2021 SUMMER CAMP PROGRAMS - CITYFUN
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Summer
Program
Registration Forms
Inside
wpb.org/parks
2021
Summer Camp
Programs
CityFun
FOR EVERYONE
FOR EVERYONE
The City of West Palm Beach Department of Parks
and Recreation believes that all kids should have the
opportunity to go to camp.
Would you like to help children with fewer resources spend
their summer in a safe, supervised environment while
learning new skills and having fun?
We gladly accept and appreciate all scholarships of any
amount to out CityFun 2021 Scholarship Assistance
Program.
Day Camp Information 3
Due to the ongoing Coronavirus (COVID-19) pandemic,
the City of West Palm Beach Department of Parks and Sports & Specialty Camp
Recreation has implemented new guidelines to our CityFun Information 5
Summer Camp to ensure the safety of campers and staff Summer Swim Lessons 9
alike.
Summer Sailing 10
The following changes have been made:
Resident Only
• Smaller groups Payment Worksheet 13
• A COVID-19 waiver that must be signed by parents/ Non Resident
guardians Payment Worksheet 15
• A health screening checklist and temperature check Sports & Specialty Camp
at morning drop-off Payment Worksheet 17
• Frequent handwashing, increased sanitization of Registration Form 19
frequently touched surfaces, social distancing, and
wearing of face coverings.
• Designated camp counselors for the duration of
camp.
• Fewer off-site field trips
• Parents/Guardians and visitors will not be allowed
into the facility.
Day Camp Information
Enrollment is NOW Available Online at wpb.org/parks
RESIDENT NON RESIDENT
Your Registration begins March 1, 2021 Your Registration begins April 1, 2021
Registration will be accepted online and by postmarked mail. Registration will be accepted online and by postmarked mail.
Spaces will be filled on a first come, first served basis. Resident Spaces will be filled on a first come, first served basis. Non-
registration cannot be postmarked prior to March 1, 2021. resident registration cannot be postmarked prior to April 1,
Envelopes with a postmark prior to March 1, 2021 will not be 2021. Envelopes with a postmark prior to April 1, 2021 will not be
processed. processed.
Proof of City of West Palm Beach residency required. For Summer Day Camp, a minimum payment of 50% of the total
must be submitted with your registration. For all other programs, full
Enclose a copy of your City of West Palm Beach water bill for proof of payment is required with registration.
residency. If you live in an apartment or condominium, enclose a letter
PBC SCHOLARSHIPS
from your Association or rental agency, or a copy of your lease.
If you do not qualify for Early Learning Coalition (ELC) or a PBC Summer
Camp Scholarship, Fee Assistance may be available for City of West Summer Camp Scholarships from Palm Beach County Youth Services
Palm Beach Residents ONLY; written proof from ELC or PBC will be are accepted.
required.
Register on-line at pbcgov.org/youthservices. You must include 50%
Applications are also available at City of West Palm Beach Community payment for the first session of day camp. Payment will be refunded
Centers. when we receive the award letter from Palm Beach County Youth
Services. For further information please call (561) 242-5700.
For Summer Day Camp, a minimum payment of 50% of the total
must be submitted with your registration. For all other programs, full
payment is required upon registration.
*Fee Assistance, Summer Camp Scholarships, and Early Learning Coalition must register by mail.
Make checks or money orders payable to City of West Palm Beach.
Visa, MasterCard and American Express are also accepted.
See payment worksheet for credit card information.
NO Cash will be accepted.
No priority or special delivery will be accepted.
Walk-ins will only be accepted after April 1, 2021, at your local Community Center
Or City Center, 401 Clematis St., 3rd floor.
FOR MORE INFORMATION CALL (561) 804-4900
CityFun Summer Camp 2021 - 3 - wpb.org/parks
Day Camp Information
Session 1: June 21 - July 16 (No camp July 5)
Session 2: July 19 - August 6
DAY CAMP SUMMER CAMP
Sessions 1 & 2 • Grades K - 5 Swim Lessons
Children currently in Kindergarten through 5th grade at time of Swim Lessons are available for children that attend the City of West
registration. Palm Beach Summer Camp K–5 programs. Lessons are held during
Proof may be required upon request. the weekly visit to the Aquatic Center.
7:30 a.m. - 5:30 p.m.
Children will be placed in levels according to their swimming ability,
Coleman Park Community Center assessed on their first visit to the pool.
1116 21st Street
Lessons will begin on June 28 and end on August 5. Cost is $35 for
Gaines Park Community Center six 40-minute lessons. Please call the Aquatic Center, (561) 804-
1501 North Australian Avenue 4961, with questions.
Howard Park Community Center
1302 Parker Avenue Children must register for both summer camp sessions to participate
in all swim lessons.
South Olive Community Center WebTrac# 314135
345 Summa Street
WebTrac# 312102
TEEN DAY CAMP
Sessions 1 & 2 • Grades 6 - 8
Children enrolled in 6th, 7th or 8th grades, with a maximum age of
14, when camp begins.
7:30 a.m. - 5:30 p.m.
Gaines Park Community Center
1501 North Australian Avenue
Vedado Park Community Center
3710 Paseo Andalusia
WebTrac# 312102
denotes lunch site
CityFun Summer Camp 2021 - 4 - wpb.org/parks
Sports & Specialty Camps
Enrollment is NOW Available Online at wpb.org/parks
RESIDENT NON RESIDENT
Your Registration begins March 1, 2021 Your Registration begins April 1, 2021
Registration will be accepted online and by postmarked mail. Registration will be accepted online and by postmarked mail. Spaces
Spaces will be filled on a first come, first served basis. Resident will be filled on a first come, first served basis. Non-resident
registration cannot be postmarked prior to March 1, registration cannot be postmarked prior to April 1, 2021.
