Welcome to Black Canyon Gymnastics Day Camp. It is our purpose to provide a
healthy and safe environment for your child during summer. It is our goal to
help keep you child active and fit for the summer.
Activities might include:
Open gym, going to the park, gymnastics, swimming, biking / skating at the park, climbing, arts
and crafts, special guests, theme days, board games, reading, field trips to the library, open play
and snacks. We will provide a weekly calendar of events so that you and your child may be
prepared for the upcoming activities.
Policies
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Day Camp is for children between the ages of 5 - 12.
Campers must sign up at least two weeks in advance. Deadline to sign up is Thursday for
the following week. Drop-ins will only be taken if we have room.
Payment is due at the time of sign up. No refunds are given for missed days.
We reserve the right to change or amend our posted schedule.
Day Camp packets must be filled out before your child may participate.
You will be charged a late pick up fee of $1.00 per minute after five minutes.
Day Camp doors open at 7:30 a.m. There is NO early drop off.
Drop off is from 7:30 – 9:00 a.m. or from 12:30 – 1:00 p.m. For your child’s safety
please adhere to these times. Drop off only at Black Canyon Gymnastics. We will not
accept drop offs or pick ups at any other location.
If your camper is doing full day, they must bring a sack lunch and drink.
Parents or authorized individuals must sign the camper in and out. Campers will not be
released to anyone who is not on their card.
Photo i.d.’s are required for identification at sign in and sign out.
Hours of Operation
Half Day Camp is from 7:30am – 12:00 or from 12:30 p.m. – 5:30 p.m.; Monday - Friday
Full Day Camp is from 7:30 a.m. – 5:30 p.m.; Monday - Friday
Fees
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$20.00 for a half day 7:30-12:30 or 12:30-5:30.
$32.00 for a full day 7:30-5:30.
A 10% discount will be given to siblings for full day sign ups.
A discount will be given for full day – full week sign ups.
There will be no refunds for missed days.
Members will pay a $25 annual registration fee.
There is late fee of $1.00 per minute after 5 minutes.
There will be a $25.00 fee on all returned checks.
Payment is due at the beginning of the week.
There will be no refunds or makeup days.
Day Camp Cancellation Policy
When you sign up for day camp you are given a calendar on which to mark your days. All
circled days are assumed to be full days. To sign up for a half day write am or pm across the
date. To cancel a day, you need to notify the office by phone or in person no later than Thursday
at 5:00 pm before the start of the next week. The calendar must then be initialed and dated for
the cancellation to be valid. If the calendar is not initialed and dated, you may still be charged
for that day.
Extreme weather
In the event of extreme snow or heat you will be notified if Day Camp is canceled before the
start of the day. Our facility is equipped with all first aid materials to be kept safe in the event
that your child is at the facility.
Registration
All registration packets must be filled out in order to participate.
Day Camp students must supply a copy of current immunization records and statement of health.
There is an annual registration fee of $25.00.
Immunization Record
*Please submit a copy of your child’s immunization record. If you do not have a copy you may
obtain one from your health care provider or have them fill out the attached form. You may also
bring us a printed copy from the Montrose County School District’s parent portal page for your
child (a password is required which you may set up with the School’s Administration office if you
do not already have one.) Log in to the parent portal through the mcsd.org website and click on
the “health” tab under the desired student’s name then print that page.
*If you have opted to not immunize your child then please fill out the “Statement of
Exemption to Immunization Law” portion at the bottom of the attached Immunization record
form.
General Health Appraisal From:
*Please submit a current “General Health Appraisal Form” for your child. It must be
completed, signed and dated within the last year by your health care provider. A form has been
included in this packet for your convenience.
Special Needs
Reasonable accommodations will be made for children with disabilities, as long as the
accommodations do not fundamentally alter the Day Camp program.
Diapering and Toilet Training
The Gym N’ Learn and Day Camp policies require that your child must be potty trained to
attend our Gym N’ Learn and Day Camp programs. In the event of an accident you are asked to
provide extra clothes or a pull- up if necessary. If in a pull-up please provide any necessary
wipes or cream. Cream will not be applied to broken skin.
