City of Los Angeles Department of Recreation and Parks

City of Los Angeles Department of Recreation and Parks North Hollywood Recreation Center 11430 Chandler Blvd North Hollywood, CA 91601 (818) 763-7651 Tiara Street Park 11480 W. Tiara Street North Hollywood, CA 91601 (818) 623-4108 Turkey Camp 11/20 to 11/22 Registration For Fall: On-Going Winter Camp 12/18-1/5 Registration for Winter Begins: November 6, 2017 at 10:00am PARK PROUD LA Persons with disabilities are welcome to participate in our programs. Reasonable accommodations will be made with prior arrangements. All programs and information in the brochure is subject to change or cancellation without prior notice.

170 FWY. C i t y o f L o s A n g e l e s D e p a r t m e n t o f R e c r e a t i o n a n d P a r k s MISSION STATEMENT We unify Los Angeles by providing diverse recreational opportunities, beautiful facilities, and innovative leadership for the universal enjoyment of our residents and visitors by providing facilities to the general population, especially youth and to all our special needs segments of the populations. Good Sportsmanship is Everyone s Responsibility. Be a Good Sport. Gender Equity North Hollywood Recreation Center is involved in City sponsored Gender Equity programs. The objective of these programs is to promote and provide sports opportunities to girls and women. Our goal at North Hollywood Recreation Center is to increase girls and women s participation in sports activities by providing a variety of choices. North Hollywood Recreation Center offers youth sports, clinics, classes, adult leagues, camp and sports camp, all of which provide opportunities for girls and women of all ages to develop sports skills and participate in sports activities. Gender Equity also provides mentoring opportunities by staffing our activities with female referees, scorekeepers, sports specialists, coaches and counselors. OFFICE HOURS Monday - Friday 9:00a.m.-9:00p.m. Saturday 9:00a.m.-5:00p.m. Sunday CLOSED CHANDLER BLVD. OFFICE (GYM) SENIOR ANNEX PRE-K/ MUSIC TUJUNGA GENERAL REGISTRATION INFORMATION Campers must be age appropriate by their first day of camp. The first week of camp must be paid in full at time of registration. Enrollment is limited and granted on a first-come, first-serve basis until camp fills. A non-refundable deposit fee of $20.00 per week is required to reserve your child s spot for each week that is requested at the time of registration. This is only a deposit. Full payments must be made by 6:00p.m. on Thursday prior to the week your child is attending camp or unless otherwise stated in the newsletters. If there is a waiting list and payment is not made by the due date, your child will lose their spot as well as the $20.00 deposit. If there is no waiting list and your payment is made late, there will be a $10.00 late fee. A $10.00 administrative fee will be applied for each program change. Camp shirts must be worn daily. Additional T-shirts may be purchased from the office for $10.00 each. If your child does not come to camp prepared with a T-shirt, they will be issued one and you will be charged $10.00. Check, exact cash, money orders or Credit Cards (Master Card/ Visa) are accepted for payment. Please make checks payable to: City of Los Angeles. Your child s name is required on all checks and money orders. Campers who require a one-on-one aide must provide their own assistants. All assistants MUST be fingerprinted and cleared through our department prior to working. Please see the office for details. Sign-In and Out: All Campers must be signed-in and out daily by parent, guardian, or older sibling. Parent/Guardian be ready to present photo ID upon request. Field-Trips: Please refer to the weekly newsletters for departure and arrival times for fieldtrips. Campers must come prepared with a camp t-shirt and be on time. Note: Parents may not accompany campers on field trips. There are no alternate activities for campers on Field Trip Days. Items from Home: Camp will provide all necessary equipment for all activities unless otherwise stated on the weekly calendar. The camp and/or camp staff are not responsible for lost or broken items. Refunds and Cancellations Due to prior scheduling of staff, busses, trip