2021. Envelopes with a postmark prior to March 1, 2021 will not be Envelopes with a postmark prior to April 1, 2021 will not be processed.
processed.
Payment of 100% must be enclosed with your registration form.
Proof of City of West Palm Beach residency required.
Enclose a copy of your City of West Palm Beach water bill for proof of For more information,
residency. If you live in an apartment or condominium, enclose a letter call Parks and Recreation Administration
from your Association or rental agency, or a copy of your lease. at (561) 804-4900
Payment of 100% must be enclosed with your registration form.
Sports and Specialty Camps are specialized one week,
Two week, or daily camps and clinics. Programming and fees vary.
Make checks or money orders payable to City of West Palm Beach.
Visa, MasterCard and American Express are also accepted.
See payment worksheet for credit card information.
NO Cash will be accepted.
No priority or special delivery will be accepted.
Walk-ins will only be accepted after April 1, 2021, at your local Community Center
Or City Center, 401 Clematis St., 3rd floor.
CityFun Summer Camp 2021 - 5 - wpb.org/parks
Sports & Specialty Camps
COUNSELOR IN TRAINING HI-FIVE PRESCHOOL
PROGRAM (CIT) SOCCER CAMP (AGES 3-5)
The Counselor In Training Program is designed to offer young people In this soccer camp, your little kicker will be introduced to the
an opportunity to gain experience and skills for their future success. fundamentals of soccer in a FUN and friendly environment. We’ll
Application, interview and selection into the program is a prerequisite dribble, pass, and score our way to a great time! All participants
to registration. receive their own soccer ball.
Grades: 9 – 12* Ages: 3-5
Days: Monday – Friday Dates: June 21 - June 25
Mandatory Time: 9:00 a.m. - 10:00 a.m.
Training: June 21 – 25 Fee: $65 Resident/
CIT Assignments: $75 Non-Resident
Session 1: June 28 – July 16 (3 Weeks) Site: Howard Park Softball Field
Session 2: July 19 – August 6 (3 Weeks) WebTrac#: 371142
Time:
Fees:
9:00 a.m. - 4:00 p.m.
$100/Residents, HI-FIVE SOCCER CAMP
$125/Non-Residents Explore the beautiful game of soccer with Hi-Five Sports. Camp will
*Student must be entering the 12th grade for the 2021 – 2022 focus on developing skills in dribbling, passing, shooting, and much
school year. more. Bring a snack and drink. All participants receive a soccer ball.
WebTrac# 311970 Ages: 6 - 12
Dates: June 21 - June 25
FISHING CAMP Time:
Fee:
10:30 a.m. - 12:30 p.m.
$95 Resident/
Fishing camp will consist of 5 days of fun, fishing and spending time
with friends. Campers will learn how to tie fishing knots, bait a hook, $105 Non-Resident
cast a line, and identify different saltwater fish of Florida. Participants Site: Howard Park Softball Field
must bring their own fishing rod but bait will be provided. There will WebTrac#: 311142
be a fishing tournament on the last day of camp.
Ages: 8 - 12 HI-FIVE LITTLE BALLERS CAMP
Session 1: June 21 - June 25 (AGES 3-5)
Session 2: July 19 - July 23 This camp will introduce your child to the game of basketball in a FUN
Time: 9:00 a.m. - 12:00 p.m. and friendly environment. We’ll help each child to get a feel for the ball
Fees: $65 Resident/ and work on their ability to dribble, pass, shoot, and play defense. All
$75 Non-Resident participants receive their own ball.
Site: Currie Park Ages: 3-5
WebTrac#: 311110 Dates: June 28 - July 2
Time: 9:00 a.m. - 10:00 a.m.
Fee: $65 Resident/
$75 Non-Resident
Site: Howard Park Basketball Courts
WebTrac#: 371142
CityFun Summer Camp 2021 - 6 - wpb.org/parks
Sports & Specialty Camps
HI-FIVE HOOPS CAMP HI-FIVE VOLLEYBALL CAMP
Dribble, shoot, and score in this FUN-filled basketball camp with Hi- Bump, set, and spike with Hi-Five Sports! Camp focuses on the
Five Sports! Camp will focus on a series of basketball drills (dribbling, fundamentals of volleyball in a FUN and friendly environment. Please
shooting, defense, etc.) to improve each player’s skills. Bring a snack bring a snack and drink. All participants receive a program t-shirt.
and drink. All participants receive their own basketball. Ages: 6 - 12
Ages: 6 - 12 Dates: July 12 - July 16
Dates: June 28 - July 2 Time: 6:00 p.m. - 7:00 p.m.
Time: 10:30 a.m. - 12:30 p.m. Fee: $95 Resident/
Fee: $95 Resident/ $105 Non-Resident
$105 Non-Resident Site: South Olive Community Center Gym
Site: Howard Park Basketball Courts WebTrac #: 311142
WebTrac #: 311142
HI-FIVE T-BALL CAMP (AGES 3-5)
HI-FIVE FLAG FOOTBALL CAMP Little Sluggers will get to experience America’s favorite past-time in
Campers will be introduced to the game of flag football in a non- this t-ball camp. We’ll work on hitting off the tee, fielding, running
competitive environment. Participants will focus on a variety of bases, and much more. All participants receive a program t-shirt.
football drills (e.g., running routes, catching, etc.) to develop their Ages: 3-5
coordination, build self-esteem, gain confidence, and much more. Dates: July 12 - July 16
Please bring a snack and drink. All participants receive a program Time: 9:00 a.m. - 10:00 a.m.
t-shirt. Fee: $65 Resident/
Ages: 6 - 12 $75 Non-Resident
Dates: July 6 - July 9 Site: Howard Park Softball Field
Time: 10:30 a.m. - 12:30 p.m. WebTrac #: 371142
Fee: $95 Resident/
$105 Non-Resident HI-FIVE MULTI-SPORT CAMP
Site: Howard Park Softball Field Have a ball with Hi-Five Sports! We’ll work on various skills and
WebTrac #: 311142 drills for different sports, including soccer, basketball, flag football,
and much more. Please bring a snack and drink. All participants will
HI-FIVE LITTLE HEISMAN receive a program t-shirt.
