Spring Hill Elementary School Panther Press
Transcripción
Spring Hill Elementary School Panther Press
Spring Hill Elementary School No. 64 Panther Press June 8, 2016 Website: http://www.fcps.edu/SpringHillES/ Office Hours 7 a.m. until 4 p.m. Monday through Friday Office Phone: (703)506-3400 Fax: (703)506-3497 Absent? Tardy? 24-hour attendance line at (703) 506-3434 6th Grade Graduation/Awards Ceremony Wednesday, June 22, 2016 9:15 a.m. in the gym NOTE: Doors to the gym will not open until 8:30a.m. Yearbooks, class photos, 6th GR Panorama & Spring Photos Class Parties Food Orders When placing food delivery orders for class parties, please place the order in the name of the classroom teacher so the office can find you. We receive a large number of delivery orders in the office on class party days and any name other than a classroom teacher will often not be recognized. We don’t want your order to get cold while we are trying to find you! Pre-paid orders with tip included are appreciated. Students Not Returning to Spring Hill for the 2016-17 School Year If your child will not be returning to Spring Hill in September and you will need documents to take with you, please email Becky Abbott([email protected]) NOW. She will need time to prepare the documents. Include in your request: Student’s name, grade, last day of attendance and where he/she will be moving. A parent also needs to stop by the office and complete a withdrawal form. There is a $5 (cash only) fee for preparing the documents. See Inside this Issue: Page 1: Yearbooks & Photos, Class Parties, Students not Returning to Spring Hill Page 2: Calendar, Yabe Page 3: Kiss & Ride, Summer Hours, Fun Fair Raffle Winners golfing w/Ms. Shaheen Page 4: 5th Grade Tdap Reminder, Page 5-7: Summer Reading Page 8: Hoop Life Summer Camp Page 9-12: Girl Scouts Last Day of School: Thursday, June 23rd 2 Hr Early Release (1:35) Thank you everyone for supporting the Yabe, Japan exchange program by purchasing popsicles for our fundraiser! Popsicles will continue to be sold every Monday and Friday in the cafeteria for $1 until the end of the school year. If you would like to support the Japan program in another way, please visit and share our fundraising page, www.gofundme.com/springhillyabe2016 Thank you!! Calendar Time Out of School Please schedule your family vacations during FCPS designated holidays / breaks, which you can see at this link: http://www.fcps.edu/cal.shtml Be aware that missing school for extended periods of time negatively impacts your child and your child's teacher. Week of June 6th: Wednesday, June 8th: Taste of Spring Hill, Cafeteria, 5:30-7:30 pm Thursday, June 9th: Talent Show Dress Rehearsal K-3, Cafeteria, 4-6 pm 5th & 6th GR Orchestra Concert, Gym, 7-8:30 pm Friday, June 10th: 5th & 6th GR Orchestra Concert, Gym, 9:15-10:15 am K-3 Talent Show Performance, Cafeteria, 2-3 pm Week of June 13th: Monday, June 13th; Dolly Madison Library Summer Reading Program (All Grade Levels), Lg Pod, 9 am –12:30 pm Patrol Picnic, Black Top, 12-12:50 pm 6th Gr Battle of the Books, Lg Pod, 2-2:30 pm Talent Show Dress Rehearsal GR 4th-6th,Cafeteria, 4-6 pm Tuesday, June 14th: 5th & 6th Gr Principal Coffee, Lg Pod, 8:30-10 am 3rd Gr Kid’s Business Day, Field behind 3rd grade wing, 9-10:40 am Talent Show Performance for 4th-6th Gr, Cafeteria, 2-3 pm 4th GR Orchestra Concert, Gym, 7-8:30 pm Wednesday, June 15th: 3rd GR Strings & 4th GR Orchestra Concert, Gym, 9:15-10:15 am Kindergarten EOY Party, Classrooms Thursday, June 16th: Field Day Friday, June 17th: Field Day (Rain Date) 2nd GR EOY Party, Classrooms,10 am-12 pm 1st GR EOY Party, Behind 3rd gr wing,10 am-12 pm SHES Got Talent Show Performance, Cafeteria, 6:30-8 pm Week of June 20th: Monday, June 20th: 6th GR Civil War Museum, Gym, 9-11 am 3rd GR EOY Party, Upper Playground & Behind 3rd GR Wing, 9:30-11:30 am Tuesday, June 21st: 6th GR Party, Outside & Gym, 9 am - 3:30 pm Ferek & Fishbone Simple Machine’s