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Thursday Folder 4/26/12

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Thursday Folder 4/26/12
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IN-BRIEF A WEEKLY NEWSLETTER OF ACTIVITIES Lumen Christi Catholic School April 26, 2012 DAY DATE EVENT TIME PLACE FRI. APR. 27 Cousin’s Sub Day NO HOT LUNCH Both 8 th Grade Bake Sale – Mequon Only Mequon OUT OF UNIFORM – Pajama Day Both SAT. APR. 28 First Communion 4:30 p.m. Mequon Church SUN. APR. 29 First Communion 9:30 & 11:15 a.m. Mequon Church WED. MAY 2 No School Mass Thiensville ACES – All Children Exercise Simultaneously 10:00 – 11:00 am Thiensville THURS. MAY 3 Mass All School Appreciation Liturgy 8:30 a.m. Mequon Thursday Folders Sent Home 8 th Grade Class Graduation Picture 1:30 p.m. Mequon FRI. MAY 4 7 th & 8 th Grade Dance 7 – 9:30 p.m. Mequon Gym Out Of Uniform Both SAT. MAY 5 First Communion 5:00 p.m. Thiensville SUN. MAY 6 First Communion 10 & 11:15 a.m. Mequon Church TUES. MAY 8 Parents Association Meeting 9:00 a.m. Dominiak Hall Homestead H.S. Placement Test 2:30 a.m. St. James Hall WED. MAY 9 Mass 1W 8:30 a.m. Thiensville Market Day Pick Up 3:00 – 4:00 pm Mequon THURS. MAY 10 Mass 4A 8:30 a.m. Mequon Washington D.C. Trip – 8 th Graders Band/Stings Concert Thiensville School Council Meeting 6:30 p.m. Dominiak Hall SUN. MAY 13 HAPPY MOTHER’S DAY! Playground Duty for the Week of April 30 th Mon. 30 th Tues. 1 st Wed. 2 nd Thurs. 3 rd Fri. 4 th M-Morris 242-1134 M-Janus 242-2696 M-Mueller 238-8921 M-O’Connor M-O’Malley 242-3306 T-Morris 414-371-1211 T-Roloff 376-4315 T-Ruiz 240-0493 T-Sehnert T-Schultlz 512-0632 CONGRATULATIONS TO THE WINNERS OF TWILIGHT TRIVIA, JR. 2012 !st Place goes to the Vegan Monsters.......Christian Roels, Anthony Greco, Andrew LoCoco, Thomas Blaubach, Quinn O'Connor, Elliot Drechsler, Nicholas Takton, and Adam Morris Best Theme Table goes to the Beverly Hillbillies.........Jay Schauer, Jake Shapiro, Charlie Langhoff, Anna Drechsler, Charles Langenfeld, Daniel Cesarz, John Cesarz, and Kevin Mackey Thank you to everyone who participated! MARKET DAY - ONLY TWO MORE MONTHS LEFT TO ORDER BEFORE SUMMER VACATION! The next Market Day will be on Wednesday, May 9th. Online orders are due Saturday, May 5th. Now is a great time to start stocking up for the summer months! If you are a new customer ordering online, use the code FIVEOFF to save $5 off a $25 order at www.marketday.com. All profits made by Market Day sales go directly to LC Parents Association. Market Day Questions? email Katie Hartzheim at [email protected]
Transcript
Page 1: Thursday Folder 4/26/12

IN-BRIEF

A WEEKLY NEWSLETTER OF ACTIVITIES Lumen Christi Catholic School April 26, 2012 DAY DATE EVENT TIME PLACE

