PARENT/CAMPER CAMP RALLY NIGHT FINAL FEE BALANCES NECESSARY FORMS CABIN MATE REQUESTS MEDICATION NEEDED

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2 PARENT/CAMPER CAMP RALLY NIGHT Our Camp Rally Night will be Friday, July 19 th at 6:30 PM at the Conejo Valley YMCA Community Room. This is a great opportunity to meet the camp staff, become familiar with the Conejo Valley YMCA Resident Camp program and ask questions. All 10 th & 11 th grade campers are REQUIRED to attend (accompanied by a parent) an LIT orientation immediately following the rally night agenda. FINAL FEE BALANCES Final fees are due by Friday, July 19 th. Mail-in payments need to arrive at the Conejo Valley YMCA by this date. Payments may also be made at the Camp Rally Night. Included in this packet (last 4 pages): CONEJO VALLEY YMCA CAMP SEQUOIA LAKE RESIDENT CAMP 4031 N. Moorpark Road, Thousand Oaks, CA Dear Camp Sequoia Lake Campers and Parents: Welcome to Camp Sequoia Lake We leave for camp on Saturday, August 3 rd and return on Saturday, August 10 th. Please carefully read the information we have provided here and if you have any questions do not hesitate to call the Conejo Valley YMCA office or contact Meghan Lopez, Director, at ext. 208 or mlopez@sevymca.org. NECESSARY FORMS Emergency/Medical Information Release Medication Form (Bring day of departure) Cabin Mate Request (Due by Camp Rally Night) Parent Cooperative Agreement Please complete all forms, sign and return these forms at the Camp Rally Night. If you can't attend the Camp Rally Night, you'll need to bring or mail the completed forms to the Conejo Valley YMCA by Friday, July 19 th. CABIN MATE REQUESTS All written requests are considered in assigning cabin groups. Assignments are principally based on age and grade level. While we want to honor every request, there are times when conflicting requests or camp program considerations prevent accommodating everyone's wishes. The Camp Directors will make the final decisions based on their judgment of what's best for the whole camp. We will not be able to consider any requests turned in after the Camp Rally Night. MEDICATION NEEDED Medications and health problems, including any recent illness, should be reported to the Camp Directors prior to departure. ALL medications are kept in the camp infirmary and dispensed by the Health Care Coordinator, at meal times or as directed in the physician's instructions. DO NOT PACK MEDICATION. Turn all medicine in at the check-in table on the day of departure in a paper bag, which is clearly labeled with the camper's name, written instructions and written parental permission for the camper to take the medication.

3 Moorpark Road Mount Clef Mail to: SENDING MAIL (MAIL MUST HAVE ALL OF THE INFORMATION) Your Camper's Name Camp Sequoia Lake c/o Conejo Valley YMCA Highway 180 Miramonte, CA Mail call is a favorite time for campers, especially when they receive something from home. We hope that you will remember to send a letter or card to your child, so that it arrives while he or she is at camp. Please, do not send care packages full of candy and junk food. Writing home is also an important part of the camp experience and keeps children connected with their family. You can help by sending self-addressed and stamped envelopes with campers, so that they will be able to write home throughout the week. SACK LUNCH: DAY 1 Lunch should be carried onto the bus on the day of departure. Please pack a lunch that will not spoil and do not send lunch "coolers". Include a drink. DEPARTURE We will depart on Saturday, August 3 rd from 9:00am at the CLU Parking Lot. Check-in will begin at 8:00 A.M. RETURN We will arrive back at the CLU Parking Lot on Saturday, August 10 th at approximately 4:00 P.M. MAP TO THE CLU PARKING LOT (Drop Off & Pick Up) Olsen Road

4 WHAT TO BRING TO CAMP The following items should be taken to cover seven full days of activities. CLOTHING 2-3 Jeans 3 Shorts 8 Underwear 7-9 Pairs of Socks 7-9 Shirts Swimsuit/trunks 2 Pairs closed toe shoes Water Shoes Jacket Sweatshirt Pajamas Hat/visor Something to Tie Dye *Theme Clothes TOILETRIES Liquid Shower Gel Shampoo & Conditioner Hair Brush Toothbrush & Paste Chap Stick Sunscreen 3 towels Washcloths MISCELLANEOUS Refillable Water Bottle Flashlight Extra Batteries Tissues Pillow Sleeping Bag or 4 blankets rolled & tied securely Laundry Bag OPTIONAL ITEMS YMCA Rag or Leather Post cards & Stamps Paper and Pencil Camera Mirror PACKING TIPS If you have an old duffel bag, it makes ideal camp luggage. It helps if everything fits into one bag. Be sure to label the bag inside and out. MARK ALL BELONGINGS WITH YOUR NAME WHAT NOT TO BRING TO CAMP Please leave expensive watches, jewelry, and expensive cameras at home. No Radios, ipods, CD Players, MP3 Players, or Electronic Games. CAMPERS ARE NOT TO BRING CELL PHONES TO CAMP. THEMES* There are several theme meals for which we encourage campers to dress creatively. Campers may bring costumes but don't buy them just for camp or spend a lot of money. Creativity is the key! Theme meals are: Rock of Ages Dance Square Dance Formal Dinner Green Day Disney Pajama Bad Hair Breakfast Carnival Craze Medieval Madness REMINDERS... You need to bring a sack lunch with your name on the sack for the first day lunch. Do NOT pack LUNCH or MEDICATION in your suitcase or bag. The camp nurse will collect all medications the morning of departure. Sleeping bags all look the same to campers when we get up to camp. Please mark your campers name on the OUTSIDE of their sleeping bag. All belongings need to be permanently and clearly marked with your campers name. The YMCA is not responsible for any lost articles.