Showcase, Cafeteria 9-10:30 am Wednesday, June 22nd: Kindergarten Field Day/Party, Lower Field & Lg Pod 6th GR Graduation, Gym, 9-11 am Thursday, June 23rd: Last Day of School, 2HR Early Release (1:20 pm) 4th GR EOY Party, Lower Field, 5th GR EOY Party, Behind 3rd GR Wing & Black Top Field Day: Kiss & Ride On Thursday, June 16 (Field Day), the Kiss and Ride area will be closed from 8:40 AM until 3:10 PM as children will be moving in and out of the Kiss and Ride area to participate in Field Day activities on the lower field. Summer Office Hours Due to the replacement of air conditioning units this summer, July 5th through July 29th, the office will have limited open hours. We will attempt to be open from 8am to 12 noon. The office will be open only by appointment in the afternoons. If we should need to be closed, we will leave a message on our phone. Call 703-506-3400 to confirm hours available. Fun Fair Raffle Winners Saturday morning was fun golfing with Connelly Roberge and Nikki Hoffman. Thanks girls. Ms. Shaheen This school newsletter will be issued every other Wednesday during the school year on our website, under “News and Events.” You will receive an email link to the newsletter if we have your current email address. Deadline for submissions are Mondays by Noon. Email [email protected] Please include Panther Press in the subject. 5th Graders: Don’t Forget to Get Your Tdap All students in Virginia must receive a booster dose of Tdap vaccine prior to entering the sixth grade. Please bring your proof of immunizations to the office as soon as possible. If your child’s birthday falls prior to the end of school, please make every effort to get the immunization and bring the documentation to school by June 23rd. If your child’s birthday falls after school is out, but by September 2nd you must bring documentation to the school by September 2nd, or you child will not be allowed to start school September 6th. If your child’s birthday falls after September 6th, you must bring documentation from your child’s doctor stating the date immunization will be given (should be on or soon after 11th birthdate). This must be turned in by September 2nd or your child will not be allowed to start school on September 6th. 6th GRADERS WILL NOT BE ALLOWED TO COME TO SCHOOL ON SEPTEMBER 6TH WITHOUT THE PROPER DOCUMENTS. Children who come to school on September 6th without the proper documentation will be called to the office and parents will be called to come and get them. Book Your Summer! We hope all Spring Hill Elementary School students will BOOK YOUR SUMMER and READ! Here are a few suggestions: 1. Print off the summer reading challenge bingo sheet to help make reading a fun challenge this summer. Go to: fcps.edu/is/book/ Submit your completed READ! card online from June 27th until September 7th. Students may submit more than one entry; however every participant has an equal chance to win a prize. In every school, students at each grade level will be randomly selected to receive $50 in books of their choice. A single student at each school will be randomly selected to receive a laptop. 2. Fairfax County Public Library offers a summer reading program. Kids can register online at: www.fairfaxcounty.gov/library/srp/ or visit a branch library beginning June 23rd. All students can submit their reading logs at a branch library and receive a coupon book. *The coupons feature items and activities such as discounts to: Six Flags, mini golf, frozen yogurt, pizza, pottery painting as well as admission to some of the RECenters and nature centers. The library offers lots of FREE fun events all summer long! 3. Participate in the Barnes & Noble Summer Reading Program. Kids can earn a FREE book from a Barnes and Noble store! To get started, either pick up a Reading Journal at the SHES library OR print one: http://www.barnesandnoble.com/u/summer-reading/379003570/ To earn a FREE book at Barnes and Noble: * Record 3 books on the Make your Own Triathlon (PDF). * Bring the completed Reading Journal to your local B&N store. * Choose a FREE BOOK from the list featured on the journal... 