[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-303352-105":53,"doc-detail-303352-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","bits-n-pieces-2024-summer-enrichment-camp-registration-form","BITS ‘N PIECES 2024 SUMMER ENRICHMENT CAMP - Registration Form","","BITS ‘N PIECES 2024 Summer Enrichment Camp is a six-week tutorial program for elementary-aged children to stay on track with studies through a safe, enjoyable, and educational environment focused on reading, writing, and critical thinking. It runs July 1 to August 9, 2024, with hours of 8:30am to 5:00pm and optional extended day. The document includes student, parent/guardian, emergency contact, and detailed medical history sections, plus scholarship documentation requirements and drop-off registration instructions.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/bits-n-pieces-2024-summer-enrichment-camp-registration-form/303352/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/bits-n-pieces-2024-summer-enrichment-camp-registration-form/303352.png","ImageObject",442,249,{"name":88,"@type":89},"Anda","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-04","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":47},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"Who can register for Bits ‘N Pieces Summer Enrichment Camp 2024?","Question",{"text":108,"@type":109},"Church Street Elementary School students entering 1st through 5th grade can register for the July 1 to August 9, 2024 camp.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What registration items are required to complete enrollment?",{"text":113,"@type":109},"Registration requires a copy of the student’s physical form, a copy of the immunization form, and (for scholarship applications) a copy of the Federal 1040 Tax Form 2023. Payment must be submitted by check/money order made out to the City of White Plains or via a completed credit card authorization form.",{"name":115,"@type":106,"acceptedAnswer":116},"How should medical authorization and dismissal arrangements be handled?",{"text":117,"@type":109},"Parents must complete the medical history section and provide permissions for treatment if injury occurs. Dismissal arrangements specify pickup status and additional release persons, and any changes after camp start must be submitted in writing to the main office.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},303352,1790647246,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":47,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":135,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":76},962075006959,"https://ap-avatar.wpscdn.com/avatar/e0002397efbe92a78e?_k=1776741047341049297","|  BITS ‘N PIECES 2024 SUMMER ENRICHMENT CAMP |\n| --- |\n| \u003Cbr>Bits ‘n Pieces is a six week tutorial camp that offers elementary aged children the opportunity to stay on track with their studies. The program provides a safe, enjoyable and educational environment emphasizing reading, writing and critical thinking.\u003Cbr>Full Fee: TBD\u003Cbr>Church Street Elementary School Students entering 1 st -5th grade\u003Cbr>July 1-August 9 , 2024\u003Cbr>8:30am – 5:00pm\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>Scholarship: TBD\u003Cbr>Extended day from (5:00 – 5:30 pm) an additional TBD/per week\u003Cbr>Registration Requirements\u003Cbr>1) Copy of student’s physical form AND\u003Cbr>2) Copy of immunization form (both must be current within the year atthe time of registration)\u003Cbr>3) Copy of Federal 1040 Tax Form 2023 (if you are applying for scholarship)\u003Cbr>4) Check/Money Order made out to the City of White Plains or Completed Credit Card Authorization form.\u003Cbr>Completed registration forms will be accepted by Drop Box Only located in the front entrance of the Youth Bureau:\u003Cbr>The White Plains Youth Bureau\u003Cbr>11 Amherst Place\u003Cbr>Monday-Friday 10-6 pm\u003Cbr>(914) 422-1378\u003Cbr>[www.whiteplainsyouthbureau.org](www.whiteplainsyouthbureau.org) |\n\n\n| \u003Cbr>YOUTH BUREAU OFFICE OF THE MAYOR\u003Cbr>11 AMHERST PLACE-WHITE PLAINS, NEW YORK 10601\u003Cbr>(914) 422-1378-FAX (914) 422-6489\u003Cbr>[www.WhitePlainsYouthBureau.org](www.WhitePlainsYouthBureau.org)\u003Cbr>THOMAS M. ROACH FRANK WILLIAMS, JR., Ph.D.