PROVIDE IDENTIFICATION UPON EACH PICKUP. YOUR CHILD WILL NOT BE RELEASED TO YOU WITHOUT IDENTIFICATION (Driver's license). Please tell anyone who might be picking your child they must provide this as well.

I will notify you if the below checkin and out will be available this summer:

All children must be signed in and out by an authorized individual each day. The individual who is signing the child out for the day must present a photo ID. Children will not under any circumstance be released without showing a proper and valid identification. Children will only be released to individuals listed on the Emergency Info Card. If an individual not listed on your child’s card is going to pick them up, it will be allowed if in writing by a parent/guardian and received in the morning by a camp counselor. Impact Day camp staff reserves the right to hold a child if the responsible parent or the third party has not provided proper notification of release or does not provide adequate photo identification.

If you need to pickup your child before 4:00pm, please notify Danielle Reed or Supervisor on duty at drop off. You must go to the Impact Sports front desk, let them know who you are picking up and they will find a supervisor to get your child. You will remain in the waiting area of Impact Sports.

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NOTE: If you are allowing your child to sign themselves in or out, we ask that you please sign them in on the first day of camp.

Please sign-out with summer camp supervisor and notify your camp counselor before leaving with your child. It is important to our staff to ensure your child is no longer in our care and is living with a person who is authorized to pick up your child.

Children ages 8+ may sign themselves in and out of camp (walking, riding a bike etc.) if a release waiver is filled out by a parent/guardian. By signing the waiver, parents understand that Impact is not responsible in any way for the safety of children outside of their care. Children who are allowed to sign themselves in/out of camp must arrive before 9:00 and remain at Impact until 4:00pm unless otherwise notified in writing by a Parent/guardian.

VISITORS

All visitors will be asked to sign the visitor log indicating name, address, phone number, date, time, provide identification and list reason for visit.

VOLUNTEERS

WE will not be excepting any volunteers during the 2022 Summer Camp.

If you are interested in volunteering at camp, you must contact the camp coordinator at least two weeks prior. Before you can volunteer at camp, you will need to fill out an Application and Background check form. The volunteer will be responsible for the cost of the background check. Please know that this procedure is to ensure the safety of your child and all campers at our day camp!

RESTRAINING ORDERS

If there is a restraining order which prohibits someone from having contact with your child, written documentation needs to be provided and notification if any changes occur.

ITEMS TO BRING TO CAMP

PLEASE LABEL ALL BELONGINGS! We will not be searching the facility for lost items that do not have names on them.
All belongings need to fit into a small backpack that can be carried by the camper.
Campers need to bring a lunch and 2 snacks (microwave or refrigeration are not available, please plan accordingly).
Campers will also have the option to purchase lunch from our restaurant Angry Horse Eatery. Price for lunch will be and must be paid to the restaurant prior to camp. No money will be collected at checkin.
Leak-proof water bottle in a backpack
PLEASE ensure that your child is in comfortable play clothes and shoes. Closed toe sneakers must be worn! Summer weather in Colorado is very unpredictable; please make sure your camper has appropriate clothing for any weather change that may arise.
Camp T-shirt on field trip days. 1 shirt will be provided to each camper and are mandatory on field trip days! If your camper forgets their shirt on a field trip day, one may be purchased at Impact for $10.00.
What to bring on swim days in a backpack (if we are able to go)

-Swim Suite

-Towel

-Not Required and not responsible for if lost (goggles, pool toys)

ITEMS NOT TO BRING TO CAMP

Note: Impact is not responsible for any items brought from home

Money,( unless campers are paying for lunch which should be collected at the sign-in desk at the beginning of camp each day or purchasing a snack from the school store).
Valuables of any type (jewelry, i-pods etc.)
NO weapons of any type: toy weapons, pocket knives etc.
Cell phones must remain in the child’s backpack throughout the day and may not be taken out during camp hours.

CHILDREN'S BELONGINGS AND STORAGE

Camper’s belongings will not be kept in a locked area. However, they will be storing their backpacks and other belongings in a girls and boys room. There will be a hook provided for each child. We will do our best to help each camper keep track of their belongings but Impact is not responsible for lost, stolen, damaged or misplaced items. All belongings will need to be taken home daily.