5 Child s Name: D.O.B: Illness or Accidents? Has your child had any serious or severe illnesses or accidents in the last 3 years? Yes No If yes, explain: Medication? Does the child take any medication during the day? Yes No If yes, Medication Release Form is required. Please list medications: Allergies? Yes No If yes, list: Special Needs or Fears? Yes No If yes, explain: Physician: Phone: Dentist : Phone: Insurance Co: Group #: I hereby give permission to Conejo Valley YMCA and it s employees and volunteers to release any and all of the above health history to any medical personnel rendering emergency medical aid or treatment to my child. Parent's or Legal Guardian s Signature: Date:

6 Conejo Valley YMCA MEDICATION FORM Parent Request to Administer Medication CAMPER S NAME: DATE: Prescription medication must be in a prescription bottle with the doctor s instruction on the label. All over-counter-medication must be in original packaging. Please administer the following medication(s) to the above named child, as directed: MEDICATION DOSAGE TIME # OF DAYS The following over-the-over medication may be given to your child during camp under the recommendation of our camp nurse. Please cross out any medication you do not wish to be administered to your child. Chloraseptic Acetaminophen Aloe Vera gel Tums Hydrocortisone Cough drops Aspirin Benadryl Antibiotic cream Pepto Bismol Cough syrup Ibuprofen Saline eye drops Imodium AD Sunscreen I authorize the medication s listed above, or their equivalent, to be administered as needed. Legal Guardian s Signature: Date: Emergency Phone #:

7 CABIN MATE REQUEST FORM If you wish for your child to be placed in a cabin with one or more of his/her friends (same age and grade), please indicate this by completing this form. This request MUST be turned in by Friday, July 19th. We will try to accommodate every request but remember that part of going to camp is making new friends. CABIN CHANGES CANNOT BE MADE THE DAY OF DEPARTURE Your Camper s Requested Cabin Mates

8 CONEJO VALLEY YMCA CAMP SEQUOIA LAKE PARENT AGREEMENT & CONSENT FORM Camper s Name: PARENT COOPERATIVE AGREEMENT Serious or repeated disregard for camp rules, drug or alcohol use or possession, or the directions of the camp staff may result in dismissal from camp. I will be responsible for arranging or paying for his/her transportation home. Parent s Signature: Date: The camp rules will be discussed at the Camp Rally Night

9 Conejo Valley YMCA Away Camp Enrollment Form Staff Use Only Daxko: Reg. Date: Child s First Name: Last: Child's Gender: Male Female (Please Circle) D.O.B: Age: Grade in Fall 2013: Mother s First Name: Mother s Cell Phone #: Father s First Name: Father s Cell Phone #: Last: Work Phone #: Last: Work Phone #: Address: City: Zip: Home Phone #: Child Lives With: Mother [ ] Father [ ] Both [ ] Other Camper s T-Shirt Size: Authorized persons who may be called in an emergency and/or take child from the facility. Only these people will be allowed to sign out the child. All authorized persons must be 18 years or older. 1. Name: Phone #: 2. Name: Phone #: 3. Name: Phone #: Camp Sequoia Lake Full Member Program Grades Dates Member Campers 4 th -9 th August 3 rd -August 10 $550 $550 th Leaders in Training 10 th -11 th August 3 rd -August 10 $550 $550 th Counselors in Training $550 $ th August 3 rd -August 10 th Program Membership None $40 All Annual Fee I am an adult over 18 years of age and wish to participate in Southeast Ventura YMCA (the YMCA ) membership/program activities, and wish my children or legal wards to participate and give them permission to participate in the YMCA activities. As used in this Agreement children shall include legal wards and parent shall include legal guardian. As a condition to being permitted to utilize the facilities, services, and programs of the YMCA for any purpose, including but not limited to observation or use of the facilities or equipment, or participation in any off-site program affiliated with the YMCA, I, the undersigned, acknowledge, agree, and represent that I have inspected and carefully considered the facilities and programs. I understand that even when every reasonable precaution is taken, accidents can happen. As a condition to participation by me or my children in YMCA activities, on my behalf and on behalf of my children, I waive and release any claims for loss or injury incurred or suffered which I or my children might make against the YMCA, its sponsors, officers, employees, volunteers, or contractors as a result of participating in YMCA activities or using its facilities. I further agree to indemnify the YMCA against and hold it harmless from loss incurred as a result of claims against it based upon alleged actions or omissions by me or my children. I have read this authorization, waiver, and release, understand it, and am voluntarily signing it. I understand that the Southeast Ventura County YMCA is not responsible for personal property lost, damaged, or stolen while members and / or program participants are using YMCA facilities, on YMCA premises, or involved in YMCA programs. I give my permission to the Southeast Ventura County YMCA to use without limitation or obligation, photographs, film footage, or tape recordings which may include myself or my children's image or voice for the purpose of promotion or interpreting YMCA programs. Parent s Name: Place in Meghan s Box Parent s Signature: Date: