GROWING GREAT KIDS. YMCA CAMP LAKEWOOD (Boys & Girls ages 6-17) 2017 Summer Camp Brochure

Transcription

1 GROWING GREAT KIDS Learn how to SAVE $100 OFF CAMP through our referral program or by being a YMCA Member (see page 9 for details) 2017 Summer Camp Brochure YMCA CAMP LAKEWOOD (Boys & Girls ages 6-17) YMCA Camp Lakewood is located 75 miles south of St. Louis between Potosi and Steelville, MO

2 < WELCOME TO YMCA CAMP LAKEWOOD! YMCA Camp Lakewood is where kids come to have fun, learn new skills, make new friends, and to simply be kids. Your camper will forget all about electronics while discovering the ultimate childhood experience, all within the safe and trusted environment of the Y. Camp Lakewood provides a well-rounded experience for campers that gets them outdoors to connect with nature. With a private lake, forest-covered hills, caves, creeks, and more, there are many opportunities for natural exploration and experiential learning. Whether it s campfires, swimming, archery, climbing tower, zip line, sports, canoeing, cookouts, fishing, kayaking or camp games, every camper delights in waking up each morning with a renewed sense of excitement as to what new activities each day at camp will bring. We welcome boys and girls of all nationalities and denominations, and pride ourselves on the cultural diversity of our campers and counselors. Camp Lakewood counselors are chosen for their maturity, skills, enthusiasm and desire to nurture the potential of the children and teens who participate in the Y s long tradition of summer residential camping. The health and safety of each camper is our primary concern. All staff are trained in skills that emphasize safety, youth development and group dynamics. Each counselor is trained in CPR and first aid, and all waterfront activities are closely supervised by waterfront staff who are lifeguard certified. A medical professional is always available in our well-equipped camp infirmary, and our local physician is on call to assist in emergencies. What does it mean when everyone calls Camp Lakewood, My Camp!? It means every one of our campers has a home away from home and a special place where they can try new things without being judged. It means every camper knows a place where they have friends, where they feel safe, happy, and wanted. It means every one of our campers has a camp - their camp - and they know the camper sitting next to them feels the exact same way. It means they are an important part of YMCA Camp Lakewood. So when campers - and parents - are asked, Whose camp is this? - we are proud to hear them say... MY CAMP! < MY CAMP! MY CAMP! < My Camp! < Camp! My 2017 OPEN HOUSE DATES AT YMCA CAMP LAKEWOOD Sunday, March 26, 2017 from 1-4 p.m. Sunday, April 9, 2017 from 1-4 p.m. Sunday, April 30, 2017 from 1-4 p.m. Sunday, May 21, 2017 from 1-4 p.m. Did you know that YMCA Trout Lodge is just next door? Ask us about staying at Trout Lodge during our Open House weekends.

3 F FOUR-DAY SUMMER CAMP PROGRAMS Page 2 O U RANCH CAMP (4-day, 3-night) Co-ed ages Come to the Triangle Y Ranch for 4 days of hands-on equestrian training! Ranch Campers will form their own special cabin group and spend all day, everyday at the ranch working with our highly experienced staff. Participants will advance riding skills while learning advanced horse care, history and ranch management. Campers will spend one night out under the stars. R D A Y MINI CAMP (4 days, 3 nights) Co-ed ages 6-8 Days at Mini Camp are filled with games, pony rides, arts and crafts, nature, swimming and more. It is a closely supervised introduction to camping with lots of individual attention for first-time campers. Cabin groups experience many of camp s activities together, but kids also have the opportunity to choose a few activities on their own. We maintain a ratio of at least one counselor per four campers. Understanding this is possibly a child s first time away from home, our caring staff keeps the new camper safe and happy. Since these four day programs are shorter, they have their own unique, individual schedules tailored to the needs of the age group. Campers may experience some of the clinics and activities offered for their age group, but not all will be provided. These shorter sessions are perfect for a camper s first time away. MINI RAPTORS CAMP (4 days, 3 nights) Coed Ages 9-10 Mini Raptors Camp is a fun, exciting and safe way to introduce your camper to a residential camp experience. Swimming, archery, arts & crafts, and campfires are just a few of the activities your camper will enjoy. Mini Raptors Camp is designed for the 9-10 year old first time camper to try Camp Lakewood for just four days. All campers are the same age so every activity is geared for them. MINI EAST CAMP (4 days, 3 nights) Co-ed ages Has your camper ever wondered what s on the other side of the lake or heard the legend of the 97 stairs? Well now they can find those answers out for themselves as they enjoy a taste of East Camp and all the excitement across the lake. Your camper will stay in the original camp cabins located on East Camp Hill, complete with bathhouse, pavilion and the throwback camping we all loved as kids ourselves. This is a great introduction to East Camp for pre-teen campers.