COMMUNICATION

Communication is going to play a key role in the success of your child at summer camp. Camp staff is always open to questions or concerns. The best way to communicate with staff will be at the beginning of camp each day. We ask that these conversations are brief and if parents would like to set up a time for a longer conversation, please call or email Danielle Reed. Weekly calendars will have a listing of on and off site activities. A completed calendar with all field trips will be posted by May 15, 2024. Modifications of the calendar and activities may be necessary due to unexpected events such as weather. We will do our best to communicate with parents all changes and updates that may occur during summer camp using email.

We have our state license and copy of inspection records available for review in the Director of Impact Sports office.

If you need to file a complaint, please do one of the following:

Speak to the appropriate level staff member/members
Call 303-866-5958
Write a description of the complaint that includes: your name, telephone number and mailing address to:

Colorado Department of Human Services Division of Early Care and Learning,

Attention Complaint Intake

1575 Sherman Street, First Floor, Denver, CO 80203-171

IMPORTANT CONTACT INFORMATION:

Danielle Reed, Day Camp Director (720) 620-2049 Email:danielle@myimpactsports.com

Rylan Reed, Director of Operations (303) 467-2288 Email: rylan@myimpactsports.com

REPORTING CHILD ABUSE

As a licensed child care facility, each staff member is required to read and sign a statement clearly defining child abuse and neglect pursuant to state law and outlining the staff member’s personal responsibility to report all incidents of suspected child abuse or neglect according to state law.

All staff receives training in the area of:

Child abuse and neglect/Mandatory reporting, FEMA emergency prepardness, Standard Precautions, CPR/FIRTS AID, and 15 hours facility training,.

Child abuse is: Physical abuse, emotional abuse, sexual abuse and neglect

As a licensed childcare facility, Impact will make every effort to provide a safe and healthy environment for your child. If you should suspect child abuse at our facility, a report of suspected child abuse must be made to the County Department of Social Services, Police Department, or other law enforcement agency in the community or county in which the facility is located.

Law requires camp staff to report any suspicion of abuse or neglect. A report of suspected child abuse or neglect must be made immediately. Once the report is made, a Social Service worker will determine if there is need for an investigation.

MEDICATION (Strictly enforced)

An Impact staff member who has received special training in medication administration will be on site at all times. Staff cannot administer any medications, prescription or over-the-counter, without the following: Camps require the same paperwork as schools do. If you fail to bring the correct information/paperwork or medications, your child will not be allowed to attend camp that day.

Written authorization from the health care provider, signed by DR and parent or guardian
Medication in the original labeled container with child’s name on it
Instructions from the health care provider with;

-reason for medication

-any information the facility may need to know regarding the medication

-specific time of administration

-length of time the medication needs to be given

If your child is taking any type of medication, and if they require special medical attention, or if they take any medications on a regular basis during camp, the parent/guardian will need to meet with the supervisor prior to camp start date. A Health Care Plan specific to your child will be put into place. The proper paperwork needs to be completed by the parent/guardian or they will be asked to return to Impact to administer medication themselves. Parents may consider checking with their healthcare provider to see if a dosage schedule can be arranged that does not involve the hours the child is at day camp. It is the parent’s responsibility to supply all medications and supplies to camp. Children are not permitted to carry any medications, prescription or over-the-counter at camp.

POSITIVE ENVIRONMENT

At Impact, our goal for the summer is to provide a safe, fun and active environment for everyone. We feel strongly that a positive relationships between staff, campers and family will encourage a summer filled with good communication, mutual respect, good problem-solving strategies and positive social interactions. We encourage campers to talk to any staff member with any concerns, worries or problems they may have during or before camp. We want to emphasize positive peer and social interaction by utilizing hands on staff and inclusion for all campers. At Impact, we also want to create an atmosphere which utilizes positive reinforcement, redirection, and conflict resolution. We will do our best to resolve all issues when they are presented in a fair and consistent manner. We understand that every child is unique and what “works” for one child may not for another. Parents are obligated to release any information/disorders about their child which may affect their ability to execute day to day activities. We will work with parents to understand and determine what interventions work best for their child to have a positive experience at camp. Failure to disclose appropriate information may result in dismissal without refund.