\u003Cbr>MAYOR EXECUTIVE DIRECTOR\u003Cbr>ELIZABETH ALMONTE, MBA DEPUTY DIRECTOR\u003Cbr>BITS ‘N PIECES TUTORIAL SUMMER CAMP 2024\u003Cbr>JULY 1ST-AUGUST 9TH, 2024\u003Cbr>STUDENT INFORMATION\u003Cbr>Child’s Name:   Date of Birth  / / \u003Cbr>Home Address   Apt   Zip:  Home phone ( )   Ethnicity/Race   Age:   Gender:   T-Shirt Size: 􀂅 Small 􀂅 Medium 􀂅 Large 􀂅 Adult Small 􀂅 Church Street 􀂅 George Washington 􀂅 Mamaroneck 􀂅 Post Road 􀂅 Ridgeway\u003Cbr>Grade as of September 2024 (please circle one): 1st 2nd 3rd 4t h 5th\u003Cbr>PARENTS/GUARDIANS INFORMATION\u003Cbr>Parent/Guardian:  Parent/Guardian:   Cell Number:   Cell Number:   Work Number:   Work Number:   E-mail Address:   E-mail Address:  \u003Cbr>EMERGENCY CONTACT INFORMATION\u003Cbr>Name   Phone:   Relationship to child  \u003Cbr>Name   Phone:   Relationship to child  \u003Cbr>Name   Phone:   Relationship to child  \u003Cbr>(Person other than parent/guardian required for emergency contact)\u003Cbr>OFFICE USE ONLY |\n| --- |\n| Medical Form   Immunization Form   Extended Day (5:00 TO 5:30)   Fee Paid   Method of Payment   Last 4 digits   |\n|  |\n\nMEDICAL HISTORY  \n(Parent is required to complete this section)  \nChild’s Name   Date of Birth   Sex   \nName of Parent/Guardian  Phone \\#    \nAddress  Is child’s health generally good?   If not, describe according to chart:  \n\n|  | Is child subject to: | Allergies: | Food Allergies: | History of Diseases: |  |\n| --- | --- | --- | --- | --- | --- |\n|  | 􀂈Sinus Trouble | 􀂈 Poison Ivy | 􀂈 Peanuts | 􀂈 Chicken Pox |  |\n|  | 􀂈 Ear Infections | 􀂈 Insect Bites | 􀂈 Other Tree Nuts | 􀂈 Measles |  |\n|  | 􀂈 Convulsions | 􀂈 Penicillin | 􀂈 Other | 􀂈 German Measles |  |\n|  | 􀂈Sleep Walking | 􀂈 Other Drugs |  | 􀂈 Rheumatic Fever |  |\n|  | 􀂈Fainting Spells | 􀂈 Hay Fever |  |  |  |\n|  | 􀂈Asthma | 􀂈 Influenza Type B |  |  |  |\n|  |  | 􀂈 Hepatitis B |  |  |  |\n| Does your child require an EpiPen, asthma inhaler and/or Benadryl? 􀂈 Yes 􀂈No\u003Cbr>Note: If child is required to take any type of medication during camp hours, a separate MEDICAL AUTHORIZATION FORM must be completed by the PARENT AND PHYSICIAN and filed with Camp Director on the first day of camp.\u003Cbr>Please list current medications   List operations or serious injuries with dates   List chronic or recurring illnesses   Please describe restrictions on your child’s participation in activities or necessary modifications\u003Cbr>Is your child designated through the Committee on Special Education? 􀂈 Yes 􀂈 No\u003Cbr>Does your child need a smaller class size or extra resources during the school day? 􀂈 Yes 􀂈 No\u003Cbr>Please describe  \u003Cbr>PARENTS MUST NOTIFY THE PROGRAM IF THERE HAS BEEN EXPOSURE TOA ","cbCaipPNSg4ULkSv","https://ap.wps.com/l/cbCaipPNSg4ULkSv","pdf",576376,8,"English","# Student Information\n## Parents/Guardians Information\n## Emergency Contact Information\n# Medical Form / Medical History\n## Medical Authorization and Hospital Release\n## Arrangements for Dismissal\n## Parental Trip Permission and Release Form","[{\"question\":\"Who can register for Bits ‘N Pieces Summer Enrichment Camp 2024?\",\"answer\":\"Church Street Elementary School students entering 1st through 5th grade can register for the July 1 to August 9, 2024 camp.\"},{\"question\":\"What registration items are required to complete enrollment?\",\"answer\":\"Registration requires a copy of the student’s physical form, a copy of the immunization form, and (for scholarship applications) a copy of the Federal 1040 Tax Form 2023. Payment must be submitted by check/money order made out to the City of White Plains or via a completed credit card authorization form.\"},{\"question\":\"How should medical authorization and dismissal arrangements be handled?\",\"answer\":\"Parents must complete the medical history section and provide permissions for treatment if injury occurs. Dismissal arrangements specify pickup status and additional release persons, and any changes after camp start must be submitted in writing to the main office.\"}]","BITS ‘N PIECES 2024 SUMMER ENRICHMENT CAMP - Registration Form | PDF",1789802435]