TOWNSHIP OF PARSIPPANY

Township of
Parsippany-Troy Hills
----------------------------------------------------------------------Recreation Department
1001 Parsippany Boulevard
Parsippany, New Jersey 07054
(973) 263-7257
**ALL DAY PLAYGROUND**
***DROP OFF AND PICK UP PROCEDURES***
DROP OFF:
All Day Playground does not open until 8:00 AM. Counselors
are not responsible for your children until that time.
PICK UP:
All Day Playground closes at 5:30 PM. If you are late, the
following steps will be taken.
1. At 5:40 PM, the director will make every effort to contact you at
home or at work. If the director is unable to reach you, an attempt
will be made to reach the person (s) listed as your emergency contacts.
2. At 6:00 PM, if the director has been unable to contact any of the
people listed on your child’s emergency information sheet, the
Parsippany Police will be called and asked to supervise your child
until contact can be made with someone authorized to pick up the
child.
3. If the police can not come to supervise your child, the director
will call the Division of Youth and Family Services Child Abuse
Hotline (1-877-652-2873) to seek assistance to care for the child
until the parents or authorized persons are available to pick up the
child.
4. A “Late Pick Up Notice” will be given to parents who are late and
this notice must be signed by the parent. Refusal to sign will be
noted. A copy of this notice will be given to the Parsippany
Recreation Department.
5. The second time your child is picked up after 6:00 PM, the child
Will be removed from the All Day Playground.
Please make every effort to pick up your child (or send someone else) PROMPTLY AT 5:30 PM.
________________________
Jennifer Zitelli
Recreation Supervisor
Township of Parsippany – Troy Hills Recreation Department
Name: ______________________________________________________________ Male____ Female____
Please print child’s name
Birth Date: __________________ Age:_____ Grade:_____ School Attending_______________________
Mailing Address__________________________________________________________________________
Number
Street (Apt# if any)
Town
Zip Code
Telephone #____________________________Emergency Contact Name___________________________
Emergency Telephone #______________________________ Relationship? _________________________
Authorized People to pick up your child in the event of illness, accident or early dismissal:
Name_________________________________________ Telephone #_____________________________
Cell #________________________________ Relationship to Child _______________________________
Name_________________________________________ Telephone #_____________________________
Cell #____________________ Relationship to Child ___________________________________________
Medical Insurance: Name of Company:______________________________________________________
Policy #_______________________________________________________________________________
Group #_______________________________________________________________________________
By enrolling and signing this application, I give my permission to attend any field trip or activity and authorize any medical treatment in my absence for the well
being of the child, in case of an emergency. Please list any special medical or physical needs, medical conditions, or allergies the personnel should be aware of.
I understand if my child requires an inhaler/epi-pen that the child is responsible for taking it with him/her on any field trip or activity.
Any accident or injury must be reported to the Recreation Office the following work day.
The applicant, parents, guardians or family members, to the fullest extent permitted by law, hereby agrees to indemnify and hold harmless the Township of
Parsippany-Troy Hills and all of its agents, directors, officers, employees and volunteers and the physician or hospital treating my child, against any and all
claims, judgments, demands for damages and expenses, including but not limited to attorney’s fees, arising out of, by reason of, on account of, in consequence
of, or in connection with their child’s participation at the
Playground and various activities, arising from accidents to any persons or property caused by or to the child or other participants or any other person(s) to
which this application applies.
Parent will be responsible for the conduct of their child while participating at the Playground and enforce all rules and regulations as required by the Township’s
recreation program. Parent agrees and acknowledges that any violations to the rules and regulations will not be tolerated and child may be subject to expulsion
from this program and any other Township sponsored program.
Parent/Guardian _____________________________________________________________________
please print
Parent/Guardian Signature _____________________________________________________________
LIST ALLERGIES (if any)______________________________________________________________
LIST MEDICATIONS (if any)____________________________________________________________
MEDICAL CONDITIONS (if any)_________________________________________________________
PARENT’S PERMISSION TO ADMINISTER ANESTHETIC AND/OR EMERGENCY TREATMENT AS MAY BE
REQUIRED? YES_______________ NO_______________________
SIGNATURE OF PARENT OR GUARDIAN____________________________________________________
PROGRAM ATTENDING__________________________________________________________________
TRIP SIGN-UP PROCEDURES
Please be advised of the following:
1. The deadlines that are listed on the
trip permission slips are
firm & NO EXCEPTIONS WILL BE
MADE!
2. Due to limitations on the number of
people at the trip locations, no one
will be allowed to drive their child to
the trip
if he/she is not signed up for the trip.
3. Although we do accept mail-ins,
NONE WILL BE ACCEPTED
THAT ARE POSTMARKED AFTER
THE DEADLINE DATE!
Thank you for your cooperation in
this matter!
Township of Parsippany- Troy Hills Recreation Department
MOVIES AT PARSIPPANY
CLEARVIEW CINEMAS
WHO:
Children in the All Day Playground Program
WHERE:
PARSIPPANY CLEARVIEW CINEMAS, located on Rt. 46 in the Morris
Hills Shopping Center
WHEN:
Thursday, July 14th, 2011
***ALL DAY PLAYGROUND WILL BE CLOSED UNTIL 1:00PM***
TIME:
Buses will leave PLAYGROUNDS at 9:30am
Buses will leave the theaters at 12:00pm
COST:
$5.00 – This is for transportation and is due by 6/17/11! NO EXCEPTIONS!
$8.75-- admission to theater, due in cash on day of trip. This fee includes admission,
child popcorn, & child drink. (The snack bar will also be open for additional purchases.) Payments
payable to PARSIPPANY RECREATION DEPARTMENT. Payment MUST be made no later than
June 17th at the Recreation Department Office. Money can NOT be accepted at the playground.
