Registration from February 1 – June 7th. First come, first serve.

Plunge into the heart of summer with 9 specialty themed Riverview day and overnight camps! From Wacky and Wild to the Coast with the Most, each camp offers action packed adventures for all ages and interest!

Whether you’re looking for a weeklong camp or a full summer escapade, each day offers unforgettable experiences!

Read on and learn more about our best summer ever!

SummerDay Camp SummerDay Camp SummerDay Camp

Enjoy warm summer days full of: » Super soaker splash tag

» Campfire cookin’

» “The Amazing Race”…Riverview style

» Mascots, wigged out wigs, and crazy clothes contest

» Exploring Maine’s sandy shores and beautiful beeches

» Mud slides and mud streams

» The crackling sound of campfires, s‘mores and sleeping under the stars.

...and tons more fun!

June 25th – August 17th

ages 6 – 17

Youth & TeenYouth & Teen

2012

WEEK 1 Boot Camp Blitz June 25 – 29

Dig out your camo and strap on your head band! Campers of all ages and abilities are going to want to break out their super soakers, and get ready to rumble!

WEEK 2 Specialty Week

Kung Fu Weapons Everywhere *Overnight camp July 2 – 3

Grab your favorite kung fu weapon and let’s spin, slash, jump and strike. With bo’s, swords, chucks, and fan’s we’ll safely travel back to ancient China…kung fu style!

WEEK 2 Specialty Week

Kung Fu Fighting *Overnight camp July 5 – 6

“Everybody was Kung fu fighting”…. Straight out of the archives of Jackie Chan and Bruce Lee, this is your chance to create your own Kung Fu fighting skit and wow your friends!

WEEK 3

And then there was MUD… July 9 - 13

Scrub a dub-dub….. we’re jumping in the mud! Slip, slide and roll in the best mud ever, then wash off and feel fantastic! This is not a week for white wear!

WEEK 4 Rolling with the “Rents” July 16 - 20 With parent overnight on July 19th

Parents - join us for an hour, afternoon, or entire week and show us how YOU roll. Share your talents, hobby’s or just enjoy the company of our campers! Don’t miss

“Camping with your Kids” on July 19th!

Check out our camp themes:

WEEK 5

Coast with the Most July 23-27

Did you know Maine’s Seaboard is longer than the rest of the Eastern United States combined! From tidal pool ecosystems to sunny sandy shores, no rock will be left unturned as we dive into the depths of Maine’s Craggy Coast!

WEEK 6

Stem to Stern July 30- August 3

All aboard, Mateys! Join the ‘View Crew’ and set sail to explore Maine’s rich maritime tradition. From basic boats to Maine’s biggest rigs, we’ll delve into a nautical themed adventure with a few added surprises!

WEEK 7

Wacky and Wild August 6 - 10 With overnight on August 9th

Expect the unexpected this week, ‘cuz we’re pulling out all the stops! Think crazy, creative & comical as we jump into good ol’ summer fun!

WEEK 8

Olymp-pa-looza August 13 - 17

The 2012 ‘View Summer Games’ are on! Test your abilities as we leap, vault, and tumble our way to discover our inner gold!

Please note that Riverview’s children (ages 6-11) and teens (ages 12-17) will share the same unique themes but will be different camps offering age appropriate themed activities.

Arrival: 8:00am–9:00am daily Departure: 4:00pm–5:00pm dailySouth Portland Transportation: 8:00am pickup – 4:45pm–5:00pm drop-off

Open Registration for Camp is from Feb. 1st to June 1st. Space permitting, camp registration will remain open until the Saturday before each camp session. We do strive to plan appropriately for the unique activities that each week offers and appreciate your early registration!

To reserve your child’s space, we request a non-refundable deposit of $50.00 per Camp session. Payment in full for all Camps is due on June 7th, 2012. All payments become non-refundable 10 days prior each Camp session. Please mail your payments to:

Riverview FoundationP.O. Box 310

Topsham, Maine, 04086

To pay by credit card, please call our office at (207) 729-7300 ex: 303

Keeping Riverview’s Staff informed of any health conditions or concerns for your child is very important. Your Registration Form provided the information about your child’s medications, injuries, allergies and other details; however, if your child’s health concerns or medications have changed, be sure to inform us before Camp begins!

If your child takes medication either daily or for specific emergency conditions, Riverview will ensure the proper administration of the medication according only to the information you have provided. If your child is bringing medications, please ensure that it is securely packaged, preferably in a waterproof baggie around the container; announced to the Rivervew Staff; and clearly labeled with your child’s name, an emergency phone number, identification of the medicine and its purpose, times or circumstances it is administered, and any special details including preferred hospital or doctor.

