ENROLLMENT FORM VPK 3-HOUR PROGRAM 20-2021 - Cambridge Preschools

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6100 Coral Ridge Drive, Coral Springs, FL 33076ENROLLMENT FORMVPK 3-HOUR PROGRAM2020-2021 SCHOOL YEAR(4 YEARS OF AGE BY SEPTEMBER 1, 2020)MONDAY – FRIDAY – 3 hours per dayTODAY’S DATE:DATE TO START SCHOOL:CHILD’S NAME:DATE OF BIRTH:PARENT’S NAME(S):ADDRESS:HOME PHONE #: ( ) WORK PHONE #:( )CELL PHONE #: ( ) EMAIL:I/we agree to enroll my/our child in the VPK Program for the 2020-2021school year.I/we understand that the State VPK Child Eligibility and EnrollmentCertificate must be submitted along with all other Cambridge Schools VPKparticipation forms, enrollment forms and medical forms required toattend the school.Primary Parent/Legal Guardian SignatureOther Parent/Legal Guardian SignaturePrint NamePrint Name

*** Voluntary PreKindergarten ***Policies for Families Enrolled in the VPK Program6100 Coral Ridge Drive, Coral Springs, FL 33076 (954) 796-11772020-2021Child’s Name: Parent’s Name:These policies are in addition to the Cambridge Schools Payment and Policy Agreement and are specific to the StateSponsored VPK Program.All parents whose children are participating in VPK at Cambridge Schools must sign an agreement to ensure allpolicies are understood. Please read carefully, initial each section and sign.Families who are participating in the VPK program. Must be present during the scheduled hours of the program each day to be eligible for the VPK program. Students will follow the Cambridge Schools VPK calendar and will participate in all VPK activities.Sign In/Out ProcedureInitialI/We understand that it is State mandated for all families participating in the VPK program to keep accurateattendance records. Parents and guardians must sign children in and out everyday with their full signature. Paymentfrom the state is based on attendance records. Appropriate payment is not possible if attendance is not accuratelydocumented. Parents and guardians must sign their first and last name. No initials are accepted. Signatures must belegible.PARENTS AND GUARDIANS MUST SIGN IN AND OUT EACH DAY, AT ARRIVAL AND DISMISSAL TIME.Signing in or out cannot be done in advance of the actual time.Monthly Attendance Verification for ParentsInitialI/We understand that the State requires Cambridge Schools to document each child’s attendance on a monthlybasis. Parents and guardians will be responsible for signing an Attendance Verification Form at the end of eachmonth. The forms will be available at the front desk, ready to be signed on the last school day of each month. THISFORM MUST BE COMPLETED EACH MONTH. Parents and guardians must sign with their first and last name. No initialsare accepted. All signatures must be legible.Attendance PolicyInitialI/We understand that if a child does not begin attendance on the first day of the school year, parents or guardiansmust complete a Delayed Enrollment Form. Students will not be eligible for the full VPK 540 hours.Absence PolicyInitialI/We understand that students are expected to attend at least 80% of the VPK Program and are ONLY allowedabsences less than or equal to 20% of the scheduled VPK class time per month. Exceeding the number of daysallowed for VPK absences could lead to withdrawal from the program.Uniform PolicyInitialI/We understand that Cambridge Schools is a uniform school. A Cambridge Schools shirt or dress is required to beworn every day. Each school has a clothing store in which you can purchase uniforms. Any shorts or pants areacceptable. Closed toed shoes or sneakers are required. Sandals, Crocs and other open toe shoes are not allowed.If a child arrives without the approved uniform, the parent will be called to deliver the necessary clothing or authorizea purchase for the needed item(s).VPK PoliciesPage 1

