your registration form here.

Hands On! Museum
Discover the fun
Summer Camps 2015
of Science & Art!
Where else can you custom tie dye a Hands On! T-shirt, build an air rocket, paint a masterpiece, construct
giant bridges and domes, send giant suds flying into the air, explore the subzero science of dry ice, walk
on eggshells, create glowing ooze, make rock candy, and more?!?! Children ages 5 to 12 can explore and
discover the worlds of the sciences, arts, and more in our week long summer camps that are sure to make
learning memorable, exciting, and most of all-FUN! Register by May 1st and SAVE!
Choose the week of camp that is right for your camper:
• Monday, June 15th - Friday, June 19th
• Monday, July 20th - Friday, July 24th
Choose the type of day that is right for your camper:
• Half day (9:30 am - 12:30 pm)
Cost: $100 members / $150 non-members
Half day camps include a healthy mid-morning snack,
a Hands On! t-shirt, all activity and experiment
supplies, play time in the museum, as well as
enthusiastic educators to guide the fun and learning!
• Full day (9:30 am - 4:30 pm)
Cost:$150 members / $200 non-members
In addition to what half day camp offers, full day camps also include
additional activities and experiments, extended play time in the museum, and a healthy
mid-afternoon snack. Full day campers will need a bag lunch and drink each day.
Register by May 1st and receive a 5% discount on each camper’s deposit!
Please call (423) 928-6508 ext. 100 or email reservations@handsonmuseum.org for more information or to
register. If you prefer, you may mail in the registration form on the back.
•
•
•
•
•
•
•
•
•
•
•
A separate registration form must be completed for each child.
Campers must be 5 years old by May 1, 2015, or no older than 12 years old on May 1, 2015. Proof of age may be asked to be
provided prior to as well as during camp. If the museum has been purposefully misinformed as to the age of the child, all fees
paid will be forfeited and the camper dismissed.
All campers must be fully potty trained.
A 50% deposit is due at the time of registration. Full payment is due a minimum of 2 weeks prior to the start date of camp.
You will receive a full refund if you cancel at least 2 weeks prior to the start of camp. If a cancelation is made less than 2 weeks
in advance, your deposit will not be refunded. Hands On! Museum reserves the right to cancel any camp and will fully refund
payments in the event that a camp is canceled based on attendance or unforeseen circumstances.
A healthy snack will be provided daily. Please inform staff of any allergies your child may have. Please send a bag lunch with a
drink for each full day camper. If your camper has specific dietary needs, you may bring a snack(s) of your own each day.
Parents/guardians must sign each child in and out of camp each day, we are unable to accommodate drop-offs.
Please drop off and pick up your child in accordance with scheduled camp times. We are unable to accommodate early arrivals or
late departures. In the event of an emergency, please contact the front desk as soon as possible.
Please send an extra set of clothes and shoes with your camper daily as many activities may get messy.
To ensure a fun, effective, and consistent camp experience we ask that parent/guardians are not present during camp hours.
Hands On! Regional Museum is not responsible for lost or stolen items.
I would like to register my child for:
q
q
Member
June 15th - 19th, 1/2 day $100
June 15th - 19th, full day $150
q
q
July 20th - 24th, 1/2 day
July 20th - 24th, full day
Regis
SAVE ter by Ma
y
5% o
n you 1st and
r dep
osit!
Non-Member
$150
$200
$100
$150
$150
$200
M
*Child’s full name:
*Date of birth:
Gender:
(you may be asked to provide proof of age)
Child’s t-shirt size:
Youth XS
YS
YM
F
YL
*Please list any allergies and/or sensitivities (foods, medications, dyes, animals):
*Please list any restrictions to activity (physical limitations, what adaptations are required):
*Please list any behavioral, medical, physical, emotional, mental health, or special needs***:
*Parent/guardian name:
*Address:
Relationship to child:
*Museum member:
*City:
*Contact Phone Number:
*Secondary Contact Name:
(*required information)
*State:
Yes
No
*Zip Code:
Email address:
*Phone:
I authorize Hands On! Regional Museum to capture, use, publish, and reproduce photographs, slides, moving pictures
or television video tapes for its records, public relations programs, social media, and promotional purposes. Permission is
granted for the camper to participate in all planned camp activities and programs, except as otherwise noted.
Sign:
Date:
I understand that payment is due in full at the time of registration to reserve a spot for my child. No refunds will be
given for camp registrants if canceled less than 2 weeks in advance. I also understand that no refunds or transfer of funds
will be made for withdrawal, failure to attend, or incomplete attendance.
Sign:
Date:
***I understand that Hands On! Regional Museum is not equipped for and does not charge in its normal session fees for
providing any special needs services. Parents of children with special needs must provide the nature and scope of these
needs for review by the staff. Hands On! Regional Museum reserves the right to determine a camper’s special needs
beyond the scope of the program capability or requiring a special qualified staff person, responsible for his/her needs.
Parents/guardians are required to provide to pay this extra staff person salary in addition to the standard session fee. If
full disclosure does not occur and special needs become apparent to the camp’s staff, all fees paid will be forfeited and the
camper dismissed.
Sign:
Date:
I hereby waive Hands On! Regional Museum its officers, employees, and volunteers from any liability of injury, loss, or
damage to personal property associated with this event.
Sign:
To register, call 434-HAND or complete this form
and email to reservations@handsonmuseum.org
or mail with payment to:
Hands On! Regional Museum
315 East Main Street, Johnson City, TN 37601
Date:
Spread the Word & Invite a Friend!
If registration is low a camp may be canceled,
so invite your best buddy and have fun!