FRI. APR. 27 Cousin’s Sub Day NO HOT LUNCH Both 8th Grade Bake Sale – Mequon Only Mequon OUT OF UNIFORM – Pajama Day Both SAT. APR. 28 First Communion 4:30 p.m. Mequon Church SUN. APR. 29 First Communion 9:30 & 11:15 a.m. Mequon Church WED. MAY 2 No School Mass Thiensville ACES – All Children Exercise Simultaneously 10:00 – 11:00 am Thiensville THURS. MAY 3 Mass All School Appreciation Liturgy 8:30 a.m. Mequon Thursday Folders Sent Home 8th Grade Class Graduation Picture 1:30 p.m. Mequon FRI. MAY 4 7th & 8th Grade Dance 7 – 9:30 p.m. Mequon Gym Out Of Uniform Both SAT. MAY 5 First Communion 5:00 p.m. Thiensville SUN. MAY 6 First Communion 10 & 11:15 a.m. Mequon Church TUES. MAY 8 Parents Association Meeting 9:00 a.m. Dominiak Hall Homestead H.S. Placement Test 2:30 a.m. St. James Hall WED. MAY 9 Mass 1W 8:30 a.m. Thiensville Market Day Pick Up 3:00 – 4:00 pm Mequon THURS. MAY 10 Mass 4A 8:30 a.m. Mequon Washington D.C. Trip – 8th Graders Band/Stings Concert Thiensville School Council Meeting 6:30 p.m. Dominiak Hall SUN. MAY 13 HAPPY MOTHER’S DAY!

Playground Duty for the Week of April 30th Mon. 30th Tues. 1st Wed. 2nd Thurs. 3rd Fri. 4th

M-Morris 242-1134 M-Janus 242-2696 M-Mueller 238-8921 M-O’Connor M-O’Malley 242-3306 T-Morris 414-371-1211 T-Roloff 376-4315 T-Ruiz 240-0493 T-Sehnert

T-Schultlz 512-0632

CONGRATULATIONS TO THE WINNERS OF TWILIGHT TRIVIA, JR. 2012 !st Place goes to the Vegan Monsters.......Christian Roels, Anthony Greco, Andrew LoCoco, Thomas Blaubach, Quinn O'Connor, Elliot Drechsler, Nicholas Takton, and Adam Morris Best Theme Table goes to the Beverly Hillbillies.........Jay Schauer, Jake Shapiro, Charlie Langhoff, Anna Drechsler, Charles Langenfeld, Daniel Cesarz, John Cesarz, and Kevin Mackey Thank you to everyone who participated! MARKET DAY - ONLY TWO MORE MONTHS LEFT TO ORDER BEFORE SUMMER VACATION! The next Market Day will be on Wednesday, May 9th. Online orders are due Saturday, May 5th. Now is a great time to start stocking up for the summer months! If you are a new customer ordering online, use the code FIVEOFF to save $5 off a $25 order at www.marketday.com. All profits made by Market Day sales go directly to LC Parents Association. Market Day Questions? email Katie Hartzheim at [email protected]

Page 2: Thursday Folder 4/26/12

SCHOOL LUNCH PROGRAM We are currently re-evaluating the hot lunch program for next year, and interested in your feedback! A change in providers would give us the option to choose from 2 different menus on a daily basis. One offers the traditional kids favorites (i.e. Chicken Nuggets, Pizza, Burgers), while the other offers salads, wraps and a slightly lighter fare. Both menus would be available in either a standard, or hearty portion size. All ordering would be done ahead of time online, with payment thru Paypal. The cost of this lunch would most likely increase $1.00-$1.55 from our current price of $2.50. Milk is not included, so an additional minimal cost would be added to that. We would no longer offer the fruit and veggie bar, as fresh fruit and vegetables are incorporated into each meal. If you have any feedback, positive or negative, please feel free to call or email Sarah Langhoff at [email protected], or call the Mequon school office. Thank you! WE APPRECIATE YOU! Thursday, May 2nd at 8:15 AM is our Appreciation Liturgy at the Mequon Campus. It is our time to say "Thank You" to all parents, grandparents, friends, and parish members for helping us throughout the school year. We hope all members of our school community are able to join us at the Mass. We will be recognizing ALL for their help throughout the year. Our parents volunteer in so many different ways- from the parent who sends in the cookies for a special treat, to the coaches for the basketball or volleyball teams, the volunteers on the different committee's at our school, to those who cleans up after a school event. ALL of you contribute and we want ALL to be recognized for their contributions. Lumen Christi would not be the outstanding school that it is without the combined effort of ALL. There will not be any individual awards given out this year. There will be a blessing and a special recognition for the 8th grade parents for their time, treasure and talent that has been so generously given throughout the years. Please plan on attending and please sit in the reserved section. Looking forward to seeing everyone there! All students, grades 4K – 8 will be attending this Mass. Students need to report to the Mequon campus in the morning. A bus will be transporting 4K-2nd grade students back to Thiensville at approximately 10:00 am. The 3rd grade students will stay at Mequon to “shadow” the 4th grade students. A bus will take them back to Thiensville at approximately 12:00 pm. RAINBOW OLYMPICS We are in need of volunteers to help out at Rainbow Olympics, Thursday, May 17, (Rain Date: Thursday, May 24) at the Lumen Christi Mequon Campus! Approximately 30 volunteers total will be needed in one to two hour shifts in the morning (8:30am - 10am), around lunch (10:30am - 12:30pm) and clean up just after lunch (12:30pm - 1:30pm). If you can help, please email Robin Handal at [email protected], indicating your time preference no later than Friday, May 4. Many thanks!