BEHAVIOR INTERVENTIONS

Serious and continuous behavioral problems may result in; talks with the child, talks with the parent, written reports, meeting with the child and parent implementing a behavioral contract, and dismissal as a last resort. If a camper receives two written reports in a week they will be dismissed from the session and will not be able to attend future sessions until a meeting has taken place with the Director, Parent/guardian and camper

Extreme incidents may require immediate dismissal without prior notice. Refunds will not be issued for children dismissed due to behavior. Actions that will not be tolerated at Impact Summer Camp and will require the child be picked up immediately.

Behavior that is continuously disruptive
Behavior that poses a threat to him/herself or others (hitting or fighting of any kind)
Destruction of property
Leaving without permission
Failure to respond to staff or camp policies
Inappropriate touching

OUR IMPACT STAFF

Our Impact Staff is an amazing and diverse group of individuals made up of teachers, college students, graduating high school students and highly qualified sports instructors. Each staff member goes through an interview process, adequate training, and CPR and First Aid to make certain that they are a good fit for the unique summer program at Impact. Not only will your child be interacting with talented and energetic counselors and aides, but they will also be spending time with Impact’s Sports Training Staff. These trainers will be introducing a variety of sports along with the fitness based program and activities your camper will receive. In order to ensure the safety of all campers, each staff member has been fingerprinted which provides us with an extensive background check. They have also met all licensing qualifications for the position they hold. We will maintain a 1:10 or 1:15 ratio at all times so we can provide a high level of supervision.

Counselors all receive training in child abuse, sexual harassment and body safety rules. Counselors and campers should never be alone one on one and out of the public eye. If you have any questions or concerns with a staff member at Impact, please see Director.

All camp counselors will be wearing a staff t-shirt at all times. This will allow campers to easily recognize camp staff members during daily activities and field trips.

I have read, understand and agree to the policies and procedures in the Summer Day Camp Handbook.

(Please initial):

AGREEMENT CANCELLATION/REFUND POLICY:

The only time a refund will be given is in the event a child becomes injured, or does not possess the necessary skills to participate in camp, a pro-rated refund may be given upon request. Proper documentation (Doctor's note) will be needed to process
Non-payment, late payments or return payments may result in permanent dismissal of child from camp

(Please initial):

RETENTION OF RIGHTS: I understand and acknowledge that Impact Sports Performance owns and retains all video and photographic rights in connection with the participant's involvement in all programs, camps, and activities conducted by Impact Sports Performance, LLC.

(Please initial):

Choose your favorite sport:

Choose one:

Impact Sports Performance, LLC One Superior Drive, Unit B Superior, CO 80027
303.IMPACT.U (467.2288)
www.MyImpactSports.com

Name of Adult Participant and/or Parent or Legal Guardian of Minor:

First Name:	Last Name:	Birth Date:
Address:	City:	State:
Zip:	Email:	Phone:

Relationship to minor:

Full Name and Birth Date of family members under the age of 18

#1	First Name:	Last Name:	Birth Date:
#2	First Name:	Last Name:	Birth Date:
#3	First Name:	Last Name:	Birth Date:
#4	First Name:	Last Name:	Birth Date:
#5	First Name:	Last Name:	Birth Date:
#6	First Name:	Last Name:	Birth Date:
#7	First Name:	Last Name:	Birth Date:
#8	First Name:	Last Name:	Birth Date:
#9	First Name:	Last Name:	Birth Date:
#10	First Name:	Last Name:	Birth Date:

Date and Time Signed:

By checking this box I agree to have read and agree to the legal agreement above.

Send me emails about Account Management, Reminders, and Schedule Changes

Send a copy of this handbook to my email

Add text here.

Our Privacy Policy

PLEASE NOTE THAT WAIVERKING, INC.’S (“WaiverKing”) PRIVACY POLICY HAS CHANGED EFFECTIVE May 25th, 2018.