Signing in and out
You must sign your child in and out every day. Children will not be released to anyone who is
not on their card and cannot show a photo id. If children are not picked up with in 15 minutes of
the end of class your emergency contacts will be called. If not picked up within one hour social
services will be called and your child will be considered abandoned. You may not drop off or
pick up your child away from the facility. You will need to wait until the group is back at the
facility to sign in or out.
Visitors
All visitors are required to check in at the main office. Visitors must be accompanied by a staff
member to the Day Camp area. At no time are adults or siblings allowed on the gym floor.
Where is my child at
You can pick up a copy of our daily schedule or call the office for our daily schedule. Children
are in the care of their teachers at all times..
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Sample daily Schedule
7:30-9:30 arrival: Check in. Free play in the gym, socialization time
9:30-10:00 snack
10:00-11:45 Field Trip to park / library
11:45-12:45 Lunch (mid-day drop-off and pick-up)
12:45-3:30 Field Trip to pool
3:45-4:15 Snack
4:30-5:30 Gym Time
5:30 Departure
Storage of Personal items
Each child has a cubbie to store their personal belongings in. Children are responsible for
keeping tack of their items. Black Canyon Gymnastics is not responsible for lost, stolen or
damaged items.
Attire for your day camper
I agree to dress my child appropriately for the day’s activities.
Jacket, gloves, hat, boots (when necessary)
Walking shoes (when necessary; on all walking field trip days)
Gym clothes (please do not wear shorts or pants with buttons/zippers)
Swim Suit and Towel on swim days
Snacks
Day Campers will be provided with a daily healthy snack in the am and pm. If your child is
allergic to our posted snack an alternative will be provided.
Lunch
If your Day Camper is full day they must bring a sack lunch.
Discipline procedures
Our facility believes in the time out philosophy. For serious infractions a child may be sent
directly home.
Example of discipline procedures may be:
1st offense
Short time out away from activity
2nd offense
An age appropriate time out for and apology if necessary
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3 offense
Parents called and child sent home
If a child is sent home, there will need to be a meeting with the staff, parents, and child to see if
they will be able to return to Day Camp.
Communication
The day camp director is available at drop off or pick up time to discuss any concerns you may
have. If your child has any special circumstances that we need to be aware of please let the
director know. If at any time you feel that you need to schedule a conference, please feel free to
contact the director or the office and we will be happy to set one up. Please check white boards,
bulletin boards, and your child’s cubby for information. There is an anonymous
suggestion/comment box located on the sign in/out desk. Also, located on this desk is an
informational resource area for parents to utilize upon check-out. Remember to check bulletin
boards and sign in books for information.
Field Trips
Black Canyon Gymnastics L.L.C. has my permission to take my day camper on any field trip
away from the facility.
I understand that my child will be walking to the park, pool, and library. I understand that First
Student will transport my child in the event of a field trip that is not within walking distance.
I agree to provide my child with the proper walking shoes and attire for field trips and recognize
that is not Black Canyon Gymnastic L.L.C.’s responsibility to ensure that my child is properly
dresses.
Park Policies
I understand that in order for my child to ride their bike, skate board, scooter or heeleys that they
must have a helmet on.
Sunscreen policy
Black Canyon Gymnastics L.L.C. will assist with applying sunscreen to bare surfaces including
but not limited to the face, tops of ears, bare shoulders, back, legs, arms, and feet.
Sunscreen will not be applied to any broken skin or if a skin reaction has been observed.
Special instructions
Black Canyon Gymnastics L.L.C. will supply the following sunscreen for all children’s use: NOAD 30spf, UVA / UVB Sunblock Lotion with Aloe and Vitamin E. If your child has an allergy
to the above sunscreen you may supply sunscreen specifically for your child. Please provide
your child’s name written on the side of the bottle.
Swimming Ability:
Parents are required to put the appropriate bracelet on their child upon check
in.