4. Read the attached articles to encourage your child to read this summer. Happy Reading! Janis Lefcourt and Janet Hugger Raising a Reader How do you raise a child to be an enthusiastic and consistent reader? TV, videogames, computers, and other modern distractions sometimes make it difficult for children to focus on reading. Here are some strategies that the diligent parent can use to help motivate a child to read. Try them all -- what doesn't work one day may work well the next. Visit your local library often. Get your children their own library cards. Try a story hour or other free event at the library. Check out the local bookstore. A book or gift certificate always makes a terrific gift. Let your child see you reading, whether it's the newspaper, a magazine, or the latest bestseller. Encourage older children to read to their younger brothers and sisters. Or have the whole family set aside some time to read together! Show your child how people use reading all the time. Read aloud street and store signs, maps, billboards, menus, and labels on packages. Create a library for your child of new or used books. Look for affordable books at yard sales, secondhand book stores, and library book sales. Set up an area in your home where a variety of reading materials are within easy reach. Encourage writing by including paper, crayons, pens and pencils. Subscribe to a children's magazine. Read it with your child every month. Carry books to read to your child wherever you go - at the doctor's office, in line at the store, or on a long car ride. (You can also listen to stories on tape.) Encourage a love of words by playing rhyming and word games, singing silly songs, or writing poems and stories together. Talk about daily activities or tell stories about your family or culture to help children develop their language skills. Visit the Between the Lions web site (pbskids.org/lions) for more on children and reading. http://www.nea.org/grants/raising-a-reader.html Some more ways to Encourage Reading 1. Scout for things your children might like to read. Use their interests and hobbies as starting points. 2. Leave all sorts of reading materials including books, magazines, and colorful catalogs in conspicuous places around your home. 3. Notice what attracts your children's attention, even if they only look at the pictures. Then build on that interest; read a short selection aloud, or simply bring home more information on the same subject. 4. Let your children see you reading for pleasure in your spare time. 5. Present reading as an activity with a purpose—a way to gather useful information for, say, making paper airplanes, identifying a doll or stamp in your child's collection, or planning a family trip. 6. Play games that are reading-related. Check your closet for spelling games played with letter tiles or dice, or board games that require players to read spaces, cards, and directions. 7. Perhaps over dinner, while you're running errands, or in another informal setting, share your reactions to things you read, and encourage your children to do likewise. 8. Read aloud to your child, especially a child who is discouraged by his or her own poor reading skills. The pleasure of listening to you read, rather than struggling alone, may restore your child's initial enthusiasm for books and reading. 9. Encourage your child to read aloud to you an exciting passage in a book, an interesting tidbit in the newspaper, or a joke in a joke book. When children read aloud, don't feel they have to get every word right. Even good readers skip or mispronounce words now and then. 10. On gift-giving occasions, give books and magazines based on your child's current interests. 