You acknowledge that this privacy policy is a part of our website’s Terms of Service, and by accessing or using our website, you agree to be bound by all of its terms and conditions. IF YOU DO NOT AGREE TO THESE TERMS, AS UPDATED, PLEASE IMMEDIATELY STOP ACCESSING THE WEBSITE.

This document explains how we use your personal data.

When you sign up to use this service provider’s services, you do so through software provided by us, WaiverKing.

We are committed to ensuring the privacy of all users of our software and services and other visitors to our website. In this policy we explain how we hold, process and retain your personal data.

In respect to the account data, waiver data, and payment data (as defined below) that you provide to us, we are acting as a data processor on behalf of the service provider, who will be acting as the data controller in respect to such data. We will never store or control this data. You should direct any requests or queries you have regarding this data to the data controller, your service provider.

1. How we use your personal data

1.1. This section provides you with information about:

a) what personal data we hold and process;

b) in respect of personal data that we did not collect from you directly, where we obtained that data from, and what types of data we have collected;

c) the purposes for which we may process your personal data; and

d) the legal grounds on which we process your data.

Members and end users of our services

1.2. Account data. We may process information about you that you provide to us when you first sign up with a service provider ("account data"). This account data may include your name, address, telephone number, email address, date of birth, gender, employment details, and a photograph of you. We may use this data to create your account with the service provider when you sign up. This account data may be updated each time you complete a document through our software. We do not process your account data in any other way, or have access to it in any way.

The legal basis for this processing is our legitimate interests in providing our services to our clients, and ensuring that your account is updated each time that you complete a document through our software.

1.3. Waiver data. If you are using our software in order to sign documents such as a waiver, health form, contract, or questionnaire, we may process information that you put into such documents (“waiver data”). This waiver data may include your name, signature, date of birth, email address, information about your health and medical history, and any other information that you are required or requested to put into the document.

Once you have completed the document, we will process it, convert the document into a different format, and send it to your account with the service provider in order for it to be stored. We will never store your data permanently on our systems (although it may be stored in your account with your service provider).

The purpose for our processing your data in this way is to maintain and administer a complete and accurate record of the documents that you have signed and completed for your service provider. The legal basis for our processing your waiver data (to the extent that such waiver data does not class as a special category of personal data), will be our legitimate interests in providing our services to our clients who have asked you to complete the document in question, in order to ensure that a complete and accurate record of your signing and completing the documents is maintained and administered.

1.4. Sensitive Personal Data. During the course of using our software and services and providing us with information in order for us to provide our services to you, you may provide us with sensitive information about yourself (“sensitive data”). This sensitive data may include your health and medical history. We may use this data for providing our services to you. However, we will only process this sensitive data if you consent to us doing so.

[The consent to use this information needs to be provided by the parent for children under the age of 13. Anyone over the age of 13 can provide consent for use of their data under GDPR]

We comply with the requirements of the Children’s Online Privacy Protection Act. You must be at least 18 years old to have our permission to use the WaiverKing website. If you are between the ages of 13 and 17, or under the age of majority where you live, you represent that your legal guardian has reviewed and agreed to this privacy policy.

Other processing that we may carry out

1.5. Website data. We may process data about your use of our website and services ("website data"). The website data may include your IP address, geographical location, browser type and version, operating system, referral source, length of visit, page views and website navigation paths, as well as information about the timing, frequency and pattern of your service use. The source of the website data is our analytics tracking system. This website data may be processed for the purposes of analyzing the use of the website and services.

The legal basis for this processing is our legitimate interests, namely monitoring and improving our website and services.

We may also process this data for the purposes of diagnosing any issues we detect in relation to the use of our products or services. This data may be collected by our error-tracking software which is provided by Rollbar. We always try to ensure that any such data is anonymized so that you cannot be identified before it is stored in our records.

The legal basis for this processing is our legitimate interests in monitoring and improving our products and services.

1.6. Enquiry data. We may process information contained in any enquiry you submit to us regarding our products or services ("enquiry data"). The enquiry data may be processed for the purposes of offering, marketing and selling relevant products and/or services to you.

The legal basis for this processing is our legitimate interests, namely dealing with and responding to your enquiry appropriately.

