2017
AMERICAN RED CROSS
CITY OF JACKSONVILLE BEACH
JR. LIFEGUARD PROGRAM
#2 Ocean front Jacksonville Beach, FL 32250
249-9141 or 860-2175
PARTICIPANT INFORMATION (Must be filled out)
Participant’sName: (print)______M______F______Address: ______
City: ______, State: ______Zip: ______
Parents cell: ______Email______
Age: ______Date of birth: ______
Doctor’s Name: ______Phone # ______
Any pertinent medical problems we should be made aware of? _____ Yes _____ No If yes—please explain:
______
Is applicant on any prescribed medication(s): _____Yes _____No If yes—specify: ______
(Please check which camp child will be attending)
Checks payable to: VOLUNTEER LIFE SAVING CORPS
First camp 2017 $185.00 ~ 2nd camp 2017 $135.00 (no family discounts for multiple siblings)
Campers who qualify will be placed in advanced group
Ages 9 thru 15~June 12-16______June 19-23_____June 26-30_____ July 10-14____July 24-28_____ July 31-August 4____Competition Camp all ages/ July 17-20______Competition July 22 $150.00 previous 2017 campers $100.00
T-Shirt size______
EMERGENCY CONTACTS1. NAME: ______HOME: ______WORK: ______
2. NAME: ______HOME: ______WORK: ______
PHOTOGRAPHIC WAIVER: I______
(PARENT OR GUARDIAN, OR INDIVIDUAL ~ PLEASE PRINT)
GIVE MY PERMISSION TO THE CITY OF JACKSONVILLE BEACH, TO TAKE PHOTOGRAPHS. I UNDERSTAND THAT THESE MAY BE USED FOR PROMOTIONAL MATERIAL BUT WILL NOT BE USED FOR THE PURPOSE OF PROFIT.
JR. LIFEGUARD PROGRAM GUIDELINES
Parents:
1. Due to the strenuous nature of this program and since lifeguards must first learn to be responsible for themselves before they can be responsible for others the following will apply to participants of this program.
1. Report to camp ON TIME each day.
2. You must bring a lunch. Do not bring money expecting to buy lunch.
3. Do not litter. Throw your trash away. Remember a CLEAN BEACH IS A HAPPY BEACH!
4. Appropriate swim attire must be worn and foot coverings such as sandals, sneakers, or flip flops be worn. Mark all personal gear with a permanent marker. All participants are responsible for their own possessions. It is recommended that only inexpensive items be brought each day. Do not bring valuables such as surf boards, cell phones, CD’s etc.
5. Rough play, profanity and in appropriate hand gestures will not be tolerated. KEEP YOUR HANDS TO YOURSELF.
6. Never take or use any gear or personal items that belong to others without permission.
7. All participants in the program must attempt the activities presented.
8. Sick or ailing children must be kept home until well. The program is not funded to provide care for non participants.
9. Participants will follow directions and instructions. Safety is paramount. Failure to follow directions could end in injury.
10. Give instructors your full attention and act quickly when asked to do a task. Disrespect for other participants and staff will not be tolerated. Expulsion from the program may occur.
11. Participants must remain with their groups at all times. They will leave only with the lead counselors permission and an assistant counselors escort.
12. The training room and equipment used will be cleaned and stored properly at the end of each day. Help from all participants is expected. Various pieces of equipment will not be touched by participants unless told to do so. Defiance may result in expulsion.
13. You are expected to be polite, courteous and respectful of fellow Jr Lifeguards, instructors and the general public.
14. We expect you to display good sportsmanship when competing with one another and with other beaches.
15. Jr Lifeguards represent the City of Jacksonville Beach, the American Red Cross Volunteer Lifesaving Corp., City of Jacksonville Beach Ocean Rescue Division and the City of Jacksonville Beach Jr Lifeguard Program, any violation of rules and procedures will be dealt with accordingly. After parents are notified, participants will be expelled from the program if negative behavior continues.