11. Introduce the bookmark. Remind your youngster that you don't have to finish a book in one sitting; you can stop after a few pages, or a chapter, and pick up where you left off at another time. Don't try to persuade your child to finish a book he or she doesn't like. Recommend putting the book aside and trying another. 12. Treat your children to an evening of laughter and entertainment featuring books! Many children (parents, too) regard reading as a serious activity. A joke book, a story told in riddles, or a funny passage read aloud can reveal another side of reading. 13. Extend your child's positive reading experiences. For example, if your youngster enjoyed a book about dinosaurs, follow up with a visit to a natural history museum. 14. Offer other special incentives to encourage your child's reading. Allow your youngster to stay up an extra 15 minutes to finish a chapter; promise to take your child to see a movie after he or she has finished the book on which it was based; relieve your child of a regular chore to free up time for reading. 15. Limit your children's television viewing in an effort to make time for other activities, such as reading. But never use TV as a reward for reading, or a punishment for not reading. 16. Not all reading takes place between the covers of a book. What about menus, road signs, food labels, and sheet music? Take advantage of countless spur-of-the-moment opportunities for reading during the course of your family's busy day. Source: RIF Parent Guide Brochure. http://www.rif.org/us/literacy-resources/articles/children-who-can-read-but-dont.htm Reserve A Space Today For Only A $40 Deposit Hoop Life Summer Basketball Camp Does your child like basketball? Do you want them to learn the game and have a good time during their summer break? Well, enroll them in the Hoop Life Summer Basketball Camp. Hoop Life is a premier basketball training organization that trains players ranging from beginners to professionals. Our camps will raise your child’s basketball skills and IQ in a fun, safe, and competitive basketball environment. All of our coaches have playing or coaching experience on higher levels of basketball including the NBA. Areas of Focus Individual Skills • Passing • Shooting • Dribbling • Defense Team Skills • Fast Breaks • Pick n’ Roll • Reading & Using Screens • Help n’ Recovery McLean, VA Location Attendees: Boys & Girls Ages: 4 to 14 years old Dates: July 5-8; July 25-29 Time: 9am – 4pm Where: Cooper Middle School 977 Balls Hill Road McLean, VA 22101 Price: $40 Non-refundable Deposit $200 - $250 Early Registration (before 6/1) $225 - $275 Normal Registration *Register multiple children and save 10% **Register as a team and save 20% ***Refer friends for split $50 discount For more information: Call Coach Kevin Harris @ 571-241-1486 or email him at [email protected] This camp is operated to battle against childhood obesity and bullying. Help us with the fight for healthy lifestyles!!! Go to www.myhooplife.com to register online for any camp Basketball Camp Registration Form Head of Household (first/last name) _________________________________________________________________ Address________________________________City______________________________State______Zip__________ Home Ph. __________________Work Ph. __________________Cell_________________ Email_________________________________________ Camper Name____________________________________ Gender M__ F__ Grade____ Date of Birth__/__/__ Camper T-Shirt Size________ (Check All that Apply) Session 1 (July 5 - 8): *$40 Deposit ___ $200 Early Registration (before June 1st) __ $225 Normal Registration __ Session 1 (July 25 - 29): *$40 Deposit ___ $250 Early Registration (before June 1st) __ $275 Normal Registration __ Lunch: $30 Lunch (2 pizza slices & Gatorade daily) ____ **Multi-Family Discount available for 2nd & additional children Register online at: www.myhooplife.com ***Must register at least 5 children at once Some discounts cannot be combined Total Enclosed $_________ Mail completed registration form