1.7. Notification data. We may process information that you provide to us for the purpose of subscribing to our blog and press releases ("notification data"). The notification data may be processed for the purposes of sending you newsletters.

Where you are a corporate customer, the legal basis for this processing is our legitimate interests, namely the marketing of relevant products and services to you.

1.8. Correspondence data. We may process information contained in or relating to any communication that you send to us ("correspondence data"). The correspondence data may include the communication content and metadata associated with the communication. Our website will generate the metadata associated with communications made using the website contact forms. The correspondence data may be processed for the purposes of communicating with you and record-keeping.

The legal basis for this processing is our legitimate interests, namely the proper administration of our website and business and communications with users.

1.9. Payment data. We do not process payment information relating to goods and services that you purchase from the service provider. However, we do capture certain data relating to your payments and use them to update your account with the service provider ("payment data"). The payment data may include your contact details, your card details and the transaction details. The payment data may be processed for the purposes of updating your account with the service provider. The legal basis for this processing is our legitimate interests, namely our interest in the proper administration of our software and ensuring your account with the service provider is updated.

1.10. Other processing activities. In addition to the specific purposes for which we may process your personal data set out above, we may also process any of your personal data where such processing is necessary for compliance with a legal obligation to which we are subject, or in order to protect your vital interests or the vital interests of another natural person.

2. Providing your personal data to others

2.1. To our clients and partner service providers. The only third parties that we will disclose your personal data to are our clients (your service provider) who is the data controller in respect to the account data, waiver data, and payment data that we collect about you, and MINDBODY Inc. (“MINDBODY”), who provide software services to service providers in conjunction with the WaiverKing software. Your accounts are created by WaiverKing in the MINDBODY software on behalf of our clients.

2.2. Our insurers/professional advisers. We may disclose your personal data to our insurers, legal counsel, and/or professional advisers insofar as reasonably necessary for the purposes of obtaining and maintaining insurance coverage, managing risks, obtaining professional advice and managing legal disputes.

2.3. Where we provide your personal data to any third party. Where we share your personal data with any of the third parties referred to above, we will ensure this processing is protected by appropriate safeguards including a suitable data processing agreement with that third party.

2.4. To comply with legal obligations. In addition to the specific disclosures of personal data detailed above, we may also disclose your personal data where such disclosure is necessary for compliance with a legal obligation we have to comply with, or in order to protect your vital interests or the vital interests of another individual. This may include disclosing your personal data in response to lawful requests by public authorities, including to meet national security or law enforcement requirements.

2.5. We take reasonable and appropriate steps to ensure that third-party agents and service providers process your personal data in accordance with our Privacy Shield obligations and to stop and remediate any unauthorized processing. Under certain circumstances and pursuant to applicable laws, we may remain liable for the acts of our third-party agents or service providers who perform services on our behalf for their handling of your personal data that we transfer to them.

3. Transfers of your personal data outside of the European Economic Area

As further detailed below, we may transfer your personal data to our servers based in the US, as we are part of the Privacy Shield. Otherwise, where your personal data is transferred outside of the EEA, we will ensure that either (a) The European Commission has made an "adequacy decision" with respect to the data protection laws of the country to which it is transferred, or (b) we have entered into a suitable data processing agreement with the third party situated in that country to ensure the adequate protection of your data. In all cases, transfers outside of the EEA will be protected by appropriate safeguards.

4. Retaining and deleting personal data

4.1. Personal data that we process for any purpose or purposes shall not be kept for longer than is necessary for that purpose or those purposes. Details about members of our clients (your service provider) and end users of our services, including the account data, waiver data and sensitive personal data, will not be stored by WaiverKing.

4.2. Unless we contact you and obtain your consent for us to retain your personal data for a longer period, we will retain and delete your personal data as follows:

a) Website data will be retained for 12 months following the date of our last contact or dealing with you, at the end of which period it will be deleted from our systems.

b) Enquiry data will be retained for 12 months following the date of our last contact or dealing with you, at the end of which period it will be deleted from our systems.

c) Notification data (other than Notification data that is also Contact data) will be retained for 12 months following the date of our last contact or dealing with you, at the end of which period it will be deleted from our systems.

d) Correspondence data will be retained for 12 months following the date of our last contact or dealing with you, at the end of which period it will be deleted from our systems.