All medical necessities must be written on your child’s Registration Form. If these necessities change between now and the Camp, please ask to fill out a new Health Form, and we will do everything we can to support your child’s needs. Please note also that you should inform us of any changes to your “emergency phone numbers” for the week! Thank you.

In Topsham, arrivals and departures will take place in the Riverview parking lot at 610 Augusta Road. In South Portland, the Riverview Camp van will pick up and drop off campers at 146 Ocean Street. Riverview Staff will gladly be on hand at both locations to assure the safety of your child and assist with any questions you may have.

Arrivals & Departures

Late or Mid-Summer Registrations

Payment Instructions

Health Information

Please bring all of the following items with you. The items listed are for your child’s comfort, and safety. To assure your child returns with their proper belongings, please write your child’s name on all of their clothes and gear! We ask that children do not bring games, electronics, phones, or other valuable items.

Scheduled water, canoeing, camp skills, and shelter building days and will be announced on Monday of each week. During specialty days please bring:

Campers will need to bring a healthy morning snack and bag lunch every day. We encourage a healthy lunch that your kids will enjoy, so that their energy is high and their attitude is positive. Here are some suggested examples of items to bring for lunch - and things to avoid:

Although each day at Riverview Day camp offers unique experiences and activities, a sample day may look like this!

GOOD to bring:> Healthy sandwich > Fruit – apples, oranges, grapes, bananas> Veggies – carrot, celery sticks, cucumbers> Non-carbonated drinks -juice, water, lemonade> Granola bars, trail mix, nuts, raisons> Other desired light, energetic foods.

AVOID bringing:> Candy, sweets, or sugary foods> Soda> Food that spoils in the sun > Heavy foods that deter from good exercise>Glass items or breakables

Gear required for campers

Bag Lunches

Example of a daily schedule

ፌ Extra: socks, T-shirt, sneakers, long sleeve shirt, pants

ፌ Gi – for Riverview Students

ፌ Warm layer

ፌ Rain gear

ፌ Hat for sun

ፌ Sunscreen

ፌ Insect repellent

ፌ Canteen/water bottle

ፌ Towel

ፌ 1-2 Plastic trash bags

ፌ Snack

ፌ Lunch (see below)

PLEASE PACK IN A DAYPACK:

ፌ Life jacket ፌ Tarp - 4 ! x 7 feet ፌ 50 ft nylon cord

SPECIALTY DAYS

8:00–9:00 Students arrive. Outdoor Arts and crafts

9:00–10:15 Martial art obstacle course challenges

10:15–10:30 Snack

10:30–11:15 Native American hand signals & pictographs

11:15–Noon Taste Testing “organic Vs. Non-organic”

Noon–12:30 Lunch

12:30–3:30 Canoe trip on the Androscoggin River

3:30–4:00 Pack up and closing camp discussion

4:00–5:00 Student departure

If you need to reach your child during the camp day, please call the Riverview office at (207) 729-7399 Ex. 0 and a Riverview representative will promptly deliver your message. If the camp is on a field trip, or away from phone reception, we will deliver your message as soon as possible!

If your child has a health emergency we will contact you immediately using the emergency phone number listed on your camp registration form. Your child will be brought to the Brunswick Midcoast Hospital (729-0181) for medical attention.

One of the high points of Camp is always the time spent swimming, canoeing, kayaking, or just hanging out, training martial arts or playing by and in the river. In order to take part in all the water events, you must make sure that: (a) your child has a good Life Preserver with them, and (b) you have informed Riverview of your child’s “water skills”.

Our Staff needs to know whether your child is already a reasonable swimmer, whether they’re comfortable in the water, and whether they enjoy it. The children themselves will have the option to partake in many of the water activities or not, as they choose, if you have listed them as able to swim on their Registration Form. Please note that many children have either had their first experience with water, or learned to swim, right here at Riverview—it’s up to what they enjoy and would like to do, within the limits of safety. So once again, please be sure to let us know the level of your child’s water abilities, and we will help them to enjoy their Camp and broaden their experience!

Riverview prides itself on having an exceptional reputation for safety and positive growth in its classes and Camps. Because safety and positive experiences have always been our focus, Riverview is chosen every year to receive children from public and private schools, to engage in State programs, and to teach other educators throughout Maine.

An important part of the safety and success of the Camp is the good behavior of the children. At Camp, we require that children do their best to cooperate, listen well, and try to get along with each other. Children will always have difficulties, and we do not expect them to be perfect; however, all the children will be reminded what is “acceptable” and “unacceptable” behavior. We do reserve the right, although we rarely find the need, to remove disruptive children from camp.