with payment to: Hoop Life, Inc. P.O. Box 25672 Alexandria, VA 22313 Make Checks Payable to: Hoop Life, Inc. Hold Harmless Agreement: In consideration of Hoop Life, conducting various programs and allowing the above to participate in such programs, the undersigned realizing the risk of injury attendant to such programs, does hereby and forever discharge Hoop Life and its officers, agents, and employees from any and all action, claims or liability resulting from or arising out of or based upon any bodily injury or property damage which may be sustained by the undersigned or the undersigned’s child while participating in such programs. Signature required of adult participant, parent or guardian of child ____________________________________________________________________________________________________________________ Date____________________ These materials are neither sponsored nor endorsed by the Fairfax County School Board, the Superintendent, or this school. Division. Want to know what it’s like to be a Girl Scout? Join us at Girl Scout Camp Try It this summer Disclaimer: These materials are neither sponsored nor endorsed by the County School Board, the Superintendent, or this school. Camp Try It is a community-based camp designed for girls in grades K-6 who are not currently enrolled in Girl Scouts. Activities include arts and crafts, songs, games, STEM experiments, Girl Scout traditions and so much more! Camp Try It es un campamento de comunidad diurno diseñado para las niñas que no son miembros actualmente de las Girl Scouts que cursan los grados K-6. Las actividades incluyen: artes, manualidades, canciones, juegos, ciencias, tecnología, ingeniería, matemáticas, tradiciones de Girl Scouts y mucho más. Cost $50 Costo $50 To Register Online Registracion en línea To Register by Mail Registracion por correo For more information Para más información Financial Assistance Available Includes: camp, t-shirt, snacks and bus transportation www.gscnc.org/CampTryIt Fill out enclosed form and mail form and check to: Girl Scouts Nation’s Capital Camp Try It 4301 Connecticut Ave, NW Washington, DC 20008 Annette Rollins 202-274-3321 [email protected] Asistencia Financiera Disponible Incluye: campamento, camiseta, meriendas y el transporte en autobús www.gscnc.org/CampTryIt Enviar hoja y pago en cheque o giro a nombre de: Girl Scouts Nation’s Capital Camp Try It 4301 Connecticut Ave, NW Washington, DC 20008 Zoe Rodriguez 202-274-3315 [email protected] Volunteer opportunities! We are looking to hire adult staff for camp to serve as Camp Directors, Unit Leaders and First Aiders. If you or someone you know is interested, please complete the application at: www.gscnc.org/CampTryIt Teens in grades 7-12 that are looking to earn Student Service Learning Hours can apply to volunteer at: www.gscnc.org/CampTryIt Make sure you keep this page for the contact information! Camp Name Dates Location Bus Stops Camp Try It - St. Mary’s June 15-17 St. Mary’s County Fairgrounds 42455 Fairgrounds Rd. Leonardtown, MD 20650 Charlotte Hall Library, Chaptico Market, Benjamin Banneker ES, Lexington Park ES, Wildewood Shopping Center and Doresy Park Camp Try It - Loudoun June 20-24 Algonkian Regional Park 47001 Fairway Dr. Sterling, VA 20165 Meadowland ES, Sugarland ES, Sterling Community Center, Dulles South Multipurpose Center, Pinebrook ES, Legacy ES and Broad Run ES Camp Try It - Manassas June 20-24 Nokesville Park 12560 Aden Rd. Nokesville, VA 20181 Yorkshire ES, Cougar ES, Round ES, Marsteller MS, Weems ES, West Gate ES and Sinclair ES Camp Try It - Brookeville June 20-24 Camp Brighton Woods 120 Brighton Dam Rd. Brookesville, MD 20862 Cloverly ES, Greencastle ES, Cannon Road ES, Kemp Mill ES, Glenallen ES, Olney ES, Rock Creek Terrace Apartments and Wheaton Woods ES Camp Try It - La Plata June 20-24 Grace Lutheran Church & School 1200 Charles St. La Plata, MD Smallwood MS, Pisgah Park, McDonough HS, Berry ES, Wade ES and