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needs flotation(your child will only be in the outdoor pool- you must provide flotation
device)
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outside pool only
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fair swimmer (can go indoor and outdoor- no diving boards)
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swims well (can go indoor outdoor and diving boards)
Media Policies
All television, video, music, computer and video games used in the classroom will be age
appropriate and for educational purposes.
You agree to provide Black Canyon Gymnastics, L.L.C. with specifics about your child
that they should know e.g. allergies seizures, diabetes, asthma, surgeries, unusual
behaviors, extreme fears, etc. Please note these in the space provided on the registration
agreement page at the end of this document.
Medication Administration
Black Canyon Gymnastics has a non-administration of medication policy. We will only
administer medication in the event of a life threatening emergency, which includes epi pens and
nebulizers or inhalers for asthma. To administer these meds, they must be accompanied by:
 The permission to administer medication form.
 They must have a current prescription label, be in the original container bearing the
original pharmacy label that shows the prescription number, patient’s name, name of
medication, date filled by pharmacy, expiration date, physician’s name and directions for
dosage.
 Accompanied by an individual health care plan filled out by your health care provider
which will be kept in their file.
Medication must be given directly to the director who will enter medication in the medication
log. Parents must initial that information is correct.
Illness Policy
Deciding whether to keep your child at home or when to send them to Day Camp can be
difficult. It is important for parents and staff to discuss what observations have been made and
agree on a plan.
Please contact the facility when your child is ill and describe the illness. If a specific diagnosis is
made, e.g., strep throat, conjunctivitis, chicken pox, etc., let the facility know so that other
families can be alerted.
The following is a guideline and recommendation:
Illness
Come to Day Camp
Diarrhea with vomiting, fever
no
Chicken pox
no
Pink eye
no
Head lice
no
Strep throat
no
Hepatitis A
no
Mild cold symptoms
yes-if able to participate in
normal activities
Upper Respiratory complications
no
- large amounts of yellow or green nasal discharge
- extreme sleepiness
- ear pain
- fever above 100 degrees
Children cannot attend if they have a fever or other sickness, which may harm other children. If
your child becomes ill during class they will be sent to the office and will need to be picked up
within one hour of the call. You will be notified of any exposure to contagious illness, infection
or disease.
If Black Canyon Gymnastics feels that your child’s illness is harmful to others you will be
notified and should pick up your child as soon as possible.
Emergency Procedures: I have read the following emergency procedures and give my
permission for Black Canyon Gymnastics to direct my child in the manner indicated during an
emergency.
Lost Child
In the event of a lost child at the facility: All doors will be locked and the facility checked for the
missing child. If the child is not found 911 will be called. If away from the facility all children
will be seated next to their instructor and the additional staff will check the area. If the child is
not found 911 will be called.
In the event of a fire, gas leak, electrical problems
The children will follow the posted evacuation plan to the safety zone. In the event of an
emergency that does not allow us to return to the facility parents will be contacted to pick up
their children.
Flood
In the event of a flood the children and staff will seek higher ground and parents will be called to
pick up.
Tornado
In the event of a tornado alert, the children will be seated on the floor next to an interior wall
away from all windows or put in the pit and covered with mats.
Earthquake
In the event of an earthquake the children will be instructed to get under tables or into the pit and
covered with mats.
Lockdown
In the event of an unsafe situation our phones are able to receive reserve 911 calls and the facility
would be immediately locked down and all windows covered. In the event we are away from the
facility, we will go to the nearest secure location and remain there until the threat is over.
Child Abuse or Neglect
We are required by law to report any signs of abuse or neglect. Failure to report such signs could
cause our facility to be fined. Children’s Protective Services and or the Police Department will
be notified if it appears that a child is being physically, sexually, emotionally abused, neglected
or exploited.
