Shia Association of Bay Area (SABA Inc.) - Shia Muslim Association ...

Shia Association of Bay Area (SABA Inc.)
4415 Fortran Court, San Jose, CA 95134
http://www.saba-igc.org, email: sab-admin@saba-igc.org
Phone: 510-918-7450
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SABA is offering a 3-day summer camp for children ages 5 through 13 with daily field trips.
June 25 th to 30 th are filled with excitement! Send your children to enjoy summer activities such
as sports, games, hiking and water play! Lots of fun in an Islamic atmosphere! Let your
children's SUMMER camp begin at SABA!
Where: SABA Center
When: Monday June 25 th , Wednesday June 27 th , and Friday June 29 th
Drop off and pick up time:
Children should arrive promptly to avoid missing activities.
Parents should sign in and sign out children each day and pick them up on time.
Drop Off -11:00 a.m. Pick up 6:30 p.m.
Sleepover option: Pick up child morning of June 30 th at 10:00 a.m.
A fine of $5 for each 5 minutes a parent is late will be enforced.
Food: Children will be daily provided with a delicious & nutritious lunch and snack. The
sleepover option includes dinner on the 29 th and breakfast on June 30 th .
Fees:
$20 per child per day and additional $20 for sleepover option. These are subsidized
figures and SABA does not intend to make any monetary profit from the camp. Parents
are urged to donate over and above this amount to make this children’s summer camp
successful (Families needing financial assistance may get a price break. Please talk to
registration staff).
Registration Deadline: June 3rd, 2007
At: Registration desk in Sunday school. Forms are available online and at Sunday school.
Please fill in ALL information. Payment is due at the time of registration.
What to wear: Comfortable clothes that conform to proper Islamic hijab.
What to bring: All Children must label all items with their name and bring in 2 bags (Bag 2 is to be
brought only on the 29 th , by the children that intend to stay for the sleepover):
BAG 1(Daily bag pack)
___sun block
___jacket (windbreaker)
___hiking shoes
___water gun (optional)
___ insect repellant (optional)
BAG 2 (small bag your child could handle by himself)
___ pajamas or sweat suit to sleep in
___a sleeping bag + pillow + optional extra blanket
___ toothbrush/toothpaste
___ hair brush/comb
___ outfit to change into the next morning
Remember, the more items your child brings the more s/he has to handle and carry, so avoid unnecessary items!
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Camping Rules and Regulations:
All Camp participants are expected to arrive and leave on time, stay in designated areas, listen
to directions, follow rules, and respect all other participants and staff. All participants have to
stay with their respective adult group leader. They may NOT wander off on their own.
Bathroom visits require permission from the group leader. Parents will be held responsible for
any damage caused by their children. Verbal or physical confrontation towards another person
will not be tolerated. Any behavior not corrected by verbal warnings may lead to expulsion
from the camp.
Contact camp organizers of any complaint or suggestion. Do not take any action yourself.
Liability and responsibility
By my signature below I permit my above named child to attend the SABA Summer Camp and agree with the
Camp Rules & Regulations. I also acknowledge and agree that Shia Association of Bay Area (SABA) and the
SABA Summer Camp authorities, and cannot be held responsible in any way, nor assume any liability
whatsoever, for acts of any delays, changes, modifications, negligence, omissions or cancellations, non
performance due to the breakdown of machinery and equipment OR due to disturbance, strike, riots or wars
wherever declared or not OR due to any other cause which is beyond the control of the said parties.
Furthermore School of Ahlul’Bait and SABA are not responsible in any way nor assume any liability
whatsoever, for any damages, lost property, personal injuries, accidents, illness, loss of life, thefts or losses
OR any delays, changes, omissions or cancellations. Participants in the Camp are requested to obtain adequate
Insurance coverage for Medical, Property Loss, Accident and Theft etc. The program is subject to change,
delays, modification, revision or cancellation. All parents or guardians are responsible for any damage,
vandalism or graffiti caused by their children inside or around the property of SABA Islamic Center.
DEADLINE FOR REGISTRATION & PAYMENT IS JUNE 3rd.
Reminder: Punctuality is of utmost importance! Children must be picked
up and dropped off on time.
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Registration Form
HURRY! DEADLINE FOR REGISTRATION &
PAYMENT IS June 3 rd , 2007
Child’s Information:
1. Last Name _________________________ First Name __________________________Birth date _______
2. Last Name _________________________ First Name __________________________Birth date _______
3. Last Name _________________________ First Name __________________________Birth date _______
4. Last Name _________________________ First Name __________________________Birth date _______
Mother’s Last Name ______________________
Mother’s Day Time Contact # ______________
Mother’s First Name ________________________________
Mother’s Cell Phone # _______________________________
Father’s Last Name ______________________
Father’s Day Time Contact # ______________
Father’s First Name ________________________________
Father’s Cell Phone # _______________________________
Home Address ______________________________________________________________________________
Home Phone #
________________________________________
Email address of one of the contacts
____________________________________________
Emergency Contact other than either parent (name/phone/relationship)__________________________________
___________________________________________________________________________________________
Name of medical insurance company _________________________________________
Name of child’s doctor(s)___________________________
Dentist _________________
Doctor’s Contact # ______________________
Dentist’s Contact # _________________________
Does the child have any allergies? ___________
If yes please provide detailed information ________________________________________________________
__________________________________________________________________________________________
List any daily medication child takes _________________________________________________________
__________________________________________________________________________________________
Are you willing to volunteer at camp? _________
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Number of days enrolled _____ x 20 = _______
Number of children enrolled
x______
Subtotal _______
+
Number of children for sleepover option ____ x 20 = _______
Total Amount due $_______
Paid on _____/_____/ 2007__
Signature of parent: _____________________________________________________
Printed Name: __________________________________________________________
(Signature confirms parent gives child/ren permission to participate and has received and agrees to comply with all
rules and regulations of camp)
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