4.3. We may retain your personal data where such retention is advisory and/or necessary for compliance with a legal obligation to which we are subject (such as with regard to applicable statutes of limitations, litigation or regulatory investigations), or in order to protect your vital interests or the vital interests of another natural person.

5. Your rights

5.1. You may instruct us to provide you with any personal information we hold about you; provision of such information will be subject to:

a) your request not being found to be unfounded or excessive, in which case a charge may apply; and

b) the supply of appropriate evidence of your identity (for this purpose, we will usually accept a notarized photocopy of your driver’s license and/or passport and an original copy of a utility bill showing your current address).

5.2. We may withhold personal information that you request to the extent permitted by law.

5.3. You may instruct us at any time not to process your personal information for marketing purposes.

5.4. In practice, you will usually expressly agree in advance to our use of your personal information for marketing purposes, or we will provide you with an opportunity to opt out of the use of your personal information for marketing purposes.

5.5. Your right to access your data. You have the right to ask us to confirm whether or not we process your personal data and, to have access to the personal data, and any additional information. That additional information includes the purposes for which we process your data, the categories of personal data we hold and the recipients of that personal data. You may request a copy of your personal data. The first copy will be provided free of charge, but we may charge a reasonable fee for additional copies.

5.6. Your right to correct. If we hold any inaccurate personal data about you, you have the right to have these inaccuracies corrected. Where necessary for the purposes of the processing, you also have the right to have any incomplete personal data about you completed.

5.7. Your right to erasure. In certain circumstances you have the right to have personal data that we hold about you erased. This will be done without undue delay. These circumstances include the following: (1) it is no longer necessary for us to hold those personal data in relation to the purposes for which they were originally collected or otherwise processed; (2) you withdraw your consent to any processing which requires consent; (3) the processing is for direct marketing purposes; and/or (4) the personal data have been unlawfully processed. However, there are certain general exclusions of the right to erasure, including where processing is necessary: for exercising the right of freedom of expression and information; for compliance with a legal obligation; or for establishing, exercising or defending legal claims.

5.8. Your right to restrict processing. In certain circumstances you have the right for the processing of your personal data to be restricted. These circumstances include the following: (1) you do not think that the personal data we hold about you is accurate; (2) your data is being processed unlawfully, but you do not want your data to be erased; (3) it is no longer necessary for us to hold your personal data for the purposes of our processing, but you still require that personal data in relation to a legal claim; and/or (4)you have objected to processing, and are waiting for that objection to be verified. Where processing has been restricted for one of these reasons, we may continue to store your personal data. However, we will only process it for other reasons: with your consent; in relation to a legal claim; for the protection of the rights of another natural or legal person; or for reasons of important public interest.

5.9. Your right to object to processing. You can object to us processing your personal data where our legal basis for the processing is that it is necessary for: the performance of a task carried out in the public interest, or in the exercise of any official authority vested in us; or the purposes of our legitimate interests or those of a third party. If you make an objection, we will stop processing your personal information unless we are able to: demonstrate compelling legitimate grounds for the processing, and that these legitimate grounds override your interests, rights and freedoms; or the processing is in relation to a legal claim.

5.10. Your right to object to direct marketing. You can object to us processing your personal data for direct marketing purposes. If you make an objection, we will stop processing your personal data for this purpose.

5.11. Your right to data portability. Where you have given us consent to process your personal data, or where we are processing your personal data for the performance of a contract, you have a legal right to receive a copy of the personal data we hold about you in a structured, commonly used and computer readable format. When a data request is made of us we will make available all applicable personal data to you in a computer readable format and will transmit your personal data to the appropriate third party pursuant to your instruction. We will not process your data in this way if we believe that it may pose a threat to the security of the data.

5.12. Your right to object for statistical purposes. You can object to us processing your personal data for statistical purposes on grounds relating to your particular situation, unless the processing is necessary for performing a task carried out for reasons of public interest.