If you would like to report a case of abuse the number to call is listed below
Montrose County Social Services
1845 S Townsend
Montrose CO 81401
970-252-5000
Where to file a complaint about child care
If you have concerns about a child care facility or would like to review a licensed file please
consult the Colorado Division of Child Care 175 Sherman St
Denver CO 80203. 303-866-5958 or 800-799-5876.
Registration Agreement:
Swimming ability: For our records / knowledge please mark the appropriate box
□ needs flotation(your child will only be in the outdoor pool- you must provide flotation device)
□outside pool only
□ fair swimmer (can go indoor and outdoor- no diving boards)
□ swims well (can go indoor outdoor and diving boards)
Specifics about your child that should be known e.g. allergies seizures, diabetes, asthma,
surgeries, unusual behaviors, extreme fears, etc.
Please list any activities you would like your child to be exempt from: __________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
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I have carefully read, understand and agree to all the above Policies, Fees and other general
information provided to me on the previous 6 pages:
Signature________________________________________ Date_______________
Enrollment / Emergency Card
Enrollment Date_________________
Child’s Name________________________________________ BirthDate_________________
Address__________________________________ City_________________ Zip_____________
Mother’s Name______________________________________ Home phone_______________
Employer___________________________ Mother’s E-mail Address:_____________________
Work Hours___________________ Work phone_____________ Cell phone________________
Father’s Name________________________________________ Home phone______________
Employer___________________________ Father’s E-mail Address:______________________
Work Hours___________________ Work phone_____________ Cell phone________________
Emergency contact other than parents
Name______________________ Phone number___________ Address_____________________
Name_______________________ Phone number___________ Address____________________
Names of persons and phone number other than parent to whom the child may be released:
Name_________________ Phone #____________Name________________ Phone #_________
Name_________________ Phone #____________Name________________ Phone #_________
Specific Medical Information
Allergies______________________________________________________________________
Medications______________________________________ Frequency____________________
Other_________________________________________________________________________
Hospital__________________________ Phone number_____________ Address:____________
Physician_________________________ Phone number_____________ Address:____________
Dentist___________________________ Phone number_____________ Address:____________
Insurance___________________________________________
I hereby give permission to Black Canyon Gymnastics L.L.C. to secure emergency medical
treatment for the above named child while in the care of the above named school. If emergency
care is warranted, all expenses of such care will be accepted by the parents.
Signature________________________________________ Date_______________
Black Canyon Gymnastics General Release and Waiver of Liability
General Release
Acknowledgement of Risk and Waiver of Liability
I am the parent or legal guardian of (child’s name)_____________________________.
I hereby consent to the above named person participating in the programs offered by Black
Canyon Gymnastics L.L.C. I recognize that potentially severe injuries, including sprains, strains,
broken bones, permanent paralysis or death, can occur in any activity involving height or motion,
including gymnastics, dance, karate, swimming, diving, and field trips. I UNDERSTAND AND
ACCEPT THAT RISK. I also realize that my child will be performing and training on flooring
and apparatus specific to each sport. For gymnastics all Olympic event plus various other
training devices including trampolines will be used.
I further understand that my child will not be able to participate unless this release form is
signed.
Therefore, in consideration for allowing my child to use the Black Canyon Gymnastics L.L.C.’s
equipment and facilities, I hereby forever release Black Canyon Gymnastics, L.L.C., it’s owners,
officers, employees, teachers, and coaches from all liability for any and all damage and injuries.
Further, for the child, and myself, I acknowledge and assume all attendant risk and hold harmless
Black Canyon Gymnastics, L.L.C., its agents and employees.
As the parent or legal guardian of the aforementioned person, I hereby agree to individually
protect and insure for the possible future medical expenses which may be incurred by my child
as a result of any injury sustained while at, for, or under the direction of Black Canyon
Gymnastics, L.L.C.
THIS ACKNOWLEDGMENT OR RISK AND WAIVER OF LIABILITY, HAVING BEEN
READ THOROUGHLY AND UNDERSTOOD COMPLETELY, IS SIGNED VOLUNTARILY
AS TO ITS CONTENT AND INTENT
Signature:______________________________________ Date__________________