PARENT
Signature Date
CAMPER
Signature Date
2016
AMERICAN RED CROSS
CITY OF JACKSONVILLE BEACH
JR. LIFEGUARD PROGRAM
$185.00 First Session per child
Each session following $135.00
AGES 9-15 (Campers who qualify will be placed in advanced group)
SESSION ONE ~ JUNE 12-16
SESSION TWO ~ JUNE 19-23
SESSION THREE~ JUNE 26-30
SESSION FOUR ~ JULY 3-7 P.A.L.
SESSION FIVE ~ JULY 10-14
SESSION SIX~ JULY 24-28
SESSION SEVEN~ JULY 30 - AUGUST 4
All AGES COMPETITION CAMPS
JULY 17-20 * Cost of this camp ~
$150.00 first time camper 2017
$100.00 previous session camper 2017 (competition camp only)
COMPETITION TO BE HELD JULY 20th
Camp hours
Monday –Friday ~ 9:00am to 4:00pm,
Boys and girls ages 9~15
The 2017 Jr. Lifeguard program is an overview of Ocean Rescue Lifeguard procedures to insure the public’s safety while visiting our beaches. We offer instruction in Ocean Rescue, first aid, C.P.R., weather patterns, and environmental awareness. You will learn how to use Lifeguard equipment such as the rescue tube, and paddleboards. This is a fun and exciting learning experience.
Must be a good swimmer and comfortable in the ocean.
CHECK LIST FOR PARENTS AND CHILDREN
SUNSCREEN
WATER OR DRINK
LUNCH (in a container ~ no bag lunches)
EXTRA SHIRT FOR CLASSROOM
SUITS TO BE WORN TO AND FROM CAMP
For more information, please contact 904/249-9141 (lifeguard station)
Coach George Paugh, cell 860-2175
FREQUENTLY ASKED QUESTIONS
If for some reason you need to contact your child, call the Jr. Lifeguard headquarters at (904) 249-9141. Your message will be delivered as quickly as possible.
Jr. Lifeguard classes will be held in all weather and surf conditions. Activities will be adjusted accordingly.
If your child is on medication or has special medical needs, please promptly inform the camp director.
Due to liability and safety reasons we do not allow any children to participate that are not enrolled.
Please call for an application and register early to ensure participation.
Camp is for ages 9-15(Campers who qualify will be placed in advanced group)
The Competition camp is for all ages 9-15
Registration forms should be mailed to:
Lifeguard Station
Attn: Jr. Lifeguard Camp/ Coach Paugh
#2 Oceanfront
Jacksonville Beach, FL 32250
Jr. Lifeguard questions can be answered year round at 249-9141
City of Jacksonville Beach
DEPARTMENT OF RECREATION, PARKS & OCEAN RESCUE
2508 South Beach Parkway. Jacksonville Beach, Florida 32250
Phone: (904) 247-6236 ~~ Fax: (904) 247-6143
DISCLAIMER 2017
NOTICE FOR ADULTS and MINOR CHILDREN’S NATURAL GUARDIANS
READ THIS FORM COMPLETELY AND CAREFULLY.
You are agreeing to let yourself and or your minor child engage in a potentially dangerous activity. You are agreeing that even if the City of Jacksonville Beach Parks and Recreation Department and the City of Jacksonville Beach uses reasonable care in providing this activity, there is a chance you and or your child may be seriously injured or killed by participating in this activity because there are certain dangers inherent in the activity which cannot be avoided or eliminated.
By signing this form, you are giving up your child’s, and or your right and your right to recover from the Jacksonville Beach Parks and Recreation Department, the City of Jacksonville Beach and its employees in a lawsuit for any personal injury, including death, to you and or your child or any property damage that results from the risks that are a natural part of the activity. You have the right to refuse to sign this form and the city of Jacksonville Beach Parks and Recreation Department and the City of Jacksonville Beach has the right to refuse to let you and or your child participate if you do not sign this form.
I have read and understand the terms of this Release.
______
Adult Participant Name (please print)
______Date: ______
Signature of Adult Participant
______
Parents or Guardians (of the minor) Name (Please print)
______Date: ______
Signed
Child(s) Name: ______
(Please print)
______
______