Submit In-Brief info to Cindy King (262)-242-7965 E-Mail: [email protected] Deadline: MONDAYS by 8:00 a.m.

Please check our Parish School website at http://www.lumenchristiparish.org/school/ for more comprehensive information

Page 3: Thursday Folder 4/26/12

Electronic Communication Devices

Students are generally prohibited from using or displaying in plain sight electronic communication devices (ECDs) including, but not limited to, cell phones, pagers and recording devices during the school day, in school buildings and vehicles, and at all school sponsored activities, and such devices should be turned off during these times. However, the school recognizes the value of students maintaining communication with their parents/guardians and other appropriate persons for health, safety, vocational and educational purposes. Therefore, use of ECDs may be permitted if use by the student is determined to be for a medical, school, educational, vocational, or other legitimate use. Students shall follow the following guidelines when using ECDs:

• Students shall turn off their cell phones before entering the school building. (Students

should not have a cell phone on their person while at school).

• Students shall turn in their cell phone to their homeroom or classroom teacher and have it returned at the end of the school day. The school encourages each student to clearly label his/her ECD with his/her first and last name.

• At the teacher’s discretion, students may be allowed to bring laptops/tablets and/or Ipads

for specific projects.

• Students may NOT have any form of electronic equipment in restrooms or locker rooms.

• When using personal devices, students should represent themselves and the school appropriately. Communication with others should be respectful. While the school’s wireless network is filtered, students are still prohibited from accessing or using offensive, profane, obscene, abusive, harassing, derogatory, threatening, sexually explicit, or otherwise inappropriate information, symbols, or images. Students are NOT permitted to engage in any illegal activities.

• When using personal devices, students must respect copyright law and other expectations

for intellectual property belonging to other parties. Plagiarism is prohibited.

• Students should promptly disclose to staff any message that they receive which is inappropriate or makes them feel uncomfortable.

• Students should keep personal information private, refraining from disclosing personal

contact information about themselves or peers. Usernames and passwords should not be shared among students, and students should refrain from falsely identifying themselves in communication with others.

• Students must respect school restrictions on computing resources. Vandalism including

introduction of viruses is not tolerated. Students should not interfere with another user’s equipment. Use of proxy sites or hacking software may not be used to bypass security.

Page 4: Thursday Folder 4/26/12

2

• An administrator may confiscate and search a personal device while on school property if he/she has reasonable suspicion that use of the device and/or the content captured on it violates school policies, guidelines, rules or other expectations for conduct.

• The school is not liable for the loss, damage or misuse of any personal device while on

school property or while attending school-sponsored activities.

• Students are strongly encouraged to ask for permission or clarification regarding any expectations related to use of personal devices prior to accessing them.

7673242_2

Page 5: Thursday Folder 4/26/12

Lumen Christi invites you to our 2012 7th and 8th Grade Dance!!

