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Summer Happenings Day Program
8:30 AM—3:30 PM
elcome to Pembroke Recreation Summer Happenings Full-Day Program. The Night Owls
Program provides additional hours 3:30-5:30PM for those who need it. The Summer
Happenings Program consists of four 2-week sessions with the option to sign-up for a day, a
week, a session, or the entire summer! Our program is offered to children in Kindergarten
through sixth grade; they are separated into groups by their grade for age-appropriate activities. For
older children we are also offering a separate program: “Teen Extreme” for students in sixth to eighth
grade. With access to air-conditioned classrooms, a gymnasium, and outdoor spaces surrounding the
Community Center, the groups rotate to various stations throughout the day to participate in a variety
of activities from Arts & Crafts to Dodge ball. Participants have the opportunity to attend weekly day
trips. All of our counselors are CPR & First Aid certified. Please read the following carefully.
WHAT TO BRING/WEAR:
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Sneakers; not sandals or loose fitting footwear
Lunch, snack, and drinks (additional snack & drink if attending Night Owls)
We do sell chips, cookies, and candies which range from 30¢ - 75¢, and our soda machine is 75¢
NO PEANUT/TREE NUT PRODUCTS
Refrigeration is not available
Clearly LABEL all your child/children’s belongings with their full name
Pack a change of clothes/bathing suit for water activities
Apply sunblock to your child in the morning and pack sunblock for your child to reapply at lunch
WHAT NOT TO BRING:
Our purpose is to provide an inexpensive, age –appropriate opportunity for all youth to experience indoor
and outdoor activities, both passive and active with their peers, all while creating great memories and new
friends. Below are several items that cause distractions and limit interaction. Any participant that needs to
contact a parent or guardian may use the office phone. Note: If a participant is observed with any of the
items below he or she can expect the staff to take the item; it will be held in the office until pick-up time.
 Cellphones
 I-Pods
 Kindles or other electronics
 Toys
DROP-OFF/PICK-UP:
DRIVE THROUGH DROP-OFF AND PICK-UP
o Drop-off 8:30-8:45 AM
o Pick-Up 3:15-3:30 PM
o Enter drive in front of the building by library entrance
o Please do not allow your child to exit the vehicle until a counselor approaches
o We will provide families with a dashboard place card and ask that parent/guardians have it
visible on your dashboard for pick-up. Also, roll down your window and be ready to present
your photo ID. No child will be released if a valid photo ID is not presented by an
authorized dismissal person.
o Night Owls Pick-Up at the Office (after 3:30 PM)
Pembroke Recreation Department
Community Center, 128 Center Street Pembroke, MA 02359
Phone: 781-293-3249
E-mail: [email protected] or [email protected]
FIELD TRIPS:
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Must register for trips separately- cost not included in weekly/session/daily cost
Deadline to register is two Fridays before the trip
Days of the trips are typically Wednesdays, but for some trips days may vary
Recreation T-shirts are required for Field Trips & may be purchased in the office prior to the day of
the trip. T-shirts will NOT be sold the morning of the trip as the staff needs to focus on coordinating
the groups to board the bus.
Refer to Trip Information Sheets to make sure your child is here on time and properly prepared for
each trip. Note: Lunch must be packed for all trips unless otherwise noted on permission slip. Lunch
cannot be purchased on the trip.
BEHAVIOR: Proper behavior in Recreation Department programs is expected at all times. If
improper behavior cannot be corrected after the second occurrence, then parents will be notified that the
child/children will have to be excused from the programs.
OUR FACILITY: The Community Center and our play areas are being improved yearly. Please
impress upon your child/children that he/she must treat all of our facilities with care and RESPECT. Our
summer program is allowed to use the Community Center only as long as we take care of it.
FINANCIAL & REGISTRATION GUIDELINES:
1. Registrations will continue until program is full.
2. Registrations are processed upon receipt of completed registration form and annual registration fee.
3. We now accept Visa, MasterCard, & Discover online and in-office. In-office we also accept cash, check,
or money order. Checks should be made payable to “Pembroke Recreation”-please include phone
number on checks, we cannot accept any temporary checks.
4. An automated e-mail will serve as confirmation when drop-off/mail-in registration or payments are
processed.