5.13. Automated data processing. To the extent that the legal basis we are relying on for processing your personal data is consent, and where the processing is automated, you are entitled to receive your personal data from us in a structured, commonly used and computer-readable format. However, you may not have this right if it would adversely affect the rights and freedoms of others.

5.14. Complaints to a supervisory authority pursuant to the GDPR. If you think that our processing of your personal data infringes data protection laws, you can lodge a complaint with a supervisory authority responsible for data protection. You may do this in the EU member state of your habitual residence, your place of work or the place of the alleged infringement. This provision is only applicable if you are subject to the protections of the GDPR.

5.15. Complaints if you are not subject to the protections of the GDPR. If you think that our processing of your personal data infringes data protection laws you may contact us via email at privacy@waiverking.com or mail at: WaiverKing, Inc. 340 S Lemon Ave # 2018 Walnut, California 91789.

5.16. Right to withdraw consent. To the extent that the legal basis we are relying on for processing your personal data is consent, you are entitled to withdraw that consent at any time. Withdrawal will not affect the lawfulness of processing before the withdrawal.

5.17. Exercising your rights. You may exercise any of your rights in relation to your personal data by written notice to us in addition to the other methods specified above.

5.18. Point of Contact Data. PARAGRAPHS 5.1 – 5.17 SHALL NOT APPLY TO ACCOUNT DATA, WAIVER DATA, OR PAYMENT DATA OBTAINED OR PROCESSED BY WAIVERKING. IN RESPECT OF SUCH DATA:

a) WAIVERKING IS ACTING AS A PROCESSOR OF THAT DATA AND THE MAIN CONTRACTOR IS THE CONTROLLER;

b) YOU SHOULD CONTACT THE SERVICE PROVIDER TO EXERCISE THE RIGHTS SET OUT IN THIS PARAGRAPH 5

6. Links To Other Websites. Except as otherwise discussed in this privacy policy, this document only addresses the use and disclosure of information we collect from you. Other websites accessible through our website have their own privacy policies and data collection, use, and disclosure practices. Please consult each website’s privacy policy. We are not responsible for the policies or practices of third parties, including any third-party site or other products and services used in connection with WaiverKing’s services. The inclusion of a link does not imply endorsement of the linked site or service by us or by our affiliates.

We are not responsible for the collection, usage and disclosure policies and practices (including the data security practices) of other organizations, such as, Apple, Google, Microsoft, or any other operating system provider, wireless service provider or device manufacturer, including any personal data you disclose to other organizations through or in connection with WaiverKing’s services.

7. Security of Your Information. The security of personal data is a high priority at WaiverKing. We seek to use reasonable technical, administrative and physical safeguards to protect personal data within our organization. Unfortunately, no data transmission or storage system can be guaranteed to be 100% secure. As a result, while we strive to protect your personal data, you acknowledge that: (a) there are security and privacy limitations of the Internet which are beyond our control; (b) the security, integrity, and privacy of any and all information and data exchanged between you and us through the website cannot be guaranteed; and (c) any such information and data may be viewed or tampered with in transit by a third party.

8. IP Addresses and Cookies. Cookies are very small text files that are stored on your computer when you visit some websites.

We use cookies to help identify your computer, including where available, your IP address, operating system and browser type, for system administration so we can keep your activity secure, tailor your user experience and remember your preferences. This is statistical data and does not identify any individual. You are always free to decline our cookies if your browser permits, but some parts of our website may not work properly.

9. Your California Privacy Rights: Notice to California Customers and Opt-Out Information. Residents of the State of California, under certain provisions of the California Civil Code, have the right to request from companies conducting business in California a list of all third parties to which the company has disclosed certain personal data, as defined under California law, during the preceding year for third party direct marketing purposes. You are limited to one request per calendar year. In your request, you must supply appropriate evidence of your identity and attest to the fact that you are a California resident and provide a current California address for our response. You may request the information by writing to privacy@waiverking.com

Some web browsers incorporate a “Do Not Track” feature that signals to websites that you visit that you do not want to have your online activity tracked. California residents are entitled to know how WaiverKing, Inc. responds to “Do Not Track” signals. How browsers communicate the Do Not Track signal is not yet uniform, so a standard technological response has not yet been developed by the appropriate technology communities. For this reason, we do not respond to Do Not Track signals currently. To opt out of direct advertising on our website, please send a request to the address above. The effect of an opt-out will be to stop direct advertising, but it will still allow the collection of usage data for certain purposes (e.g., research, analytics, and internal online services operation purposes).