When: Friday, May 4th 7:00-9:30pm Doors close at 7:30pm – no late entry without special permission

Where: Lumen Christi School Gym, 11300 N. St. James Lane

Located at the intersection of Mequon & Range Line Rd. Gym is located on the west side of the church building

Who: 7th & 8th graders from Lumen Christi, Holy Family, St. Eugene’s,

St. Monica’s, St. Robert’s, and St. Francis Borgia

Cost: $5 – pay at door. Water and snacks available for purchase. You must also bring signed permission slip!

** Each school needs to provide 2 chaperones from 6:45-9:30pm. **

THIS IS AN ELECTRONICS-FREE EVENT! WE STRONGLY ENCOURAGE ALL ELECTRONICS TO BE LEFT AT HOME. ANY ELECTRONICS BROUGHT AND

USED DURING THE DANCE WILL BE HELD BY A CHAPERONE UNTIL THE END OF THE DANCE.

(Lumen Christi is not responsible for lost or stolen devices.)

For additional information or questions, please contact this year’s dance coordinator, Laura Rowe, at (262) 488-0293 or [email protected]

Page 6: Thursday Folder 4/26/12
Page 7: Thursday Folder 4/26/12

Prepared From Scratch1 HAPPY MAY DAY! 2 3 4 CINCO de MAYO tomorrow

Whole Grain Item

Lunch Lunch Lunch Lunch USDA FoodLasagna Chicken Nuggets Cheese Pizza Quesadilla

Wheat Bread Stick Wheat Bread Slice Dessert Sour Cream Harvest of the Month Churro

Alternative Entrée(s) Fruit & Vegetable Bar Fruit & Vegetable Bar Fruit & Vegetable Bar Fruit & Vegetable Bar

7 8 NATIONAL TEACHERS DAY 9 10 11 MOTHER'S DAY on Sunday

Lunch Lunch Lunch Lunch LunchSouthwest Burger Popcorn Chicken Stadium Dog on a Turkey & Gravy Chicken Strip Wrap

on a Whole Wheat Bun Dinner Roll Whole Wheat Bun Mashed Potatoes Lettuce/CheeseSun Chips Popcorn

Fruit & Vegetable Bar Fruit & Vegetable Bar Fruit & Vegetable Bar Fruit & Vegetable Bar Fruit & Vegetable Bar

14 15 16 17 18

Lunch Lunch LunchChicken Patty on a Max Sticks Corn Dogs No ServiceWhole Wheat Bun Marinara Sauce Dessert 8th Grade Pizza Day

Chips

Fruit & Vegetable Bar Fruit & Vegetable Bar Fruit & Vegetable Bar

21 22 23 24 25

Lunch Lunch Lunch LunchBBQ Grilled Chicken Tacos Hot Pocket Spaghetti w/meatsauce

Sandwich Lettuce/Cheese Muffin Bread SticksFritos Salsa Breakfast Potatoes

Juice Fruit & Vegetable Bar Fruit & Vegetable Bar Fruit & Vegetable Bar Fruit & Vegetable Bar Fruit & Vegetable Bar

28 MEMORIAL DAY 29 30 31 Student $2.50Additional Milk $0.10

Lunch Lunch Lunch Cheeseburger on a Baked Chicken Brat on a Whole Wheat Bun Dessert Whole Wheat Bun

Sun Chips Pretzels

Fruit & Vegetable Bar Fruit & Vegetable Bar Fruit & Vegetable Bar

Lunch Prices

Lumen Christi SchoolLunch Menu

MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY

For Additional Information

In accordance with Federal Law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age, or disability. To file a complaint of discrimination, write USDA, Director, Office of Adjudication, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; or call toll free (866) 632-9992 (Voice). Individuals who are hearing impaired or have speech disabilities may contact USDA through the Federal

Relay Service at (800) 877-8339; or (800) 845-6136 (Spanish). USDA is an equal opportunity provider and employer

Brian Eaton414-362-3753

Menus are subject to change without notice. Contact

.

Milk Choice of 1%, Skim and skim Chocolate

is included with Lunch

HONEY Bees have been producing honey

from flowering plants for at least 10 million years!

A hive of bees flies over 55,000 miles to bring you one pound of honey. A honey bee can fly 15 miles per hour.