FOOTBALL CAMP Ages:
Dates:
6 - 12
July 19 – July 23
Hut, hut, hike! In this weeklong camp, your little Heisman will
be introduced to the sport of flag football in a FUN and friendly Time: 10:30 a.m. -12:30 p.m.
environment. We’ll play games and practice drills to introduce the Fee: $95 Resident/
sport in a fun manner. All participants receive a program t-shirt. $105 Non-Resident
Ages: 6 - 12 Site: Howard Park Softball Field
Dates: July 6 - July 9 WebTrac #: 311142
Time: 9:00 a.m. - 10:00 a.m.
Fee: $65 Resident/
$75 Non-Resident
Site: Howard Park Softball Field
WebTrac #: 311142
CityFun Summer Camp 2021 - 7 - wpb.org/parksSports & Specialty Camps
HI-FIVE PRESCHOOL SK8BOARD CAMP
MULTI-SPORT CAMP (AGES 3-5) at Phipps Park
4715 S. Dixie Hwy, Phone (561) 835-7170
In this week-long camp, your little athlete will have a ball with Hi-Five
Sports! We’ll participate in soccer, flag football, t-ball, and much This camp is for both beginner and experienced skateboard
more! All participants receive a program t-shirt. enthusiasts.
Ages: 3-5
Dates: July 19 - July 23 Grinders (Beginner):
Time: 9:00 a.m. - 10:00 a.m. For the future ripper with less than one month of skateboarding
Fee: $65 Resident/ experience, Grinders camp will focus on the basics of skateboarding,
$75 Non-Resident including pushing, turning, and going down banked ramps. Further
Site: Howard Park Softball Field curriculum will include proper use of skateboarding equipment and
WebTrac #: 371142 basic terminology. This camp will also highlight basic tricks for more
advanced participants.
Thrashers (Intermediate):
For the skater with more than one more of skateboarding experience,
who can demonstrate board control and confidence with speed.
During the week, Thrashers participants will focus on learning new
tricks such as drop-in’s and ollies, as well as discuss park etiquette
and skateboard maintenance.
Ages: 6 - 14
Days: Monday - Friday
Session 1: June 21 - 25
Session 2: June 28 – July 2
Session 3: July 6 - 9
Session 4: July 12 - 16
Session 5: July 19 - 23
Session 6: July 26 - 30
Session 7: August 2 - 6
Time: 9:00 a.m. - 12:00 p.m.
Fees: $50 Resident/
$70 Non-Resident
WebTrac#: 316203
CityFun Summer Camp 2021 - 8 - wpb.org/parksSummer Swim Lessons
WARREN HAWKINS Learn To Swim
AQUATIC CENTER Please call the Aquatic Center for specific class offerings during
each time slot. You will be registering for a class that meets Monday
at Gaines Park
1501 N. Australian Avenue, Phone (561) 804-4961 through Thursday for 30 minutes each day for two (2) weeks or a
class that meets every Saturday for 30 minutes for eight (8) weeks.
Please contact the Aquatic Center for placement or scholarship
Summer Operating Hours:
information.
Monday – Thursday: 9:00 a.m. – 7:00 p.m.
Saturday: 9:00 a.m. – 1:00 p.m. Weekday Courses
Friday and Sunday: Closed Ages: 6 months - adult
Days: Monday - Thursday
Summer Camp Swim Lessons Times: 4:50 - 5:20 p.m., 5:30 - 6 p.m.,
Swim lessons are available for children that attend the City of West 6:10 - 6:40 p.m., 6:50 - 7:20 p.m., 7:30
Palm Beach CityFun Summer Camp program. Lessons are held during - 8 p.m.
their weekly visit to the Aquatic Center. Children will be placed in Fees: $35 Resident
levels according to their swimming ability, assessed on their first visit $44 Non-resident
to the pool. Children must register for both summer camp sessions to (8 classes total)
participate in all swim lessons.
Sessions Registration Deadline
Dates: June 28 – August 5 June 21 - July 1 June 16
Fees: $35 for six 40-minute lessons July 5 - 15 July 1
WebTrac#: 314135 July 19 - 29 July 15
August 2 - 12 July 29
August 16 - 26 August 12
Saturday Courses
(Registration Deadline June 10)
Ages: 6 months - adult
Day: Saturday
Dates: June 19 - August 7
Times: 9:00 - 9:30 a.m., 9:30 - 10 a.m.,
10:00 - 10:30 a.m., 10:30 - 11 a.m.,
12 p.m. - 12:30 p.m.