reservations, pre-purchase of tickets, and the inability to replace your child s space on the days they are absent, NO REFUNDS, MAKE-UPS, OR TRANSFERS of money, including those related to illness or medical reasons will be given for any day including trip days. Refunds will be processed ONLY if you meet the prerequisites listed below. Refunds may be issued for long-term illnesses only (5 consecutive camp days or more), provided that we receive a signed note from a licensed physician within 3 days of illness. A non-refundable 15% administration fee will be applied by the recreation center for any patron granted a refund, cancellation, change or transfer per camp registration. Please allow 8-10 weeks for refunds.. 2

Camp Odyssey is designed to offer age appropriate activities for each camper to achieve a level of success in a safe environment with our caring staff. This is accomplished through traditional and non-traditional sports, innovative games and a spectrum of unique activities and entertaining field trips. This environment encourages participation and keeps children active, providing a unique opportunity for children to learn important social skills and values. Not only do campers learn new sports, cooking, games and go on fun field trips, but our camp also teaches them responsibility, cooperation, increased self-esteem and most importantly allows them to still be children. Achieving gender equity through a continuous commitment to girls and women in sports. Child Care Resource Center (CCRC): We will accept CCRC participants and other similar programs subject to approval. CCRC participants are responsible for payment of any unfunded portions of their subsidized payment. CCRC participants are not enrolled in the program until we have the Approval Provider s Notification letter and a completed Camp Registration form in our office. Meanwhile, it is the parent s responsibility to make payment for the registration fee and deposit to secure the spot for all weeks you are interested in. Upon receipt of the Approval Provider s Notification by the CCRC office and payment for services already given, a full refund will be given. Attendance sheet must be filled out daily, signed and dated by the end of the month. Failure to do so will result in being dropped from the program. Please allow 8-10 weeks for refund. Turkey Camp Dates: November 20 November 22 Ages: 5-12 years Camp Hours: 7:30a.m. 6:00p.m. Tuition Schedule $25.00 Registration fee: includes t-shirt (unless one has been paid this year; new fee will begin with Spring Camp 2018) $125.00 3-day program (M-W, Field Trip Included) $70.00 2-day program (M & Tu Only: No Field Trip) $10.00 Additional Camp T-shirt (must be worn daily) Additional Camp Information: Clothing: Due to the nature of the activities and safety at camp it is necessary for your child to wear appropriate footwear (i.e. tennis shoes) and clothing that is neat, presentable, and not overly revealing. Inappropriate apparel or footwear may cause a child to sit out of certain activities. To ensure the safety of your child, our policy requires campers to wear a camp T-shirt everyday. Old camp T-shirts can be worn on non-trip days. Lunch & Snacks: Campers must bring their own lunch everyday except field trip day. Afternoon snack will be provided daily. WE ACCEPT, CASH, CHECKS, AND Turkey Camp @ Camp Odyssey Week 1: Fall Harvest Turkey Camp 2017 - Camp Schedule All activities and trips are subject to change and/or cancellation without prior notice. Monday Tuesday Wednesday (Trip Day) Nov. 20th Nov. 21st Nov. 22nd Field Trip El Capitan Field Trip Thursday Nov. 23rd Thanksgiving Day! Center Closed Friday Nov. 24th Center Closed All programs and information in the brochure is subject to change or cancellation without prior notice. 3