Honeybees must tap two million

flowers to make one pound of honey.

Each worker honey bee makes 1/12th teaspoon of honey in its lifetime.

Free & Reduced-meal forms can be obtained

from all building offices at any time throughout

the school year.

May 2012

HARVEST OF THE MONTH Wheatberries Asparagus

Apricots

!"#$%&'()%#

!"#$%&'()%#

Page 8: Thursday Folder 4/26/12

!! !

At this liturgy we will be recognizing all volunteers. Individual awards will not be distributed.

Page 9: Thursday Folder 4/26/12

LUMEN CHRISTI DROP-OFF/PICK-UP MEQUON CAMPUS

MORNING DROP OFF PATTERN: Busses will enter from St. James Lane and will drop off students behind the school. Parents can enter either entrance on Mequon Road or St. James Lane. Drop off is between the school and the church in a single file line. There will be cones for students to stand behind. PLEASE DRIVE SLOWLY AFTERNOON PICK-UP: Busses will pick-up children on the lower playground behind the school. Parents can enter either entrance on Mequon Road or St. James Lane. Drivers should park between the school and church in the parking stalls. Wait for the students to come out to the parking area and proceed to your car. Exit either to St. James Lane or Mequon Road at the east exit. PLEASE DRIVE CAREFULLY ALL SCHOOL MASS DAYS: LCT bus riders will be dropped off behind the school. A teacher will meet them and they will congregate in the lunchroom. Car riders should drop their children off between the school and church parking area (see above). An LCT or LCM teacher will meet the children by the cones and will direct them where to go. Children dropped off late should go to the main school office.

Page 10: Thursday Folder 4/26/12

MEQUON RD.

CHURCH

SCHOOL

B O B O L I N K

ST. J A M E S LN.

DROP OFF AREA

EXIT CARS & BUSSES

N Cars Bus

LUMEN CHRIST MEQUON CAMPUS DROP OFF DIRECTIONS

ENTER ENTER

Page 11: Thursday Folder 4/26/12

MAY & JUNE -- PLAYGROUND SCHEDULE -- 2012

S M T W T F S

1 M-Janus-242-2696

T-Roloff-376-4315

2 M-Mueller-238-8921

T-Ruis-240-0493

3 M-O’Connor-242-5152

T-Sehnert-292-8144

4 M-O’Malley-242-3306

T-Schultz-512-0632

5

6

7 M-Read-375-9929

T-Sheehy-844-3877

8 M-Ryan-643-4488

T-Stammer-242-7854

9 M-Schauer-242-5589

T-Thomas-242-5993

10 M-Schelble-240-0555

T-Varney-618-2019

11 M-Schmich-242-6925

T-Warshauer-512-190

12

13

14 M-Ryba-512-0009

T-Szypszak-242-0757

15 M-Scholtus-238-1587

T-Voeller-512-1070

16 M-Schramka-238-9026

T-Stuckslager-242-5095

17 RAINBOW

OLYMPICS

18 M-Shore-242-3075

T-VanLaanen-643-4646

19

20

21 M-Sileno-242-2273

T-Wenzler-414-322-3361

22 M-Skow-236-0663

T-Wirthlin-238-8661

23 M-Stendler-242-5114

T-Zacharias-512-3629

24 M-Schultz-375-7004

T-Hartlieb-643-4625

25 EARLY

RELEASE

26

27

28 MEMORIAL

DAY

29 M-Sutton-238-9193

T-Boyle-241-5989

30 M-Thomas-238-8858

T-Belardi-375-9605

31 M-Stoll-238-1441

T-Aleman-414-852-7076

1 M-Walton-241-5598

T-Bigonia-512-0379

2

3

4 M-Weitzer-643-4800

T-Bahr-243-5268

5 M-White-238-1373

T-Barlament-242-6243

6 M-Ryba-512-0009

T-Brackett-377-0354

7 EARLY

RELEASE

HAVE A SAFE AND FUN

SUMMER! SEE YOU IN THE FALL!

!ONLY family members who have completed Safeguarding God’s Family may serve playground duty"!