Late Pick-UpsInitialI/We understand that our child must be picked up by the end of his/her scheduled hours or school closing hours forthose enrolled in optional after school or a late pick up fee of 3.00 per minute will be charged.Optional FeesInitialI/We understand that Parents or guardians are responsible for payment of all optional fees not covered by the VPKProgram. This may include but is not limited to lunches, uniforms, after school and enrichment programs. If paymentsare not received by due dates, the provider may discontinue enrollment in the VPK program.Returned Check feesInitialI/We understand that all returned checks shall incur a charge as set forth in Florida Statute 68.064 as amended. If tworeturned checks are received, all future payments must be made by credit card, certified check or cashier’s check.Behavior ManagementInitialI/We understand that Cambridge Schools follow a child-oriented approach to behavior management. This includes,but is not limited to techniques such as gentle reminders, ignoring negative attention seeking behavior, redirection,and reinforcing the positive with praise and love. Food and fun are never withheld from children. At no time iscorporal punishment tolerated at Cambridge Schools.Behavior PoliciesInitialI/We understand that children and families are expected to respect all staff, children and materials. If there is aconcern about a child’s behavior, parents will be called and will meet with the Director to plan a course of action.We reserve the right to withdraw a child when we determine that the program is not appropriate for the child or thefamily. If a VPK family has a concern, the Director’s door is always open to resolve all concerns. Each case is handledindividually.Additional Programs OfferedInitialI/We understand that Winter Break, Spring Break and Summer Camp Programs are separate from VPK Programs andare available for an additional fee to all students.Withdrawal and Disenrollment PoliciesInitialI/we understand that if a child is absent from VPK for five consecutive days, without an excused absence, the childwill be automatically withdrawn from the program. A parent or legal guardian may withdraw a child with or withoutreason at anytime. A child may be dismissed by the school at anytime if the family does not comply with the Policiesfor Families Enrolled in the VPK Program.I/We have read, understand and agree to the policies of VPK and Cambridge Schools described above and agree toabide by this agreement.Date:Child’s Name:Primary Parent/Legal Guardian (Print Name)Primary Parent/Legal Guardian SignatureRelationship to child:Other Parent/Legal Guardian (Print Name)Other Parent/Legal Guardian SignatureRelationship to child:These policies are subject to change without notice.VPK PoliciesPage 2

Board of County Commissioners, Broward County, FloridaHUMAN SERVICES DEPARTMENTCommunity Partnerships DivisionChild Care Licensing and Enforcement Section1CHILD ENROLLMENT INFORMATIONPASSWORDName of Child:First Date of Attendance:Address:Sex:Birth Date:Preferred Name:List of Known Allergies:Special Needs:MotherName:E-mail:Home Address:Phone:Place of il:Home Address:Phone:Place of mail:Home Address:Phone:Place of EmploymentName:Phone:Email:Address:Child’s PhysicianOffice Name:Email:Phone:Address:May facility consult the above physician if parent/guardian cannot be reached?1Yes No Revised 11/1/2014

Other persons to be notified in case of illness or accidentE-mail:Name:Home Address:Phone:Name:E-mail:Home Address:Phone:Name:E-mail:Home Address:Person(s) permitted to remove child:Phone:MotherYes No e:Name of Person Enrolling Child (Print)Yes No Signature of Person Enrolling ChildDate of Enrollment2Revised 11/1/2014

Cambridge Schools 2020-2021 Parent/Guardian Payment and Policy Agreement and ConsentChild Name:Primary Parent/Legal Guardian Name:Other Parent/Legal Guardian Name:Home Address:Cell phone #1 ( ) Cell phone #2 ( )I/We, parent(s) or guardian(s) ofdo hereby enroll my/our child in the Cambridge School. This payment and policy agreement and consent formwill remain in effect for any time my/our child is enrolled during Summer Camp 2020, School Year 2020-2021and/or Summer Camp 2021.RegistrationInitial I/We agree to pay Cambridge Schools the non-refundable, non-transferable registration fee of 160.00 forenrollment in the toddler through the 3 year old program or 260.00 for enrollment in the Pre-Kindergarten program.This is an annual registration fee and is due at the time of registration. Any circumstances that may lead to reenrolling a child during the same school year will require a new registration form and full registration fee.TuitionInitial I/We understand that I/we are enrolling our child in an ongoing school year program and tuition fees arepayable either in full prior to the 1st day of school or can be paid in scheduled payments by the first day ofattendance and following with payments due on the 2nd of each month. Winter, Spring and Summer Campsare separate programs that require separate registrations and fees. The school year payments remain thesame for the months that Winter, Spring and Summer Camps occur. There is no proration of school yeartuition during those months, as the tuition fee is part of the full school year program.I/We have received, read and understand the Tuition Fee Schedule. Payment can be made by check on siteor by enrolling in Tuition Express to pay by credit card, debit card, or bank account. American Express is notaccepted. When paying by check, please note your child’s name in the memo section. If I/we are enrollingour child in only the Summer Camp program, Winter Break or Spring Break camps.I/We agree to follow the payment requirements and due dates described in the camp registration forms.No refunds or credits are given for any absences due to illness, family vacations, moving or any otherinterruptions in attendance.DiscountsInitial Multiple Child Discount: If two or more siblings attend full time (8:30 – 3:00), the child with the greater tuitionwill pay the full amount and a 10% discount will be applied to the lesser tuition of the siblings (not applicableto Summer Camp, Winter Break, Spring Break or registration fees). School Year Paid in Full: If the entire school year tuition is paid in full by the first day of the school yearcalendar in August, a 2% discount will be given if payment is made by check or credit card. Camp Cambridge Discount: Tuition fees will remain at last year's rates ( 240 [Full-time]/ 185 [Part-time] perweek) if registration is received by March 27, 2020. Any weeks reserved after March 27, 2020 will be subject toa fee increase of 20 per week. Discounts do not apply to fees for before school, after school, before camp, after camp, Winter Break, SpringBreak, or any fees other than preschool or summer camp tuition.Payment and Policy Agreement and ConsentPage 1