5. The Recreation Department reserves that right to consolidate, postpone, or cancel a program/trip for any
reasonable cause. We otherwise have a no refund policy unless the seat is filled by another participant.
We hope that your child/children’s stay with us is enjoyable and rewarding. We look forward to the
opportunity of working with them. If you have any questions, please call the Recreation office.
6. A $10.00 late fee will be assessed to any “Weekly” activity not paid in full by the due date. A $20.00 late
fee will be assessed to any “Session” activity not paid in full by the due date. Due dates are posted on
the website and can be retrieved from the Recreation Office.
7. If you pick-up after 3:30 PM you will be charged the Night Owl rate of $7.00 per hour with a one hour
minimum. We extended the program an hour in 2014 to accommodate the large number of parents that
just needed an addition 15-30 minutes on either end of the day. The safety of the children depends on
keeping our ratios low and too many unexpected late pick-ups can jeopardize the ratios. The best way to
know if you are late in the afternoon is if you must come in the building to pick-up your child. If you are
on time you will be able to utilize the drive up.
Recreation Director: Susan Roche, Assistant Director Shauna Ferris
Recreation Office: 781-293-3249
Pembroke Recreation Department
Community Center, 128 Center Street Pembroke, MA 02359
Phone: 781-293-3249
E-mail: [email protected] or [email protected]
SUMMER SCHEDULE 2017
Session
Week
Dates
4
Lights, Camera, Action!
Movies
The Mighty Jungle
Drop Zone
3
July 17th-21st
Water, Water Everywhere
George’s Island
4
July 24th – 28th
Mission Impossible
5 Witz
5
July 31st Aug 4th
Holiday Hullabaloo
Launch
6
August 7 – 11
7
August 14 – 18
8
August 21 – 25
1
3
Event/Trip
2
1
2
Theme
July 3 – July 7
Closed 7/4
July 10th -14th
rd
th
th
th
th
st
Sports Extravaganza
One Stop Fun
th
So You Think You Got Talent
Pinz
th
Best of the Best
Water Wizz
Summer Happenings Pricing
Registration
Drop-In
Weekly
Session
First Child
$25
$35 per day
$90 per week
$165 per session
Each Additional Child
$25
$35 per day
$90 per week
$100 per session
Night Owls Pricing
Contract Rates are weekly; double for session rates
One Hour
Two Hours
Drop-In
One Child
$20
$40
$7 per hr.
Each Additional
$16
$28
$7 per hr.
Pembroke Recreation Department
Community Center, 128 Center Street Pembroke, MA 02359
Phone: 781-293-3249
E-mail: [email protected] or [email protected]
If you already have an account, please fill in your last name & address and then you may skip to the registration form on the back.
Primary Adult Member Information
Male / Female
First Name
Last Name
Date of Birth
Gender (circle)
Residential Address
Mailing Address (if not the same as residential address)
Emergency Contact Name & Number
Physician Name & Number
Email Address
Allergies & Conditions
Primary Phone
Home / Work / Cell
Type
Alt. Phone 1
Home / Work / Cell
Alt. Phone 2
Type
Home / Work / Cell
Type
Yes / No
Cellphone Carrier
Text Alerts Opt-In
Adult Member Information
Male / Female
First Name
Last Name
Date of Birth
Gender (circle)
Residential Address
Mailing Address (if not the same as residential address)
Emergency Contact Name & Number
Physician Name & Number
E-mail Address
Allergies & Conditions
Primary Phone
Home / Work / Cell
Type
Alt. Phone 1
Home / Work / Cell
Alt. Phone 2
Type
Home / Work / Cell
Type
Yes / No
Cellphone Carrier
Text Alerts Opt-In
Child Member Information
Male / Female
First Name
Last Name
Date of Birth
Emergency Contact Name
Emergency Contact Number
Physician Name
Physician Number
Allergies & Conditions
Primary Parent/Guardian
Grade
Gender (circle)
Grade
Gender (circle)
Child Member Information
Male / Female
First Name
Last Name
Date of Birth
Emergency Contact Name
Emergency Contact Number
Physician Name
Physician Number
Allergies & Conditions
Primary Parent/Guardian
Pembroke Recreation Department
Community Center, 128 Center Street Pembroke, MA 02359
Phone: 781-293-3249
E-mail: [email protected] or [email protected]
Child Member Information
Male / Female
First Name
Last Name
Date of Birth
Grade
Emergency Contact Name
Emergency Contact Number
Physician Name
Physician Number
Allergies & Conditions
Primary Parent/Guardian