Only cash or check!! NO EXCEPTIONS!!
**PLEASE NOTE: AN ADDITIONAL FEE OF $3.50 WILL BE DUE IN CASH ON THE DAY
OF THE TRIP IF CHILD CHOOSES A 3D MOVIE**
THERE ARE NO REFUNDS UNLESS THE TRIP IS CANCELLED
------------------------------------------------------------------------------------------------------------------------------All DAY PLAYGROUND 2011 MOVIE TRIP
Child’s Name: (Print) ______________________________________________________
Parent/Guardian Signature: _________________________________________________
Movie Choices:
To Be Announced 1 week prior to the trip
**REMINDER:
Payment of $5 must be made by June 17th, at the Recreation Office
TOWNSHIP OF PARSIPPANY-TROY HILLS
Recreation Department
ROLLER SKATING
WHO:
PROGRAM
Children in the ALL DAY PLAYGROUND
WHERE:
Florham Park Roller Rink
WHEN:
Tuesday July 19th, 2011
***PLAYGROUND WILL BE CLOSED THIS DAY UNTIL 1:00PM***
TIME: Buses will leave from Smith Field at 9:30AM
Buses will leave from Florham Park Roller Rink at NOON
COST: $5.00 -- This is for transportation and is due by 6/17/11! NO EXCEPTIONS!
$7.00-- admission to Florham Park Roller Rink, payable in cash on day of trip.
This fee includes rental of Regular Roller Skates and some Roller Blades on a
“First come, first serve basis.” You may bring your own skates of any type, but this does
not reduce the admissions fee. Payments are payable to Parsippany Recreation
Department. Payment MUST be made no later than June 17th at the Recreation Office.
Money can NOT be accepted at the playground. Only cash or check!!
**
NO EXCEPTIONS **
NOTE: NO food or beverage is allowed to be brought into the Rink. You may bring extra
money for the snack bar, if you wish. NO GUM CHEWING IN THE BUILDING.
THERE ARE NO REFUNDS UNLESS THE TRIP IS CANCELED
--------------------------------------------------------------------------------------------------------------------ADP Summer 2011 Roller Skating
CHILD’S NAME:___________________________________________________________________
please print
PARENT/GUARDIAN SIGNATURE:___________________________________________________
**REMINDER**
- All Day Playground will be closed until 1:00PM
- Payment of $5.00 MUST be made by June 17th, at the Recreation Office.
- No Gum Chewing in the Building
TOWNSHIP OF PARSIPPANY - TROY HILLS
Recreation Department
BOWLING at HANOVER LANES
WHO:
Children in the ALL DAY PLAYGROUND PROGRAM
WHERE:
HANOVER LANES, Located on Route 10, East Hanover
WHEN:
Thursday, July 28, 2011
*** PLAYGROUND WILL BE CLOSED THIS DAY UNTIL 1:00PM ***
TIME:
Buses will leave SMITH FIELD at 9:30AM
Buses will leave HANOVER LANES at 12:00PM
COST:
$5.00 -- This is for transportation & is due by 6/17/11!! NO EXCEPTIONS
$8.00-- admission to Hanover Lanes, payable in cash to bowling alley on day of trip.
This fee includes two (2) games of bowling and use of rental shoes and bowling balls.
ABSOLUTELY NO GUM CHEWING!!!
Payments:
Payable to PARSIPPANY RECREATION DEPARTMENT. Payment MUST be made no later
than June 17th at the Recreation Department Office. Money can NOT be accepted at
the playground. Only cash or check!! NO EXCEPTIONS!!!
NOTE:
NO Food or Beverage is allowed to be brought into the Bowling Lanes.
You may bring extra money for the snack bar, if you wish.
THERE ARE NO REFUNDS UNLESS THE TRIP IS CANCELED
-----------------------------------------------------------------------------------------------ADP Summer 2011 BOWLING TRIP
Child’s Name: _________________________________________________________
Parent/Guardian Signature:______________________________________________
**REMINDER**
--All Day Playground will be closed after 12:30PM
-- Payment of $5.00 MUST be made by June 17th, at the Recreation Office.
TOWNSHIP OF PARSIPPANY-TROY HILLS
Recreation Department
SPORTS ‘N’ GAMES
--Funplex-WHO:
Children in the ALL DAY PLAYGROUND PROGRAM
WHERE:
Sports ‘N’ Games, Route 10, East Hanover
WHEN:
Thursday, August 11, 2011
***PLAYGROUND WILL BE CLOSED THIS DAY UNTIL 1:00PM***
TIME:
Buses will leave Smith Field at 9:00AM
Buses will leave Sports ‘N’ Games at 12:30PM
COST:
$5.00 -- This is for transportation and and is due by 6/17/11! NO
ACCEPTIONS!
$11.00-- admission to Sports and Games, payable in cash on day of event.
This fee includes unlimited use of the Foam Frenzy and the Bumper Cars, plus 20
tokens. Additional tokens may be purchased at the facility. Payment MUST be
made no later than June 17th at the Recreation Office. Money can NOT be
accepted at the playground. Only cash or check!!
** NO EXCEPTIONS **
NOTE:
NO food or beverage is allowed to be brought into Sports ‘N’ Games.
You may bring extra money to the snack bar, if you wish.
THERE ARE NO REFUNDS UNLESS THE TRIP IS CANCELED
-------------------------------------------------------------------------------------------------------------------ADP Summer 2011 SPORTS ‘N’ GAMES
CHILD’S NAME: __________________________________________________________
Please print
PARENT/GUARDIAN SIGNATURE: __________________________________________
**REMINDER**
- All Day Playground will be closed until 1:00PM
- Payment of $5.00 MUST be made by June 17th at the Recreation Office