10. Privacy Shield Framework

10.1. WaiverKing Inc. complies with the EU-U.S. and Swiss-U.S. Privacy Shield Framework as set forth by the U.S. Department of Commerce regarding the collection, use, and retention of personal information transferred from the European Union and Switzerland to the United States. WaiverKing has certified to the Department of Commerce that it adheres to the Privacy Shield Principles. If there is any conflict between the terms in this privacy policy and the Privacy Shield Principles, the Privacy Shield Principles shall govern. To learn more about the Privacy Shield program, and to view our certification, please visit https://www.privacyshield.gov/

10.2. In compliance with the Privacy Shield Principles, WaiverKing commits to resolve complaints about our collection or use of your personal information. Any individual(s) with inquiries or complaints regarding our Privacy Shield policy should contact us at: privacy@waiverking.com

10.3. WaiverKing Inc. has further committed to refer unresolved Privacy Shield complaints to Judicial Arbitration and Mediation Services (JAMS), an alternative dispute resolution provider located in the United States. If you do not receive timely acknowledgment of your complaint from us, or if we have not addressed your complaint to your satisfaction, please visit https://www.jamsadr.com/eu-us-privacy-shield for more information or to file a complaint. The services of JAMS are provided at no cost to you. In certain situations, you may also have the right to pursue binding arbitration under the Privacy Shield Framework.

10.4. You may have the option to select binding arbitration for the resolution of your complaint under certain circumstances, provided you have taken the following steps: (1) raised your complaint directly with WaiverKing Inc. and provided us the opportunity to resolve the issue; (2) made use of the independent dispute resolution mechanism identified above; and (3) raised the issue through the relevant data protection authority and allowed the U.S. Department of Commerce an opportunity to resolve the complaint at no cost to you. For more information on binding arbitration, see U.S. Department of Commerce's Privacy Shield Framework: Annex I (Binding Arbitration).

10.5. For purposes of enforcing compliance with the Privacy Shield, WaiverKing is subject to the investigatory and enforcement authority of the U.S. Federal Trade Commission.

10.6. WaiverKing Inc. is controlled and operated by us from the United States. Except where you are a resident of a Member State of the EU, in which case paragraphs 2 and 3 above will apply, your personal data may be stored and processed in any country in which we engage service providers, and by using WaiverKing’s services you understand that your information may be transferred to countries outside of your country of residence, including the United States, which may have data protection rules that are different from those of your country. In certain circumstances, courts, law enforcement agencies, regulatory agencies or security authorities in those other countries may be entitled to access your personal data. Regardless of where your information is processed, we apply the same protections described in this policy.

11. Changes to the privacy policy. We reserve the right to change this policy at any time, without prior notice to you. Such changes, modifications, additions, or deletions shall be effective immediately upon notice thereof, which may be given by means including, but not limited to, issuing an e-mail to the e-mail address provided by you or posting the revised policy on this page. You acknowledge and agree that it is your responsibility to maintain a valid e-mail address and/or review the WaiverKing website and this policy periodically, and be aware of any modifications. Your continued use of the WaiverKing website after such modifications will constitute your: (a) acknowledgment of the modified policy; and (b) agreement to abide and be bound by the modified policy.

12. Our details

12.1. This website and software is owned and operated by WaiverKing Inc.

12.2. We are registered in the state of California under registration number C3518177, and our registered office is at 340 S Lemon Avenue, # 2018 Walnut, California 91789.

12.3. You can contact us:

a) by mail, using the postal address given above;

b) using our website contact form;

c) by telephone, on the contact number published on our website from time to time; or

d) by email, using the email address published on our website from time to time.

13. Data protection officer

Our data protection officer may be contacted via email: privacy@waiverking.com, or telephone: +1 (888) 211-6693.

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