Thomas Stone ES Camp Try It - DC June 20-24 H.D. Cooke Elementary School 2525 17th St. NW Washington, DC 20009 Shepherd ES, Bancroft ES, Mann ES and Garrison ES Camp Try It - Urbana June 27-30 Green Meadow Farm 10102 Fingerboard Rd. Ijamsville, MD 21754 Middletown Primary, Waverly ES, North Frederick ES, Urbana Library, Whittier ES, Monocacy ES, Liberty ES, New Market ES and Kemptown ES Camp Try It - Braddock June 27-July 1 Braddock Elementary School 7825 Heritage Dr. Annandale, VA 22003 Woodson HS, Little Run ES, Bren Mar ES, Weyanoke ES, Pine Spring ES, Glen Forest ES and Mason Crest ES Camp Try It - Leesburg June 27-July 1 Leesburg Elementary School 323 Plaza St. NE Leesbrug, VA 20176 Lovettsville ES, Lucketts ES, Balls Bluff ES, Round Hill ES, Harmony ES and Evergree Mill ES Camp Try It - Oxon Hill June 27-July 1 Oxon Hill High School 6701 Leyte Dr. Oxon Hill, MD 20745 Giant Food Livingston Rd., Rosaryville ES, Kettering ES, Samuel P. Massie Academy, District Heights ES, Suitland ES, Francis T. Evans ES and Brandywine ES Camp Try It - Rockville July 5-8 Katherine Thomas School 9975 Medical Center Dr. Rockville, MD 20850 Germantown ES, Rachel Carson ES, Bethesda ES and Meadow Hall ES Camp Try It - St. Leonard July 11-15 Crossroads Christian Church 150 Ball Rd. St. Leonard, MD 20685 Rolands Grocery Store, Huntingtown HS and Prince Frederick Safeway Camp Try It - Stafford July 11-15 Camp Coles Trip 134 Payne Ln. Stafford, VA 22554 Occoquan ES, Leesylvania ES, Mary Williams ES, Penn ES, Minnieville ES, Fannie Fitzgerald ES, Montclair ES, and Dumfries ES Camp Try It - Oakton July 11-15 Camp Crowell 10900 Vale Rd. Oakton, VA 22124 Franklin Sherman ES, Churchill Road ES, Hutchison ES, Deer Park ES, Greenbrier West ES, Mosby Woods ES, Eagle View ES, Timberlane ES, Freedom Hill ES, Springfield Estate ES, Forestdale ES, Lynbrook ES, Crestwood ES, Hagel Circle and Laurel Hill ES Camp Try It - Takoma Park July 11-15 Takoma Park Elementary School 7511 Holly Ave. Takoma Park, MD 20912 Burnt Mills ES, Cresthaven ES, JoAnn Leleck ES, Viers Mill ES, Rock View ES, Oakland Terrace ES, Woodmoor Shopping Center, Silver Spring Library, Rosemary Hills ES, New Hampshire Estates ES, Long Branch Library and East Silver Spring ES Camp Try It - Aquasco July 18-22 Camp Aquasco 17100 Aquasco Farm Rd. Aquasco, MD 20608 Riverdale ES, Chuck E Cheese at Capital Blvd., Benjamin Tasker MS, Kenmoor MS, Shopper’s Food Warehouse New Carrollton, Bladensburg HS and Theresa Banks Complex Camp Try It - Haymarket July 18-22 Battlefield High School 15000 Graduation Dr. Haymarket, VA 20169 Liberty HS, Taylor MS, Marshall Community Center, P.B. Smith ES, Glenkirk ES and Haymarket ES Camp Try It - Alexandria July 25-29 Del Ray United Methodist Church 100 East Windsor Ave. Alexandria, VA 22301 Rose Hill ES, Mt. Eagle ES, Cameron ES, Whitman MS, Woodlawn ES, Mt. Vernon Woods ES, Ft. Belvoir ES, Woodley Hills ES, Riverside ES, Groveton ES, Hybla Valley ES and Hollin Meadows ES Camp Try It - Frederick July 25-29 Trinity United Methodist Church 703 W Patrick St. Frederick, MD 21701 Thurmont Primary, Walkersville ES, Hillcrest ES, Ballenger ES, Orchard Grove ES, Deer Crossing ES, Spring Ridge ES and Lincoln ES KEY: ES - Elementary School • MS - Middle School • HS - High School Write Your Camp Location Choice/ Escriba el Campamento que seleccionó _________________________________________________________ □ New Girl Scout/Registración Nueva Girl Scout □ Registered Girl Scout/Girl Scout Registrada Troop#/Tropa #__________ Name/Nombre Middle/Apellido Last Name/Apellido Date of Birth/Fecha de Nacimiento Address/Dirección City/Ciudad Apartment/ Apartamento State/Estado Zip Code/Código Postal Mother/Father/Guardian 1/ Padre/ Madre/Guardian 1 Cell/Móvil Phone/Teléfono Mother/Father/Guardian 2/ Padre/ Madre/Guardian 2 Work Phone/Teléfono del Trabajo This program offers transportation free of charge to all participants./ Este programa ofrece transportación