Fees: $35 Resident
$44 Non-resident 8 week session
Please Call (561) 804-4961
CityFun Summer Camp 2021 - 9 - wpb.org/parksSummer Sailing
FRANKLIN SAILING CAMPS BASIC SAILING - This camp is geared toward beginners. Campers
on Lake Mangonia will master sailing’s most essential skills: how to capsize and right
a small boat, how to steer and trim it’s sail, and execute sailing
Meet the Instructors maneuvers of tacking and jibing. Campers will also learn to tie
Martin Stephan – Coach Stephan has literally sailed and raced several knots, rules of the road on inland waters, and water safety.
around the world! He has raced in Block Island, Newport, Key West, Ages: 8 - 11
Antigua, Hawaii, all over the Mediterranean, and Auckland New Days: Monday – Friday
Zealand. Martin was a member of the winning America’s Cup Team Time: 9:00 a.m. - 3:00 p.m.
in 1992 on William Koch’s Team America! He has helped start high Session 1: June 21 – 25
school sailing teams and was previously the sailing director at 3 Session 2: June 28 – July 2
different yacht clubs. Session 3: July 12 – 16
Session 4: July 19 – 23
Carrik Seemann – Coach Seemann started his sailing at age 11 Location: Lake Mangonia
in the Franklin Sailing Camp! At age 15 he began to give back to the Fee: $125 Resident/
program by volunteering and later became an instructor. Carrick $150 Non-Resident
sailed for the University of West Florida and was the Fleet Captain. Maximum
He continued to teach sailing at the Franklin Sailing Camp during his Campers: 10
summer breaks from college. In 2005, Carrick became the director WebTrac#: 311122
of the Franklin Sailing Camp after Al Franklin retired.
INTERMEDIATE SAILING CAMP - Sailors are taken to the next
Requirements – Sailors are not expected to have any sailing skills level while keeping an emphasis on safety and fun! More advanced
in order to attend camp, but they must be a proficient swimmer. sailing skills are covered on faster, more challenging sailboats.
Each sailor, regardless of age or number of years participating in the *Intermediate Sailing gets you ready to sail at Currie Park on the
summer camp program, must pass a simple swim test the first day of Intercoastal. All US Sailing Small Boat Sailor Certification skills will
camp. be taught and assessed during the week of camp. One of the skills
What to Bring: covered is capsizing, be prepared to pass a capsize drill during your
• Life Jackets: All sailors are required to wear a Type 3 US Coast week of camp. Prerequisite: Basic Sailing
Guard approved life vest. These are available at Target, Walmart, Ages: 10-17
and West Marine. Campers are encouraged to purchase a Days: Monday – Friday
comfortable vest, as sailors will always wear one. The camp does Time: 9:00 a.m. - 3:00 p.m.
have a limited supply on hand. Session 1: June 21 – 25
• Non-Skid Water Shoes (not crocs or open sandals) Session 2: June 28 – July 2
• Hat Session 3: July 12 – 16
• Bagged Lunch Session 4: July 19 – 23
• Sunglasses Location: Lake Mangonia
• Sunscreen Fee: $125 Resident/
• Refillable water bottle $150 Non-Resident
• Towel Maximum
Campers: 10
Locations: WebTrac#: 311123
Lake Mangonia – 2957 N. Australian Avenue, West Palm Beach, 33407
Currie Park (Advanced Session 5 only) – 2400 N. Flagler Drive, West
Palm Beach, 33407
CityFun Summer Camp 2021 - 10 - wpb.org/parksSummer Sailing
ADVANCED SAILING CAMP - Learn basic racing techniques.
Knowledge brings confidence when you’re riding the wind in a high-
performance Laser. Prerequisite: Passing Intermediate Sailing camp
or U.S. Sailing small boat sailing standards.
Ages: 12 - 17
Days: Monday - Friday
Time: 9:00 a.m. - 3:00 p.m.
Session 1: June 21 - 25
Session 2: June 28 - July 2
Session 3: July 12 - 16
Session 4: July 19 - 23
Session 5: July 26 – 30 (The location will be Currie
Park for this session)
Location: Lake Mangonia
Fee: $125 Resident/
$150 Non-Resident
Maximum
Campers: 10
WebTrac#: 311124
CityFun Summer Camp 2021 - 11 - wpb.org/parksResident Only Payment Worksheet
City of West Palm Beach Department of Parks & Recreation
please print clearly
DAY CAMP (Grades K* – 5) WebTrac#: 312102
Session 1: June 21 – July 16 (No Camp on July 5)
VERY IMPORTANT
*Children currently in Kindergarten must provide current report card.
Camper’s Name/s:___________________________________________________________
Residents: 1st Child:_________________________$350 = $________________________ Select your top three (3) sites.
Mark 1, 2, and 3 next to the
# of additional children:_______________ X $262.50 = $________________________
location for each age group you
are registering.
TEEN CAMP (Grades 6 – 8) WebTrac#: 312102
Children currently in 6 – 8 grades, with a maximum age of 14, at the time of registration.
If registering multiple children, write
Camper’s Name/s:___________________________________________________________ their names next to the site.
Residents: 1st Child:_________________________$350 = $________________________
# of additional children:_______________ X $262.50 = $________________________
Session 1 Summer Camp Total: = $________________________ SUMMER
CAMP (Grades K – 5)
____________ Coleman Park
DAY CAMP (Grades K* – 5) WebTrac#: 312102
____________ Gaines Park
Session 2: July 19 – August 6
*Children currently in Kindergarten must provide current report card.
____________ Howard Park
Camper’s Name/s:___________________________________________________________ ____________ South Olive Park
Residents: 1st Child:_____________________ $262.50 = $________________________
# of additional children:___________________ X $197 = $________________________
TEEN
TEEN CAMP (Grades 6 – 8) WebTrac#: 312102 CAMP (Grades 6 – 8)
Children currently in 6 – 8 grades, with a maximum age of 14, at the time of registration. ____________ GainesPark
Camper’s Name/s:___________________________________________________________
____________ Vedado Park
Residents: 1st Child:_____________________ $262.50 = $________________________
# of additional children:___________________ X $197 = $________________________
Session 2 Summer Camp Total: = $________________________
Swim Lessons June 28 – August 5 WebTrac#: 314135
Swim lessons are available for children that attend both sessions of the City
of West Palm Beach Summer Camp program, grades K – 5. Lessons are
held during your child’s weekly visit to the Aquatic Center. Children will be
placed in levels according to their swimming ability assessed on their first
visit to the pool.