Camp Odyssey is designed to offer age appropriate activities for each camper to achieve a level of success in a safe environment with our caring staff. This is accomplished through traditional and non-traditional sports, innovative games and a spectrum of unique activities and entertaining field trips. This environment encourages participation and keeps children active, providing a unique opportunity for children to learn important social skills and values. Not only do campers learn new sports, cooking, games and go on fun field trips, but our camp also teaches them responsibility, cooperation, increased self-esteem and most importantly allows them to still be children. Achieving gender equity through a continuous commitment to girls and women in sports. Winter Camp Dates: December 18, 2017 January 5, 2018 Ages: 5-12 years Camp Hours: 7:30am-6:00pm Winter Camp Tuition Schedule $25.00 Registration fee: includes t-shirt (unless one has been paid this year; new fee will begin with Spring Camp 2018) $10.00 Additional Camp T-shirt (must be worn daily) *Week #1: $175.00 5-day program (M-F, Field Trip Included) $140.00 4-day program (M,T,TH,F - No Field Trip - No Camp Wed.) *Week # 2 & 3: $140.00 4-day program (Tu-F, Field Trip Included (No Camp Mon.) $105.00 3-day program (Tu/Th & F: No Field Trip - No Camp Mon/ Wed. *During Winter Camp, the park is closed on Mondays for the holidays (no camp)! Additional Camp Information: Clothing: Due to the nature of the activities and safety at camp it is necessary for your child to wear appropriate footwear (i.e. tennis shoes) and clothing that is neat, presentable, and not overly revealing. Inappropriate apparel or footwear may cause a child to sit out of certain activities. To ensure the safety of your child, our policy requires campers to wear a camp T-shirt everyday. Old camp T-shirts can be worn on non-trip days. Lunch & Snacks: Campers must bring their own lunch everyday except field trip day. Afternoon snack will be provided daily. Winter Camp Week 1: Winter Science Fun WINTER 2017 ~ 2018 - Camp Schedule All activities and trips are subject to change and/or cancellation without prior notice. Monday Tuesday Wednesday Trip Day Dec. 18 Dec. 19 Dec. 20 Field Trip Scooter s Jungle Thursday Dec. 21 Friday Dec. 22 Week 2: Rock n New Years Dec. 25 CENTER CLOSED Dec. 26 Dec. 27 Field Trip Magic Mountain Dec. 28 Dec. 29 Week 3: Winter Wonderland Jan. 1 CENTER CLOSED Jan. 2 Jan. 3 Field Trip Knott s Berry Farm Jan. 4 Jan. 5 4

Mandatory Sign In and Out of Camper by Parent or Legal Guardian/Identification Required for Pick-up Parents please note that there will be no sign in and out privileges to minor children. All children enrolled in the Camp Odyssey Day Camp, Sports Camp & Mini Camp must be signed in and out by a parent or legal guardian. Please make arrangements for someone to pick up your child by 6:00pm. This is for the safety and protection of your child. ALL persons picking up any child from the Camp Odyssey Program will be required to show proper identification in order for the child to be released. This applies to any person picking up a child whether it be a parent, grandparent, aunt, uncle, family friend, or any other authorized person, regardless of having picked up that child previously. Thank you for your understanding. All cancellations/refund requests must be made in writing with photocopy of the receipt, a minimum of 7 days prior to the start of the session being requested, minus $20.00 non-refundable deposit. In addition, a non-refundable 15% Administration Fee is assessed for all refunds. Changes or transfers per class, sports league or day camp registration maybe assessed additional fees. After the first day of a session, the Recreation Center issues a partial refund to patrons withdrawing from the activity. I understand the receipts that I receive for any camp payments will serve as proof of payments for income tax purposes. If a child is suspended we will not issue a refund or credit of any kind. **DEPOSITS ARE NON-REFUNDABLE. ** Refunds will take a minimum of 8-10 weeks. City of Los Angeles Department of Recreation and Parks WAIVER AND RELEASE FORM Authorization for Consent to Treatment of Minor At Authorized Hospital in Case of Emergency or Accident I (We), the undersigned parent(s) of, a minor do hereby authorize the directors of Camp Odyssey as agent(s) for the undersigned to consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is to be rendered under the general or special supervision of any physician or surgeon licensed under the provision of the Medical Practice Act on the medical staff of a licensed hospital whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required