gratis a todas las participantes. Home Phone/Teléfono de la Casa Custody/Custodia: □ Both Parents/Ambos Padres □ Mother/Guardian/Madre/Guardian □ Padre/Guardian □ Other/Otro (especificar) Emergency Contact Information other than those listed above. By including names and contact information below, I authorize the Camp Director to call these individuals in the event a parent/guardian cannot be reached. I also authorize my child to be released to these individuals./ Contacto de Emergencia personas distintas de las enumeradas anteriormente. Con la inclusión de los nombres e información de contacto más abajo, autorizo al Director del Campamento llamar a estos individuos en el caso de que un padre / tutor no puede ser localizado. También autorizo a que mi hija sea entregada a estas personas. Emergency Contact #1/Contacto de Emergencia #1 Relationship/Relación Phone/Teléfono Emergency Contact #2/Contacto de Emergencia #2 Relationship/Relación Phone/Teléfono Please use the space below to list any additional people, beyond those already listed, who are authorized to pick up your daughter. Utilice el siguiente espacio para enumerar personas adicionales, más allá de las ya enumeradas, que están autorizados a recoger a su hija. Girl Scouts respects and welcomes people from all backgrounds and abilities. By completing the following information (as defined by the US census), you ensure support and funding for girls in your community. Hispanic/Latina is defined as an ethnicity by the US census, not a race, therefore is reported separately./ Girl Scouts respeta y acoge con satisfacción personas de todos los orígenes y condiciones. Al completar la siguiente información (tal como se define por el Censo de Estados Unidos), se asegura el apoyo y el financiamiento de las niñas en su comunidad. Hispano / Latino se define como un grupo étnico en el Censo de Estados Unidos, no es una raza, por lo que se informa por separado. □ American Indian or Alaskan Native / India Americana o Nativa de Alaska □ Asian/ Asiática □ Black or African American/ Negra o Afroamericana □ Hawaiian or Pacific Islander / Hawaina o de las Islas del Pacífico □ White/ Blanca □ Other (Please specify)/ Otra (Favor de especificar) ______________________ □ I choose not to share at this time / Decido no compartir la información en éste momento. She is Hispanic or Latina:/ Ella es Hispana o Latina: Name of School/Nombre de la Escuela □ Yes/Si □ No □ I choose not to share at this time / Decido no compartir la información en éste momento. School City/Ciudad School State/Estado Current Grade in School/Grado Escolar de la Niña Health History/ Historial Médico Is an Epi-Pen Required?¿Inyección e Epinefrina es necesaria? □ No Home Phone/Teléfono de la Casa Email/Correo electrónico She is:(Check all that apply)/ Ella es: (Marcar todas las que apliquen) The Girl Scout Council of the Nation’s Capital and the Girl Scouts of the USA (GSUSA) may use photographs in which my child appears to promote Girl Scouting./ El Concilio de Girl Scouts de la Capital de la Nación y las Girl Scouts de los E.U. (GSUSA) podrá utilizar fotografías en las que mi hija parece promover las Girl Scouts. □ Yes/Si Email/Correo electrónico Work Phone/Teléfono del Trabajo Cell/Móvil Age/Edad □ Teen/Adolescente Do you need bus transportation?/ ¿Su hija necesita transportación? □ Yes/Si □ No Please Write your bus stop:/Escribe la parada del bus: ____________________________ The Program registration fees are $50.The fees are non-refundable./ El costo de este programa es de $50. El costo no es reembolsable. The Girl Scout Council of the Nation’s Capital offers financial assistance to make camp available to all girls grades K-12. Please remember that we want to offer financial assistance to as many girls as possible, so only request what your family truly needs./ El Concilio de Girl Scouts de la Capital de la Nación ofrece asistencia económica para niñas en los grados K-12. Por favor, recuerde