Camper’s Name/s:___________________________________________________________
# of children:_______________________________ x $35 = $________________________
Swim Lessons Total = $________________________
IMPORTANT: RETURN THIS PAGE
CityFun Summer Camp 2021 - 13 - wpb.org/parksResident Only Payment Worksheet
City of West Palm Beach Department of Parks & Recreation
please print clearly
Total Day Camp
Total camp fees Session 1, 2 and Swim Lessons: = $__________________________________
Annual per family Registration Fee: =$ 25.00
First Payment Amount Enclosed: (minimum 50%) = $__________________________________
Final Balance Payment Due by May 7, 2021: = $__________________________________
A minimum payment of 50% of your total Summer Camp registration fees must be enclosed with:
a) Registration form for each child
b) Payment Worksheet
c) Proof of Residency
**You are responsible for ensuring summer camp payment is paid in full by May 7, 2021.**
Proof of City of West Palm Beach Resident is required. This means a water bill from the City of West Palm Beach or a letter from your
condominium or landlord stating that they pay the water bill and that you reside at the address on your application.
Resident Registration ONLINE REGISTRATION
begins March 1, 2021 Enrollment is available online at wpb.org/parks
beginning March 1, 2021.
Resident Registration Forms The annual $25 registration fee must be paid prior to
cannot be postmarked prior to camp enrollment at your nearest community center.
March 1, 2021.
Envelopes with a postmark prior to Registration is
March 1, 2021 will not be processed. first come, first served
No priority or special delivery
will be accepted. Walk-ins
will only be accepted after April 1, 2021.
Mail Day Camp registration forms, payment worksheet and payment to:
City of West Palm Beach, CityFun 2021
1302 Parker Avenue, West Palm Beach, FL 33401
METHOD OF PAYMENT:
Please Print Clearly
Check/Money Orders: payable to City of West Palm Beach
Credit Card Payments: Visa ❑ MasterCard ❑ American Express ❑
Card Number:______________/______________/_____________/_____________Expiration Date:__________/__________CVV: �������������������
Name on Card:_______________________________________________________________________________________________________________________
Signature:___________________________________________________________________________________________________________________________
Phone Number:______________________________________________________________________________________________________________________
IMPORTANT: RETURN THIS PAGE
CityFun Summer Camp 2021 - 14 - wpb.org/parksNon-Resident Only Payment Worksheet
City of West Palm Beach Department of Parks & Recreation
please print clearly
DAY CAMP (Grades K* – 5) WebTrac#: 312102
Session 1: June 21 – July 16 (No Camp on July 5)
*Children currently in Kindergarten must provide current report card.
Camper’s Name/s:___________________________________________________________
# of children:______________________________ x $576 = $________________________
VERY IMPORTANT
Select your top three (3) sites.
Mark 1, 2, and 3 next to the
TEEN CAMP Grades 6 – 8) WebTrac#: 312102
location for each age group you
Children currently in 6 – 8 grades, with a maximum age of 14, at the time of registration.
are registering. If registering
Camper’s Name/s:___________________________________________________________ multiple children, write their
# of children:_____________________________ x $576 = $________________________ names next to the site.
Session 1 Summer Camp Total: = $________________________
SUMMER
CAMP (Grades K – 5)
DAY CAMP (Grades K* – 5) WebTrac#: 312102 ____________ Coleman Park
Session 2: July 19 – August 6 ____________ Gaines Park
*Children currently in Kindergarten must provide current report card.
Camper’s Name/s:___________________________________________________________ ____________ Howard Park
# of children:_____________________________ x $432 = $________________________ ____________ South Olive Park
TEEN CAMP (Grades 6 – 8) WebTrac#: 312102
Children currently in 6 – 8 grades, with a maximum age of 14, at the time of registration. TEEN
Camper’s Name/s:___________________________________________________________ CAMP (Grades 6 – 8)
# of children:_____________________________ x $432 = $________________________ ____________ GainesPark
Session 2 Summer Camp Total: = $________________________ ____________ Vedado Park
SWIM LESSONS June 28 – August 5 WebTrac#: 314135
Swim lessons are available for children that attend both sessions of the City
of West Palm Beach Summer Camp program, grades K – 5. Lessons are held
during your child’s weekly visit to the Aquatic Center. Children will be placed
in levels according to their swimming ability assessed on their first visit to
the pool.
Camper’s Name/s:___________________________________________________________
# of children:_______________________________ x $35 = $________________________
Swim Lessons Total = $________________________
IMPORTTANT: RETURN THIS PA
IMPOR PAGE
CityFun Summer Camp 2021 - 15 - wpb.org/parksNon-Resident Only Payment Worksheet
City of West Palm Beach Department of Parks & Recreation
please print clearly
Total Day Camp
Total camp fees Session 1, 2 and Swim Lessons: = $__________________________________
Annual per family Registration Fee: =$ 25.00
First Payment Amount Enclosed: (minimum 50%) = $__________________________________
Final Balance Payment Due by May 7, 2021: = $__________________________________
A minimum payment of 50% of your total Summer Camp registration fees must be enclosed with:
a) Registration form for each child
b) Payment Worksheet
**You are responsible for ensuring summer camp payment is paid in full by May 7, 2021.**
Non-Resident Registration ONLINE REGISTRATION
begins April 1, 2021 Enrollment is available online at wpb.org/parks beginning April 1, 2021.