Gender (circle)
REGISTRATION FORM
MEMBERS’ NAME
CIRCLE ALL THAT APPLY
FEE
Summer Happenings Registration
SESSIONS
1 2 3 4
OR INDIVIDUAL WEEKS
1 2 3 4 5 6 7 8
Night Owls Program
One Hour:
3:30-4:30 PM
Two Hours: 3:30 PM-5:30 PM
Payment Method:
Check #_______________ Cash Receipt # ________________ CC____
TOTAL FEES
Provide the names of all adults authorized to dismiss your child. Photo identification is needed for pick-up:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
DISCLAIMER
The Pembroke Recreation does not carry insurance on participants and assumes no liability for injuries sustained
while participating in our program. Recreation Program participants participate in a number of competitive sports
and the by signing this release I recognize and understand that injuries can occur while participating and can be an
inherent and unavoidable consequence of some activities. Having read this disclaimer I hereby consent to my
participation and or my child’s participation in Pembroke Recreation’s voluntary programs and agree to hold
Pembroke Recreation, its commissioners, coaches, directors and managers harmless from any and all actions, claims
and damages for personal injuries and disabilities that we may sustain or incur as a result of participation in this
program.
I understand that every effort will be made to contact the emergency contact person in case of an emergency
requiring medical attention for me or my child. However, if that person cannot be reached, I hereby authorize the
Pembroke Recreation Department to transport me to the nearest hospital and to secure the necessary medical
treatment. By signing below I grant the Pembroke Recreation Department permission for medical emergency
authorization.
Participant Signature
Date
Parent’s/Guardian’s Signature if participant is under 18 years of age
Date
Pembroke Recreation Department
Community Center, 128 Center Street Pembroke, MA 02359
Phone: 781-293-3249
E-mail: [email protected] or [email protected]
Movies
Field Trip Details
Location Hanover Patriot Cinema
Dates Thursday, July 6, 2017
Time 9:00am-12:00pm
Transportation School bus
Cost $17.00
What to bring
This trip includes a popcorn and
drink.
Note: No cell phones or other
electronic devices are allowed on this
field trip. Any equipment of this kind
will be taken away by a counselor and
returned at the end of the day.
Notes Your child must be in
attendance no later than
8:45AM wearing a Pembroke
Recreation T-shirt (may be
purchased in the office).
Hanover Patriot Cinema
I give permission for my child/children, ___________________________ to attend the field trip to
Hanover Patriot Cinema. I understand that Pembroke Recreation does not carry insurance on
participates and assumes no liability for injuries sustained while participating in our program. Summer
Happenings participants participate in a number of off-site field trips and the parent or guardian signing
this release recognizes and understands that injuries can occur while participating and can be an inherent
and unavoidable consequence of some activities. Having read this disclaimer I hereby approve my son’s/
daughter’s participation the Summer Happenings program and agree to hold Pembroke Recreation, it’s
commissioners, counselors, directors, and managers harmless from any and all actions, claims and
damages for personal injuries and disabilities that I and or my child/children may sustain or incur as a
result of participation in this program.
Parent / Guardian’s Signature _____________________________________Date_____/_____/_____
Enclosed is $__________ ($17.00 X # of children) to cover the cost of the trip.
Method of payment: cash _____ check #_________
Note: Please make checks payable to Pembroke Recreation. Online Registration available at
www.PembrokeRec.com
Pembroke Recreation Department
Community Center, 128 Center Street Pembroke, MA 02359
Phone: 781-293-3249
E-mail: [email protected] or [email protected]
Drop Zone
Field Trip Details
What to bring
Location Drop Zone Adventure Park
(Plymouth)
Dates Wednesday July 12, 2017
Time 9:00am-1:45pm
Transportation School bus
Cost $30.00 per participant
Notes Your child must be in
attendance no later than
8:45 am wearing a
Pembroke Recreation
T-shirt (may be purchased
in the office).
