EMERGENCY MEDICAL INFORMATION AND AUTHORIZATION

Please make selection based on the grade student will enter in the fall.
LANGUAGE ARTS
#1
American Girl Adventures (Grades 2-4)
Meet the girls from America’s past. We’ll do some reading,
crafting and cultural activities from a different American Girl
story every day. Whether you like Kit, Samantha, Josephina or
any of the other American Girls, you’re sure to have lots of fun
in this class!
Cindy Tremains, Instructor
#2
iCreate (Grades 3-4)
Create a story and give it life! By using apps like iMovie, Book
Creator, and Toontastic, we will learn how to give your story a
twist. You will turn your story into an eBook, a movie trailer
and even a talking comic book!
Lauren Burkhart, Instructor
#3
¡Buenos Amigos! (Grades 4-7)
¡Hola! Would you like to learn Spanish basics with music,
games, scavenger hunts, motions, food and other fun activities?
Look no further! Join us for a “muy buen tiempo”.
Sara Smith, Instructor
#4
WPKO & WBLL Sportscaster Camp (Grades 6-8)
Refer to description in spotlight box on other side of brochure.
Chad Wilkinson, Instructor
SCIENCE
#5
Dig In (Grades 2-4)
Keep on “rocking” as you get the scoop on “dirt”. Join me as a
hands-on soil investigator and budding geologist. Expect to be
digging around in this science class as we conduct several
simulated “digs” along with cracking geodes.
Jim King, Instructor
#6
Science Rocks! (Grades 2-4)
You will become a Scientist who will predict outcomes, conduct experiments, and share findings with the group. We will
make pop explode, erupt a volcano, create a human circuit,
observe a Popsicle chain reaction, and much more! Come and
join us for a week of scientific fun! Donna Howell, Instructor
#7
That’s AG-Mazing (Grades 3-5)
Does chocolate milk come from brown cows? How does popcorn pop? What do animals really think? All these questions
and more can be answered in this course. Participants will
learn about all areas of farming, food, animals, and soil with
hands-on activities, experiments and more that help us learn
about growing, working and living in the agriculture world.
Jill Smith, Instructor
#8
Crime Scene Investigator (Grades 4-5)
Did you ever think that you had the skills to work a crime
scene? Bring the bad guys to justice by putting together clues.
You will work side by side with real CSIs. If you like a good
“who done it”, you will love this class. Jana Core, Instructor
#9
Logan County is for the Birds & Bugs (Grades 4-7)
We will learn about birds & bugs in our community and use
nets & binoculars to observe them in their natural habitat.
Learn about nocturnal wildlife and do an optional night walk
with parents outside of class time.
Troy Shively, Instructor
#10
Sharks! (Grades 4-7)
Students will learn how fish are adapted to life in an aquatic
environment. They will explore the comparative anatomy of
bony and cartilaginous fishes through guided dissection of the
yellow perch and the spiny dogfish.
Bruce Smith, Instructor
Please make selection based on the grade student will enter in the fall.
Please make selection based on the grade student will enter in the fall.
#11
Slimy Science (Grades 4-7)
Learn how fascinating chemical and physical changes take
place when everyday substances are combined. You will be
making gloop, slime, vomit, floam, and more in the fun slimy
exploration of science. Dress to get slimy!
Nancy Forsythe, Instructor
TECHNOLOGY/MATHEMATICS
#12
Out of this World!! (Grades 4-7)
Ever wonder what a star is made of? If there is life on other
planets? If the moon is really made of cheese?! Get the answers to these questions and more while learning how to engineer a lunar rover, study the stars, even build and launch your
own rocket!! Having fun is Out of this World!
Katelyn Poland, Instructor
#20
Games (Grades 2-3)
Logic, Math and critical thinking all while playing games! We
will play several different games each day. At the end of the
week, the games will be given out to each class participant.
Angie Pemberton, Instructor
#13
Sports Science (Grades 6-8)
Did you know that science plays a key role in sports? Together
we can explore many sports science project ideas and dig into
the science behind your favorite sport!