but it is given to provide authority and power on the part of aforesaid agent(s) to give specific consent to any and all such diagnosis, Parent treatment Consent or hospital care which the aforementioned physician in the exercise of his/ her best judgment may deem advisable. This authorization shall remain effective through the conclusion of the event, unless sooner revoked in writing and delivered to said agent(s). Parent or Legal Guardian Signature: Date: I hereby give permission for my child to participate in the North Hollywood Recreation Center Camp Odyssey Program, including trips by chartered bus. I agree to complete the Camps Health History form providing Minor s current, complete and truthful health history; including immunization history and overall heath status; I agree to hold harmless the City of Los Angeles Department of Recreation and Parks and its officials, agents, and employees for any injury to my child as a result of participation in the North Hollywood Recreation Center Camp Odyssey Program. I understand that the Camp has no obligation to obtain medical treatment for the Minor. Should it become necessary for the Minor to have emergency medical care while participating in the Program; I hereby give the Camp personnel my permission to use their judgment in obtaining medical care, and; I give permission to the medical care provider selected by the Camp personnel to render medical care deemed necessary and appropriate. Permission to Photograph I hereby give permission for my child to have their picture taken for any projects or theme events pertaining to the North Hollywood Recreation Center Camp Odyssey Program. As it is difficult to pull individual children out of photographs, I understand that there is not an option for my child to be excluded from certain photographs. I also authorize the Camp, City of Los Angeles and Department of Recreation and Parks to make, procure and/or use photographs, films, tapes, digital media recordings or other likeness of the Minor s physical image and/or voice for use with the Program and/or Camps publicity, marketing and/or advertising materials. City Liability Except for the gross negligence or willful misconduct of the Camp, I (print name) waive all rights of recovery which the Minor or I may have now or in the future, whether known or unknown, against the City of Los Angeles, Department of Recreation and Parks, Camp Odyssey: Day Camp, Sports Camp & Mini Camp and its officers, agents, employees and/or personnel, and I release, acquit and forever discharge the City of Los Angeles, Department of Recreation and Parks, Camp Odyssey: Day Camp, Sports Camp & Mini Camp and its officers, agents, employees and/or personnel, from and all liability for any bodily injury, emotional injury, or other personal injury, damage, loss or expense, claims, demands, causes of action, costs, loss of services or use, compensations, debts, monetary damages, including but not limited to attorney fees, which result from or are in any way connected with the Minor s participation in the Program or any related activities. Parent or Guardian Consent Receipts for Camp Payments, Refunds and Credits I have read and understand all the above mentioned items as well as the Parent Handbook and agree to all the policies, procedures, rules, payment schedules and guidelines set forth by Camp Odyssey: Day Camp, Sports Camp, Mini Camp and North Hollywood Recreation Center. I understand that it is my sole responsibility to notify North Hollywood Recreation Center if there is a change to any of the information that I have provided in these forms. Parent or Legal Guardian Signature: 5 Date:

Camp Odyssey Registration Form Camper s Name (Last, First): Age: Gender: Address: City: Zip: Birthdate: Grade (Current): School: Parent/Guardian s Name: Cell Phone: ( ) Home Phone (Mother): ( ) Work: ( ) E-mail: Parent/Guardian s Name: Cell Phone: ( ) Home Phone (Father): ( ) Work: ( ) E-mail: EMERGENCY CONTACT (OTHER THAN PARENT) Note: Parent will always be contacted first Name: Relationship: Home Phone: ( ) Cell: ( ) Work: I Authorize ONLY these additional people to pick up my child(ren) (include carpools): (Please make sure to list every person that might come to pick up your child) (Children WILL NOT be released to any person not listed above or below) Name: Relationship: Cell: ( ) Home: ( ) Work: ( ) Name: Relationship: Cell: ( ) Home: ( ) Work: ( ) Name: Relationship: Cell: ( ) Home: ( ) Work: ( ) Name: Relationship: Cell: ( ) Home: ( ) Work: ( ) 6