Packed lunch labeled on the outside
with your child’s name.
No Flip Flops all children must wear a
closed toe shoes.
Drop Zone Adventure Park requires
each child to have a signed waiver.
Please sign and return the Launch
waiver.
Drop Zone
I give permission for my child/children, ___________________________ to attend the field trip to Drop
Zone Adventure Park. I understand that Pembroke Recreation does not carry insurance on participates
and assumes no liability for injuries sustained while participating in our program. Summer Happenings
participants participate in a number of off-site field trips and the parent or guardian signing this release
recognizes and understands that injuries can occur while participating and can be an inherent and
unavoidable consequence of some activities. Having read this disclaimer I hereby approve my son’s/
daughter’s participation the Summer Happenings program and agree to hold Pembroke Recreation, it’s
commissioners, counselors, directors, and managers harmless from any and all actions, claims and
damages for personal injuries and disabilities that I and or my child/children may sustain or incur as a
result of participation in this program.
Parent / Guardian’s Signature _____________________________________Date_____/____/____
Enclosed is $__________ ($30.00 X # of children) to cover the cost of the trip and lunch (optional).
Method of payment: cash _____ check #_________
Note: Please make checks payable to Pembroke Recreation and post-date checks to the date of the trip.
Pembroke Recreation Department
Community Center, 128 Center Street Pembroke, MA 02359
Phone: 781-293-3249
E-mail: [email protected] or [email protected]
5 Wits
Field Trip Details
What to bring
Location 5 Wits (Foxboro)
Packed lunch and drink labeled on the
outside with your child’s name.
Dates Wednesday July 26, 2017
Time 8:45am – 1:30pm
Transportation School bus
Cost $25.00 per participant
Notes Your child must be in
attendance no later than
8:30 am wearing a
Pembroke Recreation
T-shirt (may be purchased
in the office).
Note: No cell phones or other
electronic devices are allowed on this
field trip. Any equipment of this kind
will be taken away by a counselor and
returned at the end of the day.
5 Wits
I give permission for my child/children, ___________________________ to attend the field trip to 5
Wits . I understand that Pembroke Recreation does not carry insurance on participates and assumes no
liability for injuries sustained while participating in our program. Summer Happenings participants
participate in a number of off-site field trips and the parent or guardian signing this release recognizes and
understands that injuries can occur while participating and can be an inherent and unavoidable
consequence of some activities. Having read this disclaimer I hereby approve my son’s/ daughter’s
participation the Summer Happenings program and agree to hold Pembroke Recreation, it’s
commissioners, counselors, directors, and managers harmless from any and all actions, claims and
damages for personal injuries and disabilities that I and or my child/children may sustain or incur as a
result of participation in this program.
Parent / Guardian’s Signature _____________________________________Date_____/_____/_____
Enclosed is $__________ ($25.00 X # of children) to cover the cost of the trip.
Method of payment: cash _____ check #_________
Pembroke Recreation Department
Community Center, 128 Center Street Pembroke, MA 02359
Phone: 781-293-3249
E-mail: [email protected] or [email protected]
Launch Trampoline Park
Field Trip Details
Location Launch Trampoline Park
(Norwood)
Dates Wednesday August 2, 2017
Time 8:45am-1:30pm
Transportation School bus
Cost $30.00 per participant
Notes Your child must be in
attendance no later than
8:30 am wearing a
Pembroke Recreation
T-shirt (may be purchased
in the office).
What to bring
Packed lunch and drink labeled on the
outside with your child’s name.
Launch socks must be worn in order
to use the facility. The price of the
socks is included.
Note: No cell phones or other
electronic devices are allowed on this
field trip. Any equipment of this kind
will be taken away by the staff and
returned at the end of the day.
Launch Trampoline Park requires each child
to have a signed waiver. Please sign and
return the Launch waiver.