Camp Cambridge Initial Cambridge Schools are closed during County Winter and Spring Breaks. Camp Cambridge is a separateprogram offered to preschool and elementary school children during these breaks. Reservation must be made inadvance to attend any of these days. There is a per day charge for each child to attend these programs. The hours are 8:30 a.m. to 3:00 p.m. Before after camp hours will be available for an additional fee.Other FeesInitiala) Uniforms – I/We acknowledge that Cambridge Schools require all children to wear uniforms. Children mustwear a Cambridge shirt or dress of their choice each day available for sale in our on-site school store. Theonly exceptions will be on special dress up days for which parents will be notified in advance, such as Fridaycolor days, photo days and Halloween.b) Lunches – Lunch may be brought from home or preordered from our catered lunch service. Lunch must beordered and paid for at least by Wednesday in advance of the week needed. There are no refunds givenfor absences or cancellations after this time.Penalty FeesInitialI/We acknowledge that the following penalties shall apply for late payment, late pick up and/or returned checks.a) 25.00 late payment – any payment made after the 9:00 a.m. on the third business day followingthe due date of the tuition payment.b) 3.00 per minute late pick up after scheduled enrollment hours or closing hours of the school if enrolled in theafter school program.c) Return check fees: fees shall incur as set forth in Florida Statute 68.064 as amended. Replacement paymentfor all returned checks must be made by certified check, or cashier’s check. If two returned checks or twodeclined credit cards are received, all future payments must be made by, certified check or cashier’s check.Disenrollment PoliciesInitial I/We understand that if a child is in attendance on the 1st of a month, payment for that month will be due infull. Tuition payments are due no later than the 8th of each month during the school year or attendance willdiscontinue until payment is made and child may be disenrolled from the school. Summer camp fees must be paidin full according to the payment schedules. If not received by these dates, it will be grounds for disenrollment fromthe program. I/We understand that all fees not paid in full shall be subject to collection.I/We understand that there will be NO refund of registration fees.Withdrawal PoliciesInitial If a child is in attendance on the 1st of a month, payment for that month will be due in full.I/We agree to notify the school in writing submitted to the office a minimum of 15 days prior to the first of the monthduring the school year and a minimum of 1 week prior to the start of any summer camp reserved week. Summercamp will require a 30.00 fee to be paid per week for any cancellations made regardless of advanced notification.I/We understand that there will be NO refund of registration fees. If a child withdraws and returns to CambridgeSchools during the same school year, payment will be due for the time missed and a new registration fee must bepaid.Illnesses or AccidentsInitial I/We understand that should my child become ill or suffer anaccident while she/he is in the care of Cambridge Schools, school staff will first attend to the child’s immediate needsand then will make reasonable efforts to contact me/us immediately. If the school staff deems it necessary, they areauthorized to seek and obtain medical attention, treatment and service for my/our child through medical services(911).Payment and Policy Agreement and ConsentPage 2