HEALTH HISTORY FORM Please complete this form with the most recent and accurate information possible. This will help our staff with any extra information that may be pertinent to the care of your child. If there are any special needs your child may have due to diagnosed medical conditions (i.e. Autism, ADD, ADHD, etc.), we will need to be informed in order to assure proper care for your child. Some conditions may require a one-on-one provided by the family or state. Should anything happen that would alter this health history information, please let us know immediately. Form must be COMPLETED by the first day of camp. Child s Last Name, First Name: MALE or FEMALE Birth Date: Age: Doctor (name) Does your child have any Special Needs? Please explain: Camp Odyssey Phone #: Please check if your child has had the following: Chicken Pox Heart Trouble Hay Fever Stomach Upset Measles Mumps Frequent Colds Skin Rash German Measles Sinus Trouble Headaches Ear Infection Rheumatic Fever Tonsillitis Bed Wetting Nosebleeds Scarlet Fever Appendicitis Fainting Whooping Cough Diphtheria Asthma Constipation Other: Give the month and year of last immunization or booster: Tetanus Mumps Diphtheria (DPT) Measles Whooping Cough German measles Polio TB Test POS or NEG Restrictions: I have reviewed the program and activities of the camp and feel the camper can participate without restrictions. I have reviewed the program and activities of the camp and feel the camper can participate with the following restrictions or adaptations: Allergies / Other (please specify): Bee stings, mosquitoes, etc.: Food(s): Medication(s): Asthma (or hay fever): Other: Serious injuries or illness: Has the camper received medical treatment during the past year? YES or NO Date: Reason: Is the child taking any medications now? YES or NO Children must be able to administer their own medication under staff supervision. Medication must be in proper container and have only the dosage required for that days use. Dietary Restrictions: Parent/Guardian Signature: Date: 7

CITY OF LOS ANGELES MAYOR Eric Garcetti Councilmember 2nd District Paul Krekorian DEPARTMENT OF RECREATION AND PARKS BOARD OF RECREATION AND PARK COMMISIONERS Sylvia Patsaouras, President Lynn Alvarez, Vice-President Melba Culpepper, Member Misty M. Sanford, Member Pilar Diaz, Member RECREATION AND PARKS ADMINISTRATION Michael A. Shull, General Manager Anthony-Paul (AP) Diaz, Esq., Executive Officer & Chief of Staff Vicki Israel, Assistant General Manager, Recreation Services Sophia Piňa-Cortez, Assistant General Manager Ramon Barajas, Assistant General Manager, Planning, Construction and Maintenance Branch VALLEY REGION Charles Singer, Superintendent Michael Harrison, Principal Recreation Supervisor II Therman Calloway, Principal Grounds Maintenance Supervisor II NORTH HOLLYWOOD RECREATION CENTER Alfred Tutungi, Senior Recreation Director II Rosie Perez, Recreation Coordinator RECREATION ASSISTANTS Jessyka Delgado, Laura Delgado, Aimmy Galvan, Kevin Gómez, Brandy Gronich, Alma López, Dora Lozano, Karine Lozano, Nadiya Nelson, Miguel Nisthal, Helen Quezada, Rafael Regin, Sean Rivas, Isabel Rivera, Eric Sanchez, Erin Grijalva, Elizabeth Valenzuela, Samuel Rafael, Cristina Mercado, Jada Anderson, Nancy Gonzalez RECREATION INSTRUCTORS Bashirrah Creswell, Shaina Curtis, Raymond Finks, Frier McCollister, Ari Millman, Raul Paredes, Kiko Rubin, MAINTENANCE Wayne Neal, Senior Principal Maintenance Supervisor Brain Yamasaki, Park Maintenance Supervisor Juan Monzon, Lead Senior Gardener Onesimo Ramos, Gardener Lupe Buenrostro, Gardener Verneice Banks, Gardener Christian Quezada, Gardener SPECIAL PROGRAM ASSISTANT II Juan Hurtado, Natalie Aldama, Fernando Garcia, Nicolas Ruiz, Camilo Vargas City of Los Angeles Department of Recreation and Parks NORTH HOLLYWOOD RECREATION CENTER (Stop # 641-1) 11430 Chandler Blvd. North Hollywood, CA 91601 Presorted First Class Mail U.S. Postage PAID Los Angeles, CA Permit # 12932