Summer Camp Dates and Fees
June 12-16
$175.00
June 19- 23
$175.00
June 26- 30
$175.00
July 3-7
$140.00
(No Camp July 4th)
July 10- 14
$175.00
July 17-21
$175.00
July 24- 28
$175.00
July 31-Aug 4
$175.00
Aug 7- 11
$175.00
Daily rate is $40.00 per day.
We will prorate when attending four
days.
Before and after care is available for an
additional fee of $5.00 per hour.
Before care begins at 8:00AM and
includes breakfast.
Aftercare is from 4:00-6:00PM.
Alice Noble Ice Arena Summer Camp Registration Form
We pride ourselves on a low
counselor to camper ratio, providing
a positive experience.
Camper’s Name: _______________________________ M: __ F: __ Birthday: ________________
Address: (street, city, state, zip) ____________________________________________________
______________________________________________________________________________
Mother’s Name: _______________________
Email: ___________________________________
Home Phone: _________________________
Cell Phone: _______________________________
Father’s Name: ________________________
E-mail: __________________________________
Home Phone: _________________________
Cell Phone: _______________________________
Emergency Contact Name: ____________________ Relationship:________________________
Home Phone: _________________________
Cell Phone: ________________________________
Known allergies we should be aware of: _______________________________________________
Summer Camp activities include:
 Ice Skating and Hockey
 Swimming
 Yoga
 Chess Club
 Golf
 Bowling
 Cooking Class
 Water Activities
 Arts and Crafts
 Weekly Field Trips
 And Much, Much More!
Lunch and snack are included in your
fee and will be provided daily. The
snack bar and arcade will be open part
of the day for your children to utilize.
Any medication your child is taking: ___________________________________________________
Authorized individuals who may pick up your child: ________________________________________
Please circle the weeks your child will be attending: June 12-16 June 19-23 June 26-30
July 3-7 July 10-14 July 17-21 July 24-28 July 31-Aug 4 Aug 7-11
Total number of weeks____ x $175
$___________ Total Due
*Sibling discount of $50.00/week when registering more than one child per family per week.*
*Sibling discount is not applied to day rates*
Please check if you will need ___ before care (8-9 am $5/day) and/or ___aftercare (4-6 pm $5/hour).
Before and aftercare fees will be billed separately.
Method of Payment: Cash ____ Check Payable to ANIA _____ Credit _____
Credit Card Information - Type of Card: MasterCard ___ Visa ___ Discover ___
Cardholder Name
Card #
Verification Code
Expiration Date
WAIVER
In consideration of being allowed to participate in any way in Alice Noble Ice Arena (ANIA) Programs,
related events and activities, the undersigned acknowledges, understands and agrees that:
1. The risks of injury from the activities involved in this program is significant, including the
potential for permanent paralysis and death, and while particular rules equipment and personal discipline
may reduce the risk, the risk of injury does exist and,
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS INHERENT TO THIS AND ALL
RELATED ACTIVITIES AND I ASSUME FULL RESPONSIBILITY FOR MY PARTICIPATION.
3. I willingly agree to comply with the stated and customary terms and conditions for participation.
4. I, for myself and on behalf of heirs, assigns personal representatives and next of kin, HEREBY
RELEASE AND HOLD HARMLESS THE ALICE NOBLE ICE ARENA (ANIA), their officers, instructors,
agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers and, if applicable,
owners and leasers of premises used to conduct the event (“Releases”), WITH RESPECT TO ANY AND
ALL INJURY, DISABILITY, DEATH or loss or damage to person or property.
5. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT,
FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY
SIGNING IT AND SIGN IT FREELY AND VOLUNTARILY WITHOUT INDUCEMENT.
6. For Participants of Minority Age (under age 18 upon registering This is to certify that I, as
parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as
provided above of all the Releases, and for myself, my heirs, assigns and next of kin, I do also release and
agree to indemnify the Releases from any and all liabilities incident to my minor child’s involvement or
participation in these programs as provided above.
FIELD TRIP PERMISSION STATEMENT
I give permission for my child to participate in programs offered at ANIA I waive any liability to ANIA and the staff thereof
while participating in these trips or activities. I permit my child(ren) to be transported in a van or walk with authorized
personnel.
PHOTO RELEASE
I give permission for my child photograph to be taken while participating at the ANIA. and their activities, to be used for the
purpose of publicity. These photos may be used for programs brochures, media productions, advertisements or news
articles by ANIA.
Return thi
Alice Noble Ice Arena
June 12th- August 11th
Woo Summer Camp has
something for everyone.
Camp Directors
Shane Canfield
Olivia McCory
Victoria Vanata
Contact Us
Email: [email protected]
Phone: 330-345-8686
Signature: ___________________________________________________________ Date: _________________________
PARENT AUTHORIZATION FORM
(If Legal Guardian(s), please indicate status.)
Parental permission or power of the guardian is required in hospitals for the following: X-rays and treatment following diagnosis,
treatment of all injuries requiring sutures, dressings, medications and surgery. If the parents cannot be contacted, please call
Emergency Contact: _____________________________________________ Phone: _____________________________________
Parent/Guardian Signature: ___________________________________________________ Date:____________________________
Participant’s Name: ________________________________________________________ Phone: ____________________________
Please list any disabilities, allergies, and/or participation restrictions. __________________________________________________
___________________________________________________________________________________________________________
Name of Doctor: ___________________________________________________ Phone: ___________________________________
Name of Dentist: ___________________________________________________ Phone: ___________________________________
Woo Summer Camp
Campers, ages 5 to 12, will
participate in many different
activities: sports, arts & crafts,
and entertainment. You are sure
to find something you are
looking for.
Camp is from 9:00AM-4:00PM
Monday-Friday
The camp staff will consist of
counselors who have been
carefully selected to nurture
each child’s experience in a fun,
safe, and secure environment.
Woo Summer Camp is an
experience your child will never
forget!
Alice Noble Ice Arena
851 Oldman Road
Wooster, Ohio
44691
nobleice.com