Emergency CareInitial I/We understand that Cambridge Schools does not provide on-site nurses or medical professionals, nor are thereother emergency medical services available at the school. Only CPR and basic first aid are available until emergencymedical services arrive. Cambridge Schools staff are not trained to provide medical care.I/We will notify the school in writing of any medical condition, illness, allergies, or other special need that my/ourchild has.I/We understand that Cambridge Schools has the right to deny admission, or discontinue attendance if they feel theyare not able to safely care for the child. Cambridge Schools does not discriminate on the basis of disability or anyother protected status.Severe Weather ClosureInitial I/We understand that in most circumstances, if County Schools close for severe storm warnings or anyemergency situation, Cambridge Schools will also close. At this time, I/we must contact the school and immediatelypick up my/our child, if required. In some circumstances, Cambridge Schools will be open on County SchoolEmergency Days. It is my/our responsibility to contact the school to verify whether Cambridge Schools will be open.Tuition refunds will not be given for the days in which the school is closed.Family Handbook – Influenza Brochure – “Know Your Child Care Facility” Brochure – “Distracted Adult”Initial I/We will receive the Family Handbook prior to my child’s first day of school and sign an acknowledgementstating I/we have read all policies.I/We have received and read a copy of the DCF Influenza Virus Brochure.I/We have received and read a copy of the “Know Your Child Care Facility” Brochure.I/We have received and read a copy of the “Distracted Adult” Brochure.Behavior ManagementInitial I/We have been advised that Cambridge Schools follow a child-oriented approach to behaviormanagement. This includes, but is not limited to, such techniques as gentle reminders, ignoring negativeattention seeking behavior and reinforcing the positive with praise and love. Food and fun are not withheld fromthe children. At no time is physical punishment tolerated at Cambridge Schools.MediationInitial I/We have been advised and agree that any dispute or claim arising out of or relating to the servicesprovided by Cambridge Schools shall be submitted to nonbinding mediation prior to the commencement ofarbitration, litigation, or any other proceeding before a trier of fact. The parties agree to act in good faith toparticipate in mediation and to identify a mutually acceptable mediator. If a mediator cannot be agreed uponby the parties, each party shall designate a mediator, and those mediators shall select a third mediator who shallact as the neutral mediator to assist the parties in attempting to reach a resolution. All parties to the mediationshall share equally in its costs.Health RegulationsInitialI/We understand that the laws and regulations of the State of Florida require all students to have on file beforeattending the first day of class, specific records (health, immunization and physical) and required enrollment forms.I/We understand that children are allowed to enroll with a documented exemption from immunizations completedby the Department of Health on Form DH-681. A certificate of Good Health is still required. (Form DH-3040)Food SafetyInitialI/We understand that foods associated with young children’s choking incidents must not be served to childrenunder 4 years of age; such as, but not limited to, whole/round hot dogs, popcorn, chips, pretzel nuggets, wholegrapes, nuts, cheese cubes and any food that is of similar shape and size of the trachea/windpipe. Any food thatis served to toddlers must be cut into pieces ½ inch or smaller to prevent choking.Indoor and Outdoor Physical ActivityInitialI/We understand that Cambridge Schools consider the outdoors an extension of the classroom. Each class isallotted a minimum of 40 minutes of combined outdoor and indoor physical activity for every three and a halfhours in care, excluding quiet rest time. There are planned activities incorporated into each classroom’s weeklylesson plans that contain planned physical activities designed to meet the age-appropriate developmental needsPayment and Policy Agreement and ConsentPage 3