4 T R A D I T I O N A L TRADITIONAL CAMP PROGRAMS EAST CAMP (1- week) Co-ed ages East campers days are filled with lots of camp games and activities, friendship and fun, while under the watchful eye of the Camp Lakewood staff. Our goal is to help campers grow into great individuals while learning about the core values of character development. Although this is a time to make an impact on a teenager s life, it is also a time to relish the joys of being carefree and young. Campers have the opportunity to have as much fun as they possibly can. Your teen will stay in the original rustic camp cabins and use a centralized bathhouse with restrooms and showers. Each cabin will also venture into the outdoors for an overnight where they sleep under the stars and cook a meal over a campfire. MAIN CAMP (1-week) Co-ed ages 8-12 Page 3 Main Campers have the opportunity to choose from so many great camp activities, such as archery, arts & crafts, canoeing, caving, fishing, flag football, floor hockey, outdoor living skills, singing, snorkeling, soccer, yoga, cabin and unit games, and so much more. Upon their arrival each camper is welcomed by our caring staff and introduced to their cabinmates for the week. Campers gather as a cabin each day to play, learn, bond, and make life-long friendships. Main campers lodge in climate controlled cabins with indoor plumbing. Each cabin group will also venture into the outdoors for an overnight where they sleep under the stars and cook a meal over a campfire.

5 A D V E N T U R E ADVENTURE PROGRAMS JUNIOR RANGER (1-week) Co-ed ages The Junior Ranger program is a wonderful program for campers who enjoy spending all of their time outdoors, have experience in camping, or are a returning camper who wants to try something new. Junior Rangers learn campfire cooking, shelter building, how to work as a team and many more outdoor living skills. A majority of the Junior Rangers time is spent learning their ranger skills away from the everyday life of traditional camp, but they do get to experience a tiny bit of camp by choosing and participating in two morning clinics for the week. (See clinics on page 6) Junior Rangers spend each night of camp sleeping under the stars. Page 4 RANGERS (1-week) Co-ed ages The Ranger program is designed to help campers gain valuable wilderness skills in their own Ranger Village, where they spend each night of camp under the stars. Each camper is taught to cook over an open fire, build shelters, travel as part of a team, explore the outer limits of camp, trip planning, and Leave No Trace outdoor ethics under the guidance of our experienced staff. Each Rangers week-long program is specialized in a specific outdoor adventure. We offer four different experiences: Rustic Engineering: Rangers will construct towers, forts, small engineering projects, table, chairs, etc. They will also learn about and try their hand at blacksmithing. Hiking: Rangers will backpack to explore and see some of the secret gems hidden on the 5,200 acres on which camp resides. High Adventure: Rangers will spend time climbing or zip lining a majority of the climbing structures throughout camp, as well as learn proper belay techniques and knot-tying skills. Canoeing: Rangers will spend time traveling and racing across our lake to seek out the hidden coves, snorkeling and making a special trip to Mud Cave. page 5

6 L E A D E R S H I P LEADERSHIP PROGRAMS COUNSELORS IN TRAINING (CIT) (3 weeks) Co-ed, must have completed your junior year of high school The CIT program offers our oldest campers the opportunity to get a head start on training skills they will need to someday become a summer camp counselor. The 3-week course begins with a week of intensive child care skill training and program training. In the second week, CITs will shadow camp s best counselors in our youngest cabins while still receiving more active hands-on training. In the third week, CITs will be put to the test with all of their training skills as well as their past week experience in the cabin. This is a highly rigorous program, and all interested campers must complete an application, interview and reference checks to be considered for the program. CIT applications are available for download at under Forms + Parent Information. Note: Application, essay and references are due by April 4th. The last day for an interview is April 11th. Announcements about acceptance into the program will be ed to parents/guardians on April 18th. Completing the CIT program does NOT guarantee hire as a cabin counselor. Page 5 LEADERS IN TRAINING (LIT) (2 weeks) Co-ed, must have completed your sophomore year of high school The LIT program is a challenging two-week camp experience designed for campers looking to become better team players, builders, problem solvers and communicators. This program will help campers figure out who they are or the type of person they want to become. The program encourages teens to discover their potential and emphasizes the importance of self-reliance. The two-week experience will push campers and help them evaluate themselves. At the end of the program, the LITs will be put through a test just to prove how far they have come in their time spent at camp.