The annual $25 registration fee must be paid prior to camp enrollment at
Envelopes with a postmark prior to your nearest community center.
April 1, 2021 will not be processed
Registration is Walk-ins
first come, first served.
will only be accepted after April 1, 2021.
Mail Day Camp registration forms, payment worksheet and payment to:
City of West Palm Beach, CityFun 2021
1302 Parker Avenue, West Palm Beach, FL 33401
METHOD OF PAYMENT:
Please Print Clearly
Check/Money Orders: payable to City of West Palm Beach
Credit Card Payments: Visa ❑ MasterCard ❑ American Express ❑
Card Number:______________/______________/_____________/_____________Expiration Date:__________/__________CVV: ������������������
Name on Card:______________________________________________________________________________________________________________________
Signature:___________________________________________________________________________________________________________________________
Phone Number:______________________________________________________________________________________________________________________
IMPORTANT: RETURN THIS PAGE
CityFun Summer Camp 2021 - 16 - wpb.org/parksSports/Specialty Payment Worksheet
City of West Palm Beach Department of Parks & Recreation
please print clearly
# of Non Total
Res.
Children Res. Camp
June 21 - 25
Counselor In Training (CIT) 311970 x $100 or $125 = $ Name/s:
Fishing Camp 311110 x $65 or $75 = $ Name/s:
Hi-Five Preschool Soccer Camp 371142 x $65 or $75 = $ Name/s:
Hi-Five Soccer Camp 311142 x $95 or $105 = $ Name/s:
Sk8board Camp 316203 x $50 or $70 = $ Name/s:
June 28 – July 2
Hi-Five Little Ballers Camp 371142 x $65 or $75 = $ Name/s:
Hi-Five Hoops Camp 311142 x $95 or $105 = $ Name/s:
Sk8board Camp 316203 x $50 or $70 = $ Name/s:
July 6 – 9
Hi-Five Flag Football Camp 311142 x $95 or $105 = $ Name/s:
Hi-Five Little Heisman Football Camp 311142 x $65 or $75 = $ Name/s:
Sk8board Camp 316203 x $50 or $70 = $ Name/s:
July 12 – 16
Hi-Five Volleyball Camp 311142 x $95 or $105 = $ Name/s:
Hi-Five T-Ball Camp 371142 x $65 or $75 = $ Name/s:
Sk8board Camp 316203 x $50 or $70 = $ Name/s:
July 19 - 23
Hi-Five Multi-Sport Camp 311142 x $95 or $105 = $ Name/s:
Hi-Five Preschool Multi-Sport Camp 371142 x $65 or $75 = $ Name/s:
Fishing Camp 311110 x $65 or $75 = $ Name/s:
Sk8board Camp 316203 x $50 or $70 = $ Name/s:
July 26 - 30
Sk8board Camp 316203 x $50 or $70 = $ Name/s:
Franklin Sailing Camps
Beginner (6/21 – 6/25) 311122 x $125 or $150 = $ Name/s:
Beginner (6/28 – 7/2) 311122 x $125 or $150 = $ Name/s:
Beginner (7/12 – 7/16) 311122 x $125 or $150 = $ Name/s:
Beginner (7/19 – 7/23) 311122 x $125 or $150 = $ Name/s:
Circle EITHER Inter. or Adv. Below
Inter./Adv. (6/21 – 6/25) 311123/311124 x $125 or $150 = $ Name/s:
Inter./Adv. (6/28 – 7/2) 311123/311124 x $125 or $150 = $ Name/s:
Inter./Adv. (7/12 – 7/16) 311123/311124 x $125 or $150 = $ Name/s:
Inter./Adv. (7/19 – 7/23) 311123/311124 x $125 or $150 = $ Name/s:
Advance (7/26 – 7/30) 311123/311124* x $125 or $150 = $ Name/s:
*This session will be held at Curie Park.
August 2 - 6
Sk8board Camp 316203 x $50 or $70 = $ Name/s:
IMPORTANT: RETURN THIS PAGE
CityFun Summer Camp 2021 - 17 - wpb.org/parksSports/Specialty Payment Worksheet
City of West Palm Beach Department of Parks & Recreation
please print clearly
Total Sports / Specialty Camp
Specialty Camps = $__________________________________
Sailing Camps = $__________________________________
Per Family Annual Registration Fee =$ 25.00
Total Enclosed = $__________________________________
100% Payment must be made in full.
IF RESIDENT
Proof of City of West Palm Beach Resident is required. This means a water bill from the City of West Palm Beach or a letter from your
condominium or landlord stating that they pay the water bill and that you reside at the address on your application.
Resident Registration ONLINE REGISTRATION
begins March 1, 2021 Enrollment is available online at wpb.org/parks.
The annual $25 registration fee must be paid prior to
camp enrollment at your nearest community center.
Non-Resident Registration
begins April 1, 2021
Walk-ins
Envelopes with a postmark prior to appropriat will only be accepted after April 1, 2021.
dates will not be processed.
Registration is first come,
first served.