A Positive, Safe, and Fun Camp experience is what we aim to provide to all campers. See You Soon.

Emergencies

Androscoggin and Cathance Rivers

Safety and Good Behavior

ፌ�Pay by credit card(visa, mastercard or discover)

Card Number:

Expiration Date:

Signature:

2012 Summer Day Camp Registration Form

Deposits & payments

Open registration for Camp is from Feb 1st – June 7th, 2012. Register by returning this form and required payments. To register after May 1st, please call to inquire about availability.

Please enclose your full payment, or your non-refundable deposit of $50.00 per session to reserve your spaces at Camp. If you enclose only a deposit, the balance of payment is due in full no later than June 7th. All camp payments become fully non-refundable 10 days prior to each camp session in question.

PAYMENT FORMPay by: ፌ�Cash ፌ�Check

Amount Enclosed: $

Full Summer Camp + Overnights June 25–August 17ፌ $1,250 (early bird special) ፌ $1,310 (Four-month payment plan*)

* Dates for payment plan for full summer camp is March 7th, April 7th, May, 7th and June7th.

Mix & Match: Select camp weeks of your choice: Date Price

Week 1: Boot Camp Blitz June 25–29 ፌ $200

Week 2 (speciality overnight): Kung Fu Weapons Everywhere July 2-3 ፌ $180

Week 2 (speciality overnight): Kung Fu Fighting July 5-6 ፌ $180

Week 3: And then there was MUD... July 9–13 ፌ $200

Week 4: Rolling with the "Rents" (with camping with your kids on July 19th) July 16–20 ፌ $200

Week 5: Coast with the Most July 23–27 ፌ $200

Week 6: Stem to Stern July 30–Aug 3 ፌ $200

Week 7: Wacky & Wild (with overnight on August 9th) Aug 6–10 ፌ $200

Week 8: Olymp-pa-looza Aug 13-17 ፌ $200

Transportation: ፌ�Week 1��ፌ�Week 2��ፌ�Week 3��ፌ�Week 4��ፌ�Week 5��ፌ�Week 6 ፌ�Week 7 ፌ�Week 8Daily Transportation from Riverview’s South Portland dojo is free up for the first 20 students per camp week

Subtotal: Sibling discount (10% discount): Sibling discounts for Mix & Match selections only. Full summer package already includes discounts.

Order a camp t-shirt! (adult sizes only) ፌ S ፌ M ፌ L ፌ X-L $15 per shirt x ________ =

Grand Total:

–

Payment is for:

ፌ�Depositፌ�Payment Planፌ�Full Payment

Payment is for:

ፌ�Depositፌ�Payment Planፌ�Full Payment

Participants Name Date of Birth

Mother (or guardian) Father (or guardian)

Home Phone Work Phone

Email Address

Street Addres City State Zip

Local Emergency Contact Phone

Nearest Relative Phone(These are other people to contact with any emergency, question, or concern. You may list any other people you choose whom you legally authorize to sign for health care or any other decisions necessary for your child.)

Arrival: 8:00am–9:00am daily Departure: 4:00pm–5:00pm dailyTransportation: Free transportation can be provided to and from 146 Ocean Street, South Portland for the first 20 students per camp week. 8:00am pickup — 5:00 drop-off. Transport is provided by Riverview Foundation volunteers.

Behavioral expectations are based upon safety and common sense. Riverview’s guidelines on behavior are strictly enforced by all Staff. Any campers exhibiting repeated misbehavior will be warned to change their actions prior to temporary suspension. Expulsion can follow suspension if there is no evidence of improvement of attitude, or can occur without prior warning at Riverview’s sole discretion if the camper’s behavior seriously threatens the safety of others and is deliberate or judged likely to recur. Expulsions and suspensions are not eligible for tuition refund.

During any Riverview Foundation activity, class, or special programming, you may be filmed, photographed, videotaped, and/or otherwise recorded. Your signature below includes this Release of Likeness and gives your voluntary permission for Riverview to make use of your likeness or other records in the future for purposes of promotion, advertising, history, projects including books or videos, or other professional purposes, either during or after your time at Riverview. 60-days prior written notice to Riverview's office will be required to edit this permission.

As the parent or legal guardian of the participant named below, I give permission for my child (the participant) to attend all of the Events listed above. I have informed the Riverview Staff of any medical needs my child may have and give the Staff permission to administer basic first aid and non-prescription medicines if needed for minor ailments. While my child is participating in this Riverview Foundation activity, I take full responsibility for any physical injuries or conditions that my child may have at this time or have had in the past and I relinquish the rights to sue. Riverview Foundation, its Staff, and associated people will not be held liable for any injuries, illnesses, or damages that may occur during the course of these programs or events or during transporta- tion to and from events and/or locations. Riverview Foundation in turn agrees to take reasonable measures to ensure the health, safety, well-bring and personal growth of the participant while they are under the supervision of Riverview Foundation personnel.