Clifton Core, Instructor
#19
Apples Aren’t Just for Teachers Anymore! (Gr 2-3)
Do you love technology? Do you want to learn how to use an
ipad? Then this is the class for you! We will explore all that
ipads have to offer. We will create, play, and even learn a little
along the way!
Lindy Penhorwood, Instructor
#21
Coding Club (Grades 4-5)
Are you a gamer? Do you love video games? Come learn how
to design and play your own games! We will be exploring the
exciting world of computer programming. Learn how to use a
free web site (Scratch) to design your own video games and
animations.
Jill Hughes, Instructor
#14
Global Expedition! (Grades 2-4)
Brush up on your geography as we travel around the world!
We will have a great time exploring various cultures and learning about the languages, customs, and traditions. Students will
enjoy making and tasting various ethnic foods, trying their
hand at Subi bead making and more in this hands-on adventure!
Michele Garver, Instructor
#22
Adventures in Robotics (Grades 5-8)
Join others as a member of a hardworking team to explore the
exciting world of Lego Robotics! Combining the versatility of
Legos, a powerful NXT Mindstorm Brick, and the newest Lego
EV3 intuitive drag and drop programming software, you are on
your way to discovering that Legos aren’t just for building.
Come discover the exciting world of Lego Robotics as you
program your way through adventurous robotic missions—if
you dare!
Amy McCormick, Instructor
#15
Time Machine (Grades 2-4)
You say you like to travel, but do you have the courage to
travel back in time? Come with me and experience world history first hand. Eat native foods, participate in cultural activities, learn different languages, and bring home souvenirs.
Carol Fultz, Instructor
#23
Sports and Statistics (Grades 5-8)
Why does one athlete get paid more than another? What do all
of the numbers on the back of playing cards mean? Believe it
or not, statistics is the answer to both questions. In this course,
you will be playing various sports and computing statistics
using the results of the games.
Tom Braddock, Instructor
#16
Christmas Around the World! (Grades 2-5)
Do you LOVE celebrating Christmas? Do you wish the holiday spirit lasted all year? Do you wonder how other countries
around the world celebrate Christmas? In this class, we will
explore how five countries around the world celebrate Christmas through food, games, literature, and crafts!
Ashley Reser, Instructor
#24
TV Exploration (Grades 5-8)
Experience the many aspects of a TV station. Students will
interview fellow students and instructors, videotape, learn to
edit, and finally put together a show that highlights SEA.
Jere Daniels, Instructor
SOCIAL STUDIES
#17
Native American Culture (Grades 5-8)
We will make ATLATL spears, fire starters, drills, flint knapping, bead work, head bands, and more as time allows. We
will study the history of Logan County Native Americans and
artifact identification, and discuss archaeology and anthropology.
Bill Davis, Instructor
#18
OMUN Leaders! (Grades 6-8)
Interested in participating in Ohio Model United Nations, getting more involved in the program or just learning to be a
leader? This is the workshop for you! We will learn about the
I-OPEN project (International Outreach Program for Education
in Nigeria), how to be an “Outstanding Delegate’ at OMUN,
and much more! Students will learn leadership and debate
skills, to get the most out of the OMUN program! (OMUN
experience is not required. Come learn about Model UN!
Tommy Stolly, Instructor
#25
VEX Robotic Challenge (Grades 5-8)
We will use VEX erector sets to build, program and race cars
and other designs as time permits. Learn how to program in
RobotC and download your program to a cortex attached to
your vehicle. The final day, we will have a Showdown to see
whose vehicles are faster or programmed closest to the finish
line.
Sandra Chervenak, Instructor
HEALTH & FITNESS
#26
Baking BONANZA!! (Grades 2-4)
Have a lot of fun making, baking and decorating cookies and
cupcakes. We will also make our own pizza! Learn the basics
of measuring, reading a recipe, and being an artist in the
kitchen. You will also design your own apron and recipe box
during class. Students will get to take home their own measuring cups, spoon, and yummy recipes. Delicioso!