!"#$%&'()*+$,'--./01-2.34'567"&,8799"'()*+$,'--./:1-2.-0'

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Page 12: Thursday Folder 4/26/12

Spring Bake Sale!

Tomorrow, Friday, April 27th, during the lunch hour at the Mequon campus, the 8th graders will be sponsoring a Spring Bake Sale. Enjoy some home-made treats with your Cousin's Sub!! Thank you for your participation. (8th grade parents-please drop off your baked goods tomorrow morning. Thank you.)

!

Page 13: Thursday Folder 4/26/12

LC Shamrock Video Order Form We are offering, free of charge, one copy of the LC video shown at Shamrock to all school families. If you are interested, please send this order form to the school office. If you would like to make a donation for the video, feel free to do so. All donations will be put towards the $10,000 gap for the iPad Fund-an-Item. Family Name Send video home with (child’s name) who is in (child’s teacher’s name) classroom.

Please send this form to the school office.

Page 14: Thursday Folder 4/26/12

Reading is the foundational skill that supports,

reinforces and leads to student academic success !

Presented by: North Shore Center, LLC Cheryl Ward, MS, CALP

Certified Academic Language Practitioner 10303 North Port Washington Road

Mequon, WI 4

Thursday April 12, 2012 9:00 am - 11:00 am

or

Thursday May 10, 2012 6:30 pm – 8:00 pm

At: Fiddleheads Coffee Roasters 10530 N. Port Washington Road

Mequon, WI

Coffee and Pastry 9:00-11:00AM Space is limited.

Please RSVP by emailing: [email protected]

• How do you know if your child who is learning to read is struggling? • Identify signs of a student who struggles learning to read • Reading / Dyslexia / Reading Disabilities • Learn the building blocks that all good readers have • Find out how can parents help

Learning to Read

Page 15: Thursday Folder 4/26/12

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Page 16: Thursday Folder 4/26/12

 

 

   Mequon  Soccer  Club  presents  Free  Open  Skills  Clinic  Micro-­U10  (ages  3-­10)  

 Friday,  May  4,  2012  

Rain  date:  5/11/2011  same  time/place    

Girls  &  Boys:  5:30pm  -­  6:45pm      

River  Barn  Park  -­    9808  N  Cedarburg  Road  -­  Mequon    

Last  Name      __________________________________________________        First  Name    _____________________________________________________  Date  of  Birth      _________________________________________________      Age  ___________________________  Gender  _________________________  Address        ____________________________________________________________________________________________________________________  City      ________________________________________________________      Zip    ___________________________________________________________  Email      _______________________________________________________________________________________________________________________  Mother      ____________________________________        Phone      ________________________________      Cell      ___________________________________  Father      ____________________________________          Phone      ________________________________      Cell      ___________________________________  

 

Current  Allergy  and/or  Medical  Information  _____________________________________________________________________________________________________________________________  _____________________________________________________________________________________________________________________________            I,   the  parent/guardian  of  the  registrant,  a  minor,  agree  that  I  and  the  registrant  will  abide  by  the  rules  of  the  United  States  Youth  Soccer  Association  (USYSA), its  affiliated  organizations  and  sponsors.    Recognizing  the  possibility  of  injury  associated  with  soccer  and  in  consideration  for  the  USYSA  accepting  the  registrrelease,  discharge  and/or  otherwise  indemnify  the  USYSA,   including  Mequon  Soccer  Club  Inc.,   its  affiliated  organizations  and   sponsors,  their  employees  and  associated  personnel,   including  the  owners  of  the  fields  and  facilities  utilized  for  all    programs,  against  any  claim  by  or  on  behalf  of  the  registrant  as  a  result  of  the  registrants  participation  in  the  programs  and/or  being  transported  to  or  from  the  same,  which  transportation  I  hereby  authorized.            As  the  parent/guardian  of  the  above  named  player(s),  I  hereby  give  consent  for  emergency  medical  care  prescribed  by  a  duly   licensed  doctor  of  medicine  or  doctor  of  dentistry.    This  care  may  be  given  under  whatever  conditions  are  necessary  to  preserve  the  life,  the  limb  or  well-­being  of  my  dependent.    