Mail Day Camp registration forms, payment worksheet and payment to:
City of West Palm Beach, CityFun 2021
1302 Parker Avenue, West Palm Beach, FL 33401
METHOD OF PAYMENT:
Please Print Clearly
Check/Money Orders: payable to City of West Palm Beach
Credit Card Payments: Visa ❑ MasterCard ❑ American Express ❑
Card Number:______________/______________/_____________/_____________Expiration Date:__________/__________CVV:__________
Name on Card:_____________________________________________________________________________________________________________
Signature:___________________________________________________________________________________________________________________________
Phone Number:______________________________________________________________________________________________________________________
IMPORTANT: RETURN THIS PAGE
CityFun Summer Camp 2021 - 18 - wpb.org/parksDay Camp Registration Form 2021
City of West Palm Beach Department of Parks & Recreation
Registration Form | One Form per Child please print clearly
Child’s Name:_______________________________________________________________________________________________________________ Sex: M ❑ F ❑
Date of Birth:_________________________________________________________________ Age (As of June 21, 2021):_____________________________________
School Currently Enrolled in:__________________________________________________ Grade Presently In:____________________________________________
Child’s Home Address:________________________________________________________________________________________________________________________
city/state/zip
Primary Guardian:____________________________________________________________ Secondary Guardian:___________________________________________
Cell Phone #:_________________________________________________________________ Cell Phone #:__________________________________________________
Work Phone #:________________________________________________________________ Work Phone #:_________________________________________________
Home Phone #:_______________________________________________________________ Home Phone #:________________________________________________
Email:________________________________________________________________________ Email:_________________________________________________________
In case of emergency, call:____________________________________________________ at______________________________________________________________
Will anyone other than you pick up the child? Yes ❑ No ❑
If yes, please identify:________________________________________________________ Relation:_______________________________________________________
Child’s T-shirt Size: Youth S ❑ Youth M ❑ Youth L ❑ Adult S ❑ Adult M ❑ Adult L ❑ Adult XL ❑
Does your child have special needs? Yes ❑ No ❑ If yes, indicate disability or diagnosis:________________________________________________
______________________________________________________________________________________________________________________________________________
Does your child currently have an IEP or 504 plans? Yes ❑ No ❑
Does your child take any medications? Yes ❑ No ❑ If yes, list medications:_________________________________________________________
______________________________________________________________________________________________________________________________________________
Does your child have any allergies? Yes ❑ No ❑ If yes, list allergies:__________________________________________________________________
______________________________________________________________________________________________________________________________________________
ALL CHILDREN MUST BE COMPLETELY POTTY TRAINED (NO LONGER HAS ACCIDENTS)
I hereby declare that I am the parent/guardian of __________________________________________________________________and give my consent for
his/her participation in all activities at the 2021 CityFun Day Camp Program. In consideration of my child being permitted to participate in
this program, I hereby release, waive and discharge the City of West Palm Beach, its agents, employees and volunteers from all liability for
all injury, loss or damage, and any claim of damage to the person or property of my child during his/her participation. It is understood that
my child/ren may be photographed during the course of this program and the photographs may be used in official City of West Palm Beach
publications. It is further understood that any false information provided for in this registration form will be cause for immediate termination
based on participation safety and ratios. A service fee of $20 per child will be deducted from your refund if cancellation of your registration is
made. No cancellations will be accepted after May 31, 2021.
________________________________________________________________________________________________
Signature of Parent/Guardian - date
In accordance with the Americans with Disabilities Act (ADA), persons in need of special accommodations to participate in the proceeding shall, within three business days prior to any
proceeding, contact the West Palm Beach Department of Parks and Recreation at 401 Clematis Street, W.P.B., FL 33401, or call (561) 804-4900 (TTY 800-955-8771).
OFFICE USE ONLY
1ST Payment Receipt #:__________________ Date:_______ /_______ /_______ Check #:______________Credit: Amount Paid: $_______________ Staff Initials:_____________
2nd Payment Receipt #:__________________ Date:_______ /_______ /_______ Check #:______________Credit: Amount Paid: $_______________ Staff Initials:_____________
Site Location:________________________________________________________________________________________ Camp: ❑ K - 5 ❑ Teen | Session: ❑ 1 ❑ 2
IMPORTANT: RETURN THIS FORM
CityFun Summer Camp 2021 - 19 - wpb.org/parksDay Camp Registration Form 2021
City of West Palm Beach Department of Parks & Recreation
Registration Form | One Form per Child please print clearly
Child’s Name:_______________________________________________________________________________________________________________ Sex: M ❑ F ❑
Date of Birth:_________________________________________________________________ Age (As of June 21, 2021):_____________________________________
School Currently Enrolled in:__________________________________________________ Grade Presently In:____________________________________________
Child’s Home Address:________________________________________________________________________________________________________________________
city/state/zip
Primary Guardian:____________________________________________________________ Secondary Guardian:___________________________________________
Cell Phone #:_________________________________________________________________ Cell Phone #:__________________________________________________
Work Phone #:________________________________________________________________ Work Phone #:_________________________________________________
Home Phone #:_______________________________________________________________ Home Phone #:________________________________________________
Email:________________________________________________________________________ Email:_________________________________________________________
In case of emergency, call:____________________________________________________ at______________________________________________________________
Will anyone other than you pick up the child? Yes ❑ No ❑
If yes, please identify:________________________________________________________ Relation:_______________________________________________________
Child’s T-shirt Size: Youth S ❑ Youth M ❑ Youth L ❑ Adult S ❑ Adult M ❑ Adult L ❑ Adult XL ❑
Does your child have special needs? Yes ❑ No ❑ If yes, indicate disability or diagnosis:________________________________________________
______________________________________________________________________________________________________________________________________________
Does your child currently have an IEP or 504 plans? Yes ❑ No ❑
Does your child take any medications? Yes ❑ No ❑ If yes, list medications:_________________________________________________________
______________________________________________________________________________________________________________________________________________
Does your child have any allergies? Yes ❑ No ❑ If yes, list allergies:__________________________________________________________________
______________________________________________________________________________________________________________________________________________
ALL CHILDREN MUST BE COMPLETELY POTTY TRAINED (NO LONGER HAS ACCIDENTS)
I hereby declare that I am the parent/guardian of __________________________________________________________________and give my consent for
his/her participation in all activities at the 2021 CityFun Day Camp Program. In consideration of my child being permitted to participate in
this program, I hereby release, waive and discharge the City of West Palm Beach, its agents, employees and volunteers from all liability for
all injury, loss or damage, and any claim of damage to the person or property of my child during his/her participation. It is understood that
my child/ren may be photographed during the course of this program and the photographs may be used in official City of West Palm Beach
publications. It is further understood that any false information provided for in this registration form will be cause for immediate termination
based on participation safety and ratios. A service fee of $20 per child will be deducted from your refund if cancellation of your registration is
made. No cancellations will be accepted after May 31, 2021.