Christa Hammond, Instructor
(Health & Fitness Continued)
EMERGENCY MEDICAL INFORMATION
AND AUTHORIZATION FOR
SUMMER ENRICHMENT ACADEMY
June 16-20, 2014
Student’s Name________________________________
Purpose: To enable parents/guardians to authorize the
provision of emergency treatment for children who become ill or injured while attending SEA, please list three
contact names and phone numbers.
Name
Relationship
Phone
1)___________________________________________
2)___________________________________________
3)___________________________________________
To Grant Consent
In the event reasonable attempts to contact me have
been unsuccessful, I hereby give my consent for: (1) the
administration of any treatment deemed necessary by
the below named physician or dentist; and (2) the transfer of the child to any hospital reasonably accessible.
Physician:_____________________Phone: _________
Dentist:_______________________Phone: _________
Medical Specialist:______________Phone: _________
Hospital:______________________Phone: _________
This authorization does not cover major surgery unless
the medical opinions of two licensed physicians or dentists, obtained prior to the performance of such surgery,
concur in the necessity for such surgery.
**Facts concerning the child’s medical history, including
allergies, medications being taken, dietary restrictions,
and any physical impairments: ____________________
_____________________________________________
_____________________________________________
The SEA staff will not be responsible for medications.
What medications, if any, will your child be carrying
during SEA?__________________________________
_____________________________________________
Signature of
Parent/Guardian:_______________________________
Date:__________ Daytime Phone:_________________
Please make selection based on the grade student will enter in the fall.
Registration Form
HEALTH & FITNESS (CONT’D)
Student’s Name__________________________
#27
Craft & Snack Creations (Grades 2-4)
Join me in this class as we make some cool crafts and delicious
snacks. You will have a blast making new friends as we create
quesadillas and slushies. You will make awesome slime monsters and your own cookbook.
Keri Fergus, Instructor
2
Address _______________________________
2014
City, State, Zip___________________________
Parent’s Name___________________________
Home Phone____________________ Cell Phone _______________
School___________________________ Teacher _______________
Grade entering in Fall 2014: 2
3
4
5
6
7
8
***Must list two (2) choices to register.***
June 16-20, 2014 Please list your choices below:
1st choice
# :____________ Title:______________________
2nd choice
# :____________ Title:______________________
rd
3 choice
# :____________ Title:______________________
When scheduling, we will do our best to assign students to their first or
second choice. Classes require a minimum of ten students.
SEA reserves the right to: Cancel a course due to insufficient
enrollment, schedule students in any of their designated choices, and
remove students who present a discipline problem.
(One check per family)
Bellefontaine City Schools
Registration deadline is
Friday, April 11, 2014
Sponsors have provided financial assistance to students on the Free
and Reduced Lunch Program. The registration fee will be reduced to
$10 per student. Please send check for $10 with registration.
.
Mail Check, Registration, and Emergency Medical Form
by April 11, 2014 to:
Each participant will receive a t-shirt.
Adult:
M (10-12)
S
L (14-16)
M
L
XL
Disclaimer: I authorize SEA to consider my child’s photograph/
image/name as “directory information” and to utilize, release, and/
or publish my child’s photograph/image/name in all school/media
publications.
Class assignment notification will be sent home from school with your
child (not mailed) by
May 16, 2014
2014
For students entering
ART, MUSIC & DRAMA
#30
Make It, Take It, Creative Crafts (Grades 2-3)
Put on your thinking caps and roll up your sleeves. Each day
you will create some hands-on crafts to display your creativity.
Activities include painting, making Play Doh, and experimenting with tie dye designs.
Stacey Holycross, Instructor
#32
Snip, Snap, Let’s Scrap (Grades 3-6)
Do you want to learn how to take great photos, alter and enhance the images, and use them in a Scrapbook? Bring your
favorite snapshots, or use digital photos we take during class,
and learn how to make a scrapbook with stamps, stickers, ribbons, and decorative papers. Learn journaling techniques to
tell the stories behind the pictures. Gretchen Powell, Instructor
#33
Bellefontaine Bells (Grades 5-8)
Come learn how to ring handbells—no music skills are needed!