of the children. These planned activities promote physical, emotional, social, and intellectual growth of each child.Because students will be actively engaged in physical activity including but not limited to running, climbing,balancing, hopping and skipping, it is Cambridge School’s policy that each child should wear closed-toed shoeswith a rubber sole. Additionally, each child should wear clothing that permits them to move freely without gettingcaught on anything or that they may become tangled in. This clothing requirement also pertains to appropriatedress for weather conditions. Children should arrive to school wearing close-toed, rubber soled shoes daily.Babysitting PolicyInitial I/We understand that in an effort to maintain the professional status of Cambridge Schools staff and preventany potential conflict of interest, babysitting by center staff members is discouraged. However, should I/we hireany school staff members for any off-site purposes, including, but not limited to: transportation, private tutoring,instruction, coaching, swimming lessons, or babysitting care, it must be outside the school premises and with theunderstanding that such arrangements and payment for services are solely between me and the school staffmember. Cambridge Schools does not sanction the arrangements, and I/we agree to hold Cambridge Schoolsharmless from any such arrangement.Photographs/Video PermissionInitialI/We give permission for my/our child to be photographed and videotaped in the school and during programfunctions and field trips. I/We understand that photographs/videos may be taken by school staff or by otherparents/guardians.I/We will be notified if any photos/videos taken by school staff are to be used for public relationspurposes and understand I/we have the right to refuse permission for such use.Children’s Confidential FileInitialI/We understand that information about children is gathered routinely and confidentiality is maintained. Filesare accessible to the Director, Assistant Director, other administration, teachers, social service agencies,legal and regulatory authorities and other appropriate school personnel as reasonably necessary.I/We also understand that all necessary forms must be in my child’s folder for him/her to attend school and anychanges in the pertinent information in my/our child’s records must be provided within 5 days of thechanges.Merger and AmendmentInitialThis Agreement embodies the entire representation, warranties, agreements and conditions in relation to thesubject matter hereof, and no representation, warranties, understandings or agreements, oral or otherwise, inrelation thereto, exist between the parties except as herein expressly set forth. This Agreement may not beamended or terminated orally, but only as expressly provided herein or by instrument in writing, duly executed bythe parties hereto.I/We have read, understand and agree to the policies stated in this document.Date:Child’s Name:Signature of Parent/Legal Guardian:Print Name:Relationship to child:Signature of Parent/ Legal Guardian:Print Name:Relationship to child:Payment and Policy Agreement and ConsentPage 4

Child’s Profile 2020-2021Date:Child’s Name: Date of Birth:Medical HistoryType of Birth: Normal PrematureComplications Please explain:Please list any conditions, illnesses, allergies, or special needs that we should beaware of:Please list any medications that your child takes on a regular basis:Please list any special eating habits your child may have:Developmental HistoryAt what age did your child begin to walk?How do you comfort your child?What are your child’s favorite activities?What language(s) is spoken in your home?Do you have any concerns regarding your child’s speech or hearing?If yes, please explain:Toilet TrainingCan your child be relied upon to indicate his/her bathroom wishes?What words does your child use?Are there any concerns you have about your child’s toileting?

SleepingDo you have any specific ways of helping your child go to sleep?What is your child’s current sleeping schedule?Social ExperiencesIf there are other children living in your household, please complete the following:NameAgeGenderRelationship to the ChildPlease list the names of the adults living in your householdNameRelationship to the ChildWhat past experiences has your child had playing with other children?I do not need to meet with an Administrator to further discuss my child’s specific needs.I do need to meet with an Administrator to further discuss my child’s specific needs.Please list any other information, medically or socially about your child that we should know.Parent/Legal Guardian SignaturePrint Name

Board of County Commissioners, Broward County, FloridaHUMAN SERVICES DEPARTMENTCommunity Partnerships DivisionChild Care Licensing and Enforcement SectionALTERNATE NUTRITION PLANName of Child Care Provider:Cambridge SchoolName of Child:Address: 6100 Coral Ridge Drive, Coral Springs, Florida, 33076Date:Dear Parent/Guardian:In accordance with the Broward County Ordinances, parents/guardians and Child Care Providers are urged to workcooperatively to assure that children are provided with nutritious snacks and meals when they are not offered bythe Provider.The Provider agrees to offer a nutritious:(Operator/Director checks those which apply) Breakfast Mid-morning snack Lunch Mid-afternoon snack Dinner Evening snack No meals or snackThe parent agrees to provide a nutritious:(Parent checks those which apply) Breakfast Mid-morning snack Lunch Mid-afternoon snack Dinner Evening snackI have read the preceding and agree to meet the child’s nutritional needs as defined above.Parent/Guardian PrintParent/Guardian SignatureLori KornhauserOperator/Director PrintLori KornhauserOperator/Director SignatureRevised 11/1/2014