Launch Trampoline
I give permission for my child/children, ___________________________ to attend the field trip to
Launch. I understand that Pembroke Recreation does not carry insurance on participates and assumes no
liability for injuries sustained while participating in our program. Summer Happenings participants
participate in a number of off-site field trips and the parent or guardian signing this release recognizes and
understands that injuries can occur while participating and can be an inherent and unavoidable
consequence of some activities. Having read this disclaimer I hereby approve my son’s/ daughter’s
participation the Summer Happenings program and agree to hold Pembroke Recreation, it’s
commissioners, counselors, directors, and managers harmless from any and all actions, claims and
damages for personal injuries and disabilities that I and or my child/children may sustain or incur as a
result of participation in this program.
Parent / Guardian’s Signature _____________________________________Date_____/_____/_____
Enclosed is $__________ ($30.00 x #__ of children) to cover the cost of the trip.
Method of payment: cash _____ check #_________
Note: Please make checks payable to Pembroke Recreation and post-date checks to the date of the trip.
Pembroke Recreation Department
Community Center, 128 Center Street Pembroke, MA 02359
Phone: 781-293-3249
E-mail: [email protected] or [email protected]
George’s Island
Field Trip Details
What to bring
Location George’s Island (Boston)
Dates Wednesday July 19, 2017
Time 8:30am – 3:00pm
Transportation School bus to/from Boston
Boston Harbor Cruises
to/from Island
Cost $20.00 per participant
Packed lunch and drink. Your child
will be carrying their lunch so a
backpack is a good idea. (Please keep
in mind the island has a carry on,
carry off policy)
Money for concessions/gift shop.
(Optional) *Purchase of food at the
concession is for an additional snack only
and cannot be depended on for lunch.
.
Notes Your child must be in
attendance no later than
8:15 am wearing a
Pembroke Recreation
T-shirt (may be purchased
in the office).
Note: No cell phones or other
electronic devices are allowed on this
field trip. Any equipment of this kind
will be taken away by a counselor and
returned at the end of the day.
George’s Island
I give permission for my child/children, ___________________________ to attend the field trip to
George’s Island. I understand that Pembroke Recreation does not carry insurance on participates and
assumes no liability for injuries sustained while participating in our program. Summer Happenings
participants participate in a number of off-site field trips and the parent or guardian signing this release
recognizes and understands that injuries can occur while participating and can be an inherent and
unavoidable consequence of some activities. Having read this disclaimer I hereby approve my son’s/
daughter’s participation the Summer Happenings program and agree to hold Pembroke Recreation, it’s
commissioners, counselors, directors, and managers harmless from any and all actions, claims and
damages for personal injuries and disabilities that I and or my child/children may sustain or incur as a
result of participation in this program.
Parent / Guardian’s Signature _____________________________________Date_____/____/____
Enclosed is $__________ ($20.00 X # of children) to cover the cost of the trip.
Method of payment: cash _____ check #_________
Note: Please make checks payable to Pembroke Recreation and post-date checks to the date of the trip
Pembroke Recreation Department
Community Center, 128 Center Street Pembroke, MA 02359
Phone: 781-293-3249
E-mail: [email protected] or [email protected]
One Stop Fun
Field Trip Details
Location One Stop Fun (Westford)
Dates FRIDAY, August 11, 2017
Time 8:30am – 3:30pm
Transportation Coach Bus
Cost $25.00 per participant
Notes Your child must be in
attendance no later than
8:15 am wearing a
Pembroke Recreation
T-shirt (may be purchased
in the office).
What to bring
Drink, pizza, popcorn, will be
provided. If your child does not like
that meal or has allergies please notify
the office.
Wear bathing suit to Recreation and
apply sunblock in the morning. Bring
sunblock, towel, and change of
clothes.
Note: One Stop Fun requires each
child to have a signed waiver. Please
sign and return the Launch waiver.
I give permission for my child/children, ___________________________ to attend the field trip to One
Stop Fun. I understand that Pembroke Recreation does not carry insurance on participates and assumes
no liability for injuries sustained while participating in our program. Summer Happenings participants
participate in a number of off-site field trips and the parent or guardian signing this release recognizes and
understands that injuries can occur while participating and can be an inherent and unavoidable
consequence of some activities. Having read this disclaimer I hereby approve my son’s/ daughter’s
participation the Summer Happenings program and agree to hold Pembroke Recreation, it’s
commissioners, counselors, directors, and managers harmless from any and all actions, claims and
damages for personal injuries and disabilities that I and or my child/children may sustain or incur as a
result of participation in this program.