que nosotros queremos ofrecer asistencia a tantas niñas como sea posible, por lo que sólo pida lo que realmente necesita su familia. My family requests the following amount in financial assistance toward the registration fee:/ Mi familia solicita la siguiente cantidad de asistencia económica hacia el costo de inscripción: $________ □ Yes/Si □ No Allergies (Please list all)/ Alergias (Favor nombrar todas) Please specify any accommodations that are needed/ Favor indicar la necesidad de algún acomodo razonable Health Concerns/ Condiciones de Salud Operations or Serious Injuries/ Cirugías o Lesiones Graves Disabilities/Discapacidades: □ ADD/ADHD □ Emotional/Emocional □ Learning/Aprendizaje □ Physical/Física □ Visual Date(s)/Fecha(s) Please specify any accommodations that are needed/ Favor indicar la necesidad de algún acomodo razonable □ Deaf/Hard of Hearing/ Sordo/Mudo o Dificultad para escuchar □ Behavioral/ Comportamiento □ Not Applicable/ No Aplica □ Other (Please Specify)/ Otra (favor de especificar)________________ Medication Information/Historial Médico: Will your daughter be bringing medication to camp/ ¿Su hija traerá medicamentos al Campamento? □Yes/ Si □ No □ Epi-Pen/ Inyección de Epinefrina □ Insulin/Insulina □ Inhaler/Inhalador □ Over the Counter/ Medicamentos No Recetados_______________ □ Prescription/ Medicamentos Recetados_____________ Is your daughter enrolled in a public, private or public charter school?/ ¿Su hija Are all If immunizations are not up to date, is a state certificate esta matriculada en una escuela pública, privada o charter? immunizations up from the physician or parent stating medical or religious □ Yes/ Si to date:/ reasons on file with the school?/ □ No Todas las Si las vacunas no están al día, necesita presentar como evidencia certificado del estado por parte del médico o de vacunas están al Home School campers must submit additional health documentation / Niñas que los padres indicando razones médicas o religiosas. día: participan de Escuela en el Hogar deben presentar documentación adicional de □ Si □ Yes/ Si salud □ No □ No Family Physician/Médico de Familia Phone/Teléfono Health Insurance/Seguro Médico Mail To: Girl Scouts Nation’s Capital, Attn: Camp Try It, 4301 Connecticut Ave, NW, Washington, DC 20008 Policy #/ Número de Póliza The information and health history is correct so far as I know, and the person herein described has my permission to participate in all prescribed activities as noted. If she/he appears to be ill, I will not send her/him to the program. I understand my daughter will become a registered member of the Girl Scouts of the USA through participation in this program. I hereby give permission to the medical personnel selected by the camp director or her/his designee to order x-rays, routine tests and treatment for my child. In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp director, or her/his designee, to hospitalize, secure proper treatment for, and/or injection, and/or anesthesia, and/or surgery for my child as named above. / La información de salud es correcta hasta donde yo sé, y la persona aquí descrita tiene mi permiso para participar en todas las actividades prescritas como se ha señalado. Si ella parece estar enferma, no voy a enviarla al programa. Entiendo que mi hija se convertirá en un miembro registrado de las Girl Scouts de los EE.UU. a través de la participación en este programa. Por la presente autorizo al personal médico seleccionado por el director del campamento o su designado para ordenar radiografías, exámenes de rutina y tratamiento para mi hijo. En el caso de que yo no pueda ser localizado en caso de emergencia, doy permiso al médico seleccionado por el director del campamento, ella / él designe, para hospitalizar, asegurar el tratamiento apropiado, y / o inyección, y / o anestesia y / o cirugía para mi niña nombrada arriba. Parent/Guardian Signature and Name/ Firma y Nombre de Padre/Madre/Guardian