If you can count to 4 and see colors, you have all the makings
of a great bell player! This percussion instrument is fun to play
and you will be amazed at the music you can perform with just
a week’s practice. (Class size min-11, max 22)
Ellen Verbsky, Instructor
Bellefontaine City Schools
Attn: Treasurer's Office
820 Ludlow Road
Bellefontaine, Ohio 43311
2014
#29
Bake My Day! (Grades 5-8)
Come learn tips and techniques for making cake pops, gourmet
cupcakes, and fun festive desserts. Experience basic cake
decorating skills with chocolate ganache and buttercream icing.
Presentation is EVERYTHING!
Sharon Dodds, Instructor
#31
Coyote Steals Summer! (Grades 2-4)
What if it were winter all the time? What if summer was
trapped in a bag? Come find out how Coyote will save summer by performing this Native American tale! If singing, reading, and being on stage excites you, join us as we prepare a
mini-musical to perform for our guests at the close of the week.
Ann Stanley, Instructor
Please make $55.00
non-refundable check payable to:
Please circle size: Youth:
#28
Top Chef Academy (Grades 4-6)
Top Chef Academy is back with all new recipes and challenges
for the budding chef. If you enjoy cooking in the kitchen and
love to eat your own delicious results, Top Chef is for you!
Marybeth Motasem, Instructor
#34
Coral Reef Representatives (Grades 5-8)
Coral reefs are adventuresome places filled with amazing objects and creatures. Imaginations swim when viewing the
beautiful settings of coral reef environments. As artists, we
immediately notice the colors, texture, shapes and forms that
fill these settings. Join us as we represent coral reefs in many
types of media….including Sculpey clay!
Jennifer Davis, Instructor
#35
Ready, Set, Let’s Watercolor! (Grades 6-8)
Learn how to paint using watercolor! Expand your skills and
learn new techniques while creating beautiful art and having
FUN!
Erin Miller, Instructor
WPKO & WBLL
Sportscasters Camp
(in the fall of 2014)
June 16-20, 2014
**9:30 a.m.—11:30 a.m.**
(Dates subject to change if school make-up days extend into this
week. Participants will be notified if changed.)
(Grades 6-8)
**Bellefontaine Middle School**
1201 South Ludlow Rd.
Bellefontaine, Ohio 43311
9:30 a.m. – 11:30 a.m.
#4 Join us for the 7th annual WPKO &
WBLL Sportscasters Camp. Learn how to:




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2nd grade through 8th grade
Call sports play-by-play for radio
Interview famous guests
Collect and report news
Make commercials
Write stories for the Internet
Plus, you will learn from some of the best in
the business. Previous guests included; the
voice of the Buckeyes Paul Keels, Tom
Hamilton of the Cleveland Indians, World
Series champion pitcher Tim Belcher and
professional snowboarder Louie Vito,
WPKO’s Bill Tipple and Benjamin Logan
Hall of Famer, Bob Fawcett.
The highlight of the week will be YOU helping call the live play-by-play of a baseball
game from Blue Jacket Park one evening on
1390 WBLL. In addition, every camper will
be a part of a live radio show on WBLL
where we will talk sports for one hour. All of
this and MORE is packed into a fun week at
the WPKO & WBLL Sportscasters Camp!
Purpose: To provide academic and creative challenges for gifted or
highly motivated students entering 2nd through 8th grade in the fall..
REGISTRATION DEADLINE:
FRIDAY, April 11, 2014
Coordinated by Bellefontaine City Schools, Benjamin Logan Local
Schools, and the Logan County Educational Service Center, in cooperation with Indian Lake Local Schools and Riverside Local
Schools.
Please contact SEA Coordinators for more information:
Cathy Wiley, Bellefontaine City Schools
[email protected], 593-0545
Sally Stolly, Benjamin Logan Local Schools
[email protected], 593-9211
Jen Frederick, Logan County ESC
[email protected], 599-5195
2014