Parent / Guardian’s Signature _____________________________________Date_____/_____/_____
Enclosed is $__________ ($25.00 X # of children) to cover the cost of the trip.
Method of payment: cash _____ check #_________
Note: Please make checks payable to Pembroke Recreation. Online Registration available at
www.PembrokeRec.com
Pembroke Recreation Department
Community Center, 128 Center Street Pembroke, MA 02359
Phone: 781-293-3249
E-mail: [email protected] or [email protected]
Water Wizz
Field Trip Details
Location Water Wizz (East Wareham)
Dates Wednesday, August 23, 2017
Time 8:45 AM – 3:30 PM
Transportation School bus
Cost $40.00 per participant
Notes Your child must be in
attendance no later than
8:30 AM wearing a Pembroke
Recreation T-shirt (may be
purchased in the office).
What to bring
Packed lunch and drink labeled on the
outside with your child’s name.
Wear bathing suit to Recreation and
apply sunblock in the morning. Bring
sunblock, towel, and change of
clothes.
Note: No cell phones or other
electronic devices are allowed on this
field trip. Any equipment of this kind
will be taken away by the staff and
returned at the end of the day.
I give permission for my child/children, ___________________________ to attend the field trip to
Water Wizz. I understand that Pembroke Recreation does not carry insurance on participates and assumes
no liability for injuries sustained while participating in our program. Summer Happenings participants
participate in a number of off-site field trips and the parent or guardian signing this release recognizes and
understands that injuries can occur while participating and can be an inherent and unavoidable
consequence of some activities. Having read this disclaimer I hereby approve my son’s/ daughter’s
participation the Summer Happenings program and agree to hold Pembroke Recreation, it’s
commissioners, counselors, directors, and managers harmless from any and all actions, claims and
damages for personal injuries and disabilities that I and or my child/children may sustain or incur as a
result of participation in this program.
Parent / Guardian’s Signature _____________________________________Date_____/_____/_____
Enclosed is $__________ ($40.00 X # of children) to cover the cost of the trip.
Is your child less than 48 inches? YES NO
Children under 48” must wear a life jacket. Their height will be measured upon arrival.
Method of payment: cash _____ check #_________
Pembroke Recreation Department
Community Center, 128 Center Street Pembroke, MA 02359
Phone: 781-293-3249
E-mail: [email protected] or [email protected]
Pinz
Field Trip Details
What to bring
Location Pinz Bowling (Kingston)
Dates Wednesday, August 16, 2017
Time 9:00am – pm
Transportation School bus
Cost $25.00 per participant
Notes Your child must be in
attendance no later than
8:45 am wearing a
Pembroke Recreation
T-shirt (may be purchased
in the office).
This trip includes a shoe rental,
$10.00 video game card, 1 slice of
pizza and a drink.
Packed lunch and drink labeled on
the outside with your child’s name
Note: No camera, radio, cell
phone, or other electronic device is
allowed on this field trip. Any
equipment of this kind will be
taken away by a counselor and
returned at the end of the day.
Pinz Bowling
I give permission for my child/children, ___________________________ to attend the field trip to Pinz
Bowling on the dates I have selected. I understand that Pembroke Recreation does not carry insurance on
participates and assumes no liability for injuries sustained while participating in our program. Summer
Happenings participants participate in a number of off-site field trips and the parent or guardian signing
this release recognizes and understands that injuries can occur while participating and can be an inherent
and unavoidable consequence of some activities. Having read this disclaimer I hereby approve my son’s/
daughter’s participation the Summer Happenings program and agree to hold Pembroke Recreation, it’s
commissioners, counselors, directors, and managers harmless from any and all actions, claims and
damages for personal injuries and disabilities that I and or my child/children may sustain or incur as a
result of participation in this program.
Parent / Guardian’s Signature _____________________________________Date_____/____/____
$25.00 X # of children ___________ = _____________ Total Amount
Child’s Shoe Size ________
Enclosed is $________ of children to cover the cost of the trip.
Method of payment: cash ____ check #_________