Family Insurance Information 2020-2021Child’s Name: Date of Birth:Home Phone Number: ( )Primary Parent/Guardian’s name:Cell Phone #:( ) Work Phone #:( )Other Parent/Guardian’s name:Cell Phone #:( ) Work Phone #:( )I/We, the undersigned, have registered my/our childto attend Cambridge Schools.(Name of child)My child will be covered by a Supplemental Student Accident Program (“SAP”) toreimburse out-of-pocket expenses not otherwise covered by my medical, dental, oraccident insurance. Questions should be directed to the Cambridge Schools StudentAccident Administrator at 1-800-352-4466, prompt 2.I’ve/We’ve attached a photocopy of my family insurance identification card.This policy will cover my/our child in the event of expense being incurred whileparticipating in any school activities. I/We understand that I/we are responsible for anyand all expenses not reimbursed by the Cambridge SAP for emergency and medicalcare of my/our child.I/We are also aware of day to day risks involved in school activities and will not holdCambridge Schools or employees of Cambridge Schools responsible for any injuriesthat may be sustained during participation of activities at Cambridge Schools.I/We have read, signed and understand the Policy and Payment Agreement.DateSignature of Primary Parent/GuardianPrint NameDateSignature of Other Parent/GuardianPrint Name

Photograph/Video/FilmPermission FormCENTER NUMBER085006EVENT DATE2020-2021I give my permission to KinderCare Education LLC, its subsidiaries and affiliates and theirrepresentatives, permittees, contractors and assigns (collectively, and as used in this form,“KinderCare Education”) for myself and my child/children to be photographed, videotaped or filmedat the below-described event. I consent to KinderCare Education’s use of my or my child’s/children’slikeness in those media in KinderCare Education’s publications, promotional and advertisingmaterials (including third party media outlets) and on any website (whether in their original or analtered form) for any lawful purpose and acknowledge that those media are the sole property ofKinderCare Education. I understand and agree that this consent extends to third party mediarepresentatives, permittees, and contractors who photograph, videotape or film at the event.I waive any right to originals or copies of those media and to inspect or approve the media and theiruse by KinderCare Education. I also, in consideration of my child’s/children’s participating in theevent, (1) waive any claim I or my child/children may have, whether now or in the future, againstKinderCare Education or any third party relating to their use of the media, including any right topayment, royalty or any other compensation and (2) release and forever discharge KinderCareEducation from all claims, demands, and causes of action that I and/or my child/children, our heirs,representatives, executors, administrators, or any person acting on our behalf or on behalf of ourestates have or may have by reason of this form.Event:All school related events and activitiesNames:YES NO IN-HOUSE ONLYParent/Guardian:By signing below, I represent that I am at least 18 years old and that I have read this form and fullyunderstand its contents, meaning and impact.NAME (PLEASE PRINT)103552-OPS 2/16 2016 KinderCare Education LLC. All rights reserved.SIGNATUREDATEORIGINAL – CenterCOPY – Parent / Guardian / Employee

Special Snack/Cooking ActivityPermission Slip (2020-2021)Dear Parents,At Cambridge Schools as a part of our curriculum and learning activities we have a planned cookingactivity/special snack planned each week. If the classrooms are eating/preparing something other thanwhat is listed on our snack menu there will be a Home School Connection notice posted for your child’sclassroom. This is an opportunity for families to contribute an ingredient for the activity and/or to let theteachers know that your child can NOT have something that is listed. The snacks are varied throughoutthe school year depending on the curriculum. Here is a list of some of the common ingredients that areused. The younger children will not be served the same as older children due to different abilities. This isnot a complete list, so it is important that you look at the Home/School Connection that is listed eachweek to ensure that your child can participate.Common ingredients: celery, carrots, broccoli slaw, apples, bananas, strawberries, grapes, cream cheese,hummus, raisins, crackers, rice cakes, tortilla chips, cheddar cheese, tomatoes, butter, ice cream, yogurt,blueberries, raspberries, peas, salsa, ketchup, granola, eggs, milk, etc.In addition there will be some special events during the school year where other food may be served.I give my child, , permission to participate inSpecial Snack/Cooking Activities and Special Events where food might be served at Cambridge SchoolsMy child has the following allergies/dietary preferences so they may NOT have the following:Parent’s SignatureDate

Discipline PolicyCambridge believes c

6100 Coral Ridge Drive, Coral Springs, FL 33076. ENROLLMENT FORM . VPK 3-HOUR PROGRAM . 2020-2021 SCHOOL YEAR (4 YEARS OF AGE BY SEPTEMBER 1, 20. . Break, or any fees other than preschool or summer camp tuition. Payment and Policy Agreement and Consent Page 2 _Camp Cambridge