Parent/guardian      ________________________________________________________________________      Date      _______________________________    

What  to  wear:   Loose  clothes  (appropriate  for  weather),  shin  guards,  shoes.  What  to  bring:   soccer  ball  &  water  bottle  (both  labeled)  Cancellations:   Check  our  website  for  cancellations  due  to  weather.        Common  sense  -­    lightning  and  thunder  means  NO  PRACTICE.        

This form is required. Bring to clinic or mail to: Mequon  Soccer  Club-­Skills  Clinic  

Box  114  10936  North  Port  Washington  Road  

Mequon,  WI    53092  

   For  questions  visit    mequonsoccerclub.com,  phone:  262-­240-­1080    or  email  Club  at  [email protected].     03/12/2012  lec  

Page 17: Thursday Folder 4/26/12

 

 

   Mequon  Soccer  Club  Summer  Camps  

 July  16  -­  19,  2012  

     

Dhaliwal  Soccer  Park  -­    8200  West  Donges  Bay  Road  -­  Mequon         _____    U11  -­  U14  Girls/Boys       8:30am  -­  12:30pm             $160*             ____    Micro  -­  U10  Youth  Camp       9:00am  -­  12:00pm         $120    

*Dates  and  times  subject  to  change.    $10  discount  if  form  and  check  received  in  Club  office  by  June  30,  2012.  Last  Name      __________________________________________________        First  Name    _____________________________________________________  Date  of  Birth      _________________________________________________      Age  ___________________________  Gender  _________________________  Address        ____________________________________________________________________________________________________________________  City      ________________________________________________________      Zip    ___________________________________________________________  Email      _______________________________________________________________________________________________________________________  Mother      ____________________________________        Phone      ________________________________      Cell      ___________________________________  Father      ____________________________________          Phone      ________________________________      Cell      ___________________________________  

 

Current  Allergy  and/or  Medical  Information  _____________________________________________________________________________________________________________________________  _____________________________________________________________________________________________________________________________            I,   the  parent/guardian  of  the  registrant,  a  minor,  agree  that  I  and  the  registrant  will  abide  by  the  rules  of  the  United  States  Youth  Soccer  Association  (USYSA), its  affiliated  organizations  and  sponsors.    Recognizing  the  possibility  of  injury  associated  with  soccer  and  in  consideration  for  the  USYSA  accepting  the  registrrelease,  discharge  and/or  otherwise  indemnify  the  USYSA,   including  Mequon  Soccer  Club  Inc.,   its  affiliated  organizations  and   sponsors,  their  employees  and  associated  personnel,   including  the  owners  of  the  fields  and  facilities  utilized  for  all    programs,  against  any  claim  by  or  on  behalf  of  the  registrant  as  a  result  of  the  registrants  participation  in  the  programs  and/or  being  transported  to  or  from  the  same,  which  transportation  I  hereby  authorized.            As  the  parent/guardian  of  the  above  named  player(s),  I  hereby  give  consent  for  emergency  medical  care  prescribed  by  a  duly   licensed  doctor  of  medicine  or  doctor  of  dentistry.    This  care  may  be  given  under  whatever  conditions  are  necessary  to  preserve  the  life,  the  limb  or  well-­being  of  my  dependent.    Parent/guardian      ________________________________________________________________________      Date      _______________________________    

What  to  wear:   Loose  clothes  (appropriate  for  weather),  shin  guards,  shoes.  What  to  bring:   soccer  ball  &  water  bottle  (both  labeled)  Cancellations:   Check  our  website  for  cancellations  due  to  weather.        Common  sense  -­    lightning  and  thunder  means  NO  PRACTICE.        

Mail registration form to: Mequon  Soccer  Club-­Summer  Camp  

Box  114  10936  North  Port  Washington  Road  

Mequon,  WI    53092  

   For  questions  visit    mequonsoccerclub.com,  phone:  262-­240-­1080    or  email  Club  at  [email protected].     03/12/2012  lec  

Page 18: Thursday Folder 4/26/12

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