Contact Information

Arrivals & Departures

Behavior guidelines, suspensions and expulsions

Release of likeness authorization

Release of liability

Signature of Parent or Guardian: Date:

Participant's Name Phone

Parent/Guardian Phone

Parent/Guardian Phone

Alternate Contact Phone

Health History

Below, please list all allergies that are known and describe the reaction and management.

Medical Allergies (list all) Food Allergies (list all) Other Allergies (list all)ፌ None ፌ None ፌ None

Please describe: Please describe: Please describe:

Medications being takenፌ Participants takes NO medications on a routine basis.ፌ Participant takes the medications listed below:

Med #1 Dosage Specific times taken each dayReason for taking

Med #2 Dosage Specific times taken each dayReason for taking

Med #3 Dosage Specific times taken each dayReason for taking

Medical information & health history

RestrictionsThe following are all restrictions which apply to this participant.

—Dietary—ፌ Does not eat red meat ፌ Does not eat pork ፌ Does not eat poultryፌ Does not eat seafood ፌ Does no eat dairy products ፌ Does not eat eggsፌ Other (please describe):

—Activity—

Explain any restrictions to activity ፌ None

General Questions Please explain all "yes" answers below, noting the number of each question/response.

Has / Does the participant: Yes No Yes No1. Had any recent injury, illness, or infectious disease? ፌ ፌ2. Have a chronic or recurring illness / condition? ፌ ፌ3. Ever been hospitalized? ፌ ፌ4. Ever had surgery? ፌ ፌ5. Have frequent headaches? ፌ ፌ6. Ever had a head injury? ፌ ፌ7. Ever been knocked unconscious? ፌ ፌ8. Wear glasses, contacts or protective eye wear? ፌ ፌ9. Ever had frequent ear infections? ፌ ፌ10. Ever passed out during or after exercise? ፌ ፌ11. Ever been dizzy during or after exercise? ፌ ፌ12. Ever had seizures? ፌ ፌ13. Ever had chest pain during or after exercise? ፌ ፌ14. Ever had high blood pressure? ፌ ፌ

15. Ever been diagnosed with a heart murmur? ፌ ፌ16. Ever had back problems? ፌ ፌ17. Ever had problems with joints (knees, ankles, etc)? ፌ ፌ18. Have any skin problems (rash, itching, acne)? ፌ ፌ19. Have diabetes? ፌ ፌ20. Have asthma? ፌ ፌ21. Had mononucleosis in the last 12 months? ፌ ፌ22. Had problems with diarrhea / constipation? ፌ ፌ23. Have problems sleepwalking? ፌ ፌ24. Any other disease, health condition or disorder ፌ ፌ

we should know about? (please describe below.) 25. Ever had emotional difficulties for which professional ፌ ፌ�

help was sought?

Explanations:

Please include and write on additional sheets if needed to provide additional information about the participant’s behavior and physical, emotional, or mental health about which Riverview Foundation should be aware.

—IMPORTANT - THE BOX BELOW AND ALL INFORMATION ABOVE MUST BE COMPLETE FOR ATTENDANCE.—

This health history is complete and correct as far as I know. The participant has / gives permission to participate in all activities. I hereby give permission to Riverview Foundation to provide, seek, and consent to routine health care, administration of prescribed medications, and emergency treatment for me / my child, as may be necessary, including but not limited to x-rays, routine tests and treatment, and/or hospitalization. I agree to the release of any records necessary for treatment, referral, billing or insurance purposes. It is my intention that Riverview Foundation be treated as acting in loco parentis if the participant is a minor. Further, it is my intention that Riverview Foundation’s authorized representatives be treated as “personal representatives” for the purposes of disclosing protected health information pursusant to the privacy regulations promulgated pursuant to the Health Insurance Portability and Accountability Act of 1996. I hereby agree (pursuant to 45 CFR 164.510(b)) to the disclosure to Riverview Foundation representatives of the protected health information of the participant, as necessary: (i) to provide relevant information related to the participant’s ability to participate in activities; and (ii) to provide relevant information to the representatives to keep me informed of my child’s status. In the event I cannot be reached in an emergency, I here- by give permission to any physician selected by Riverview Foundation to secure and administer treatment, including hospitalization, for the participant. I also understand and abide by any restrictions placed on my / my child’s participation in activities as deemed appropriate by Riverview Foundation.

Name of Participant: Date

Signature of Parent or Guardian: Date

Medical information & health history (continued)