________________________________________________________________________________________________
Signature of Parent/Guardian - date
In accordance with the Americans with Disabilities Act (ADA), persons in need of special accommodations to participate in the proceeding shall, within three business days prior to any
proceeding, contact the West Palm Beach Department of Parks and Recreation at 401 Clematis Street, W.P.B., FL 33401, or call (561) 804-4900 (TTY 800-955-8771).
OFFICE USE ONLY
1ST Payment Receipt #:__________________ Date:_______ /_______ /_______ Check #:______________Credit: Amount Paid: $_______________ Staff Initials:_____________
2nd Payment Receipt #:__________________ Date:_______ /_______ /_______ Check #:______________Credit: Amount Paid: $_______________ Staff Initials:_____________
Site Location:________________________________________________________________________________________ Camp: ❑ K - 5 ❑ Teen | Session: ❑ 1 ❑ 2
IMPORTANT: RETURN THIS FORM
CityFun Summer Camp 2021 - 21 - wpb.org/parksSports / Specialty Camp
Registration Form 2021
City of West Palm Beach Department of Parks & Recreation
Registration Form | One Form per Child please print clearly
Child’s Name:_______________________________________________________________________________________________________________ Sex: M ❑ F ❑
Date of Birth:_________________________________________________________________ Age (As of June 21, 2021):_____________________________________
School Currently Enrolled in:__________________________________________________ Grade Presently In:____________________________________________
Child’s Home Address:________________________________________________________________________________________________________________________
city/state/zip
Primary Guardian:____________________________________________________________ Secondary Guardian:___________________________________________
Cell Phone #:_________________________________________________________________ Cell Phone #:__________________________________________________
Work Phone #:________________________________________________________________ Work Phone #:_________________________________________________
Home Phone #:_______________________________________________________________ Home Phone #:________________________________________________
Email:________________________________________________________________________ Email:_________________________________________________________
In case of emergency, call:____________________________________________________ at______________________________________________________________
Will anyone other than you pick up the child? Yes ❑ No ❑
If yes, please identify:________________________________________________________ Relation:_______________________________________________________
Child’s T-shirt Size: Youth S ❑ Youth M ❑ Youth L ❑ Adult S ❑ Adult M ❑ Adult L ❑ Adult XL ❑
Does your child have special needs? Yes ❑ No ❑ If yes, indicate disability or diagnosis:________________________________________________
______________________________________________________________________________________________________________________________________________
Does your child currently have an IEP or 504 plans? Yes ❑ No ❑
Does your child take any medications? Yes ❑ No ❑ If yes, list medications:_________________________________________________________
______________________________________________________________________________________________________________________________________________
Does your child have any allergies? Yes ❑ No ❑ If yes, list allergies:__________________________________________________________________
______________________________________________________________________________________________________________________________________________
ALL CHILDREN MUST BE COMPLETELY POTTY TRAINED (NO LONGER HAS ACCIDENTS)
I hereby declare that I am the parent/guardian of __________________________________________________________________and give my consent for
his/her participation in all activities at the 2021 CityFun Day Camp Program. In consideration of my child being permitted to participate in
this program, I hereby release, waive and discharge the City of West Palm Beach, its agents, employees and volunteers from all liability for
all injury, loss or damage, and any claim of damage to the person or property of my child during his/her participation. It is understood that
my child/ren may be photographed during the course of this program and the photographs may be used in official City of West Palm Beach
publications. It is further understood that any false information provided for in this registration form will be cause for immediate termination
based on participation safety and ratios. A service fee of $20 per child will be deducted from your refund if cancellation of your registration is
made. No cancellations will be accepted after May 31, 2021.
________________________________________________________________________________________________
Signature of Parent/Guardian - date
In accordance with the Americans with Disabilities Act (ADA), persons in need of special accommodations to participate in the proceeding shall, within three business days prior to any
proceeding, contact the West Palm Beach Department of Parks and Recreation at 401 Clematis Street, W.P.B., FL 33401, or call (561) 804-4900 (TTY 800-955-8771).
OFFICE USE ONLY
1ST Payment Receipt #:__________________ Date:_______ /_______ /_______ Check #:______________Credit: Amount Paid: $_______________ Staff Initials:_____________
2nd Payment Receipt #:__________________ Date:_______ /_______ /_______ Check #:______________Credit: Amount Paid: $_______________ Staff Initials:_____________
Site Location:________________________________________________________________________________________ Camp: ❑ K - 5 ❑ Teen | Session: ❑ 1 ❑ 2
IMPORTANT: RETURN THIS FORM
CityFun Summer Camp 2021 - 23 - wpb.org/parksFOR EVERYONE
2021
SUMMER CAMP PROGRAMS
Return all forms to:
City of West Palm Beach, CityFun 2021
1302 Parker Avenue
West Palm Beach, FL 33401
(561) 804-4900
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