7 C WHAT ARE CLINICS? Page 6 L I N I C Campers choose four learning activities called clinics during a one-week stay. Each clinic runs for about an hour, five days a week. Some activities count as two clinics. Through these activities, we coach sportsmanship, courage, healthy risk-taking, independence, goal setting, flexibility, responsibility, and self-discovery. We aim to nurture the potential of every camper. Some activities are restricted by age, height or swimming ability. Camp has more activities than a camper can visit in a session. Due to factors such as age, weather, program choices, popularity and availability, your camper will have an active week, but will not do every activity listed below. There will always be something to look forward to during their next summer at camp. CLINICS FOR YMCA CAMP LAKEWOOD The clinics listed below are examples of usual clinics offered each summer. Clinics change depending upon staff skills and popularity from session to session. CAMPERS WILL SIGN UP FOR CLINICS AT CAMP. AGES 8-10 Archery Arts & Crafts Basketball Canoeing 1 Cricket Caving^ Drama Drawing Fishing Flag Football Floor Hockey Friendship Bracelets Frisbee GaGa Nature Outdoor Living Skills Poms Singing Snorkeling* Soccer Swimming Tennis Volleyball Yoga AGES All activities listed for 8-10 plus: Animation^ Climbing^ Face Painting Kayaking*^ Riflery Rugby S AGES 13 AND UP All activities listed for 8-10 and plus: Digital Journalism^ Windsurfing*^ SWIM TEST * blue band; 1 yellow or blue band; ^ denotes an activity that takes up two clinic periods At camp, we have three different bands that demonstrate a certain level of swimming ability necessary for certain activity participation. Campers will take their swim test shortly after arriving at camp (weather permitting) and do have two opportunities to retake their swim test throughout the week. Note: Mini Campers do not take a swim test and are only allowed in the shallow section. Level of Bands Red Bands: Designated for campers who do not know how to swim, are still learning, choose not to take the swim test or cannot pass the Yellow or Blue Band qualification. Yellow Bands: This band is for an intermediate swimmer who may know how to swim but might not have enough stamina or cannot pass the Blue Band qualifications. To receive a yellow band, you must swim recognizable strokes (free style or breaststroke) for 42 meters and successfully tread water for three minutes. If a camper is unable to complete either task, the camper will receive a red band. Blue Bands: For confident swimmers who can swim a recognizable stroke (free style or breaststroke) for 84 meters and successfully tread water for five minutes. If a camper cannot complete either task, the camper will receive either a yellow or red band based on the completion of both tasks.

8 E WHAT ARE ELECTIVES? Page 7 L E C T I V Electives are additional specialized clinics that campers may choose to attend during their stay. Even if a camper chooses an elective program, they will still have time everyday to participate in other clinics such as canoeing, sports, swimming, etc. There is an additional charge for electives. Equipment will be provided by camp. Campers are NOT required to choose an elective. ADVANCED ARTS & CRAFTS (1-week) Co-ed ages 8-16 Calling all crafters! Be crafty and creative while you unleash your inner artist in Advanced Arts & Crafts! Each camper will get to paint two ceramic pieces, make two candles, create two tie dye shirts, construct a stepping stone, and design jewelry pieces. Advanced Arts & Crafts meets two clinic periods a day and allows campers to choose two additional clinics. HIGH ADVENTURE (1-week) Co-ed ages Reach for new heights with our High Adventure elective! Campers will take advantage of many of our ropes courses which may include: Pines Peak, Pines Zip, Explore & Rappel, Gladiator Zip, Alpine Tower, Alpine Swing, Pines Pole Zip and our natural rock face rappelling wall! Campers will also learn from our TEAM Works staff how to tie knots, advanced climbing techniques, rappelling and belaying skills. High Adventure meets for two clinic periods a day. HORSEMANSHIP (1-week) Co-ed ages This elective meets during two of the four clinic periods each day. Grooming, saddle, bridle, anatomy of the horse and Western riding are all taught in this introduction to horses and their care. Learn about breeds and characteristics, riding positions, commands, walking and trotting. E S PAINTBALL PARTY (1-week) Co-ed ages This fun-filled, adrenaline-pumping elective will focus on individual/team tactics and strategies, problem-solving, group communication and team building. Whether you re brand new or an expert, this program offers a wide variety of different games guaranteed to ensure everyone has a great time. We provide paintball markers, paint and protective equipment. This special elective meets for two of the four clinic periods. SNAG (Starting New At Golf) (1-week) Co-ed ages SNAG is a golf instruction program that is sweeping the nation. Suited for all starting players, SNAG teaches players the basic skills needed to enjoy a lifetime of golfing. Campers will work with professional golf instructors from Fourché Valley Golf Course and will receive two periods of instruction each day.

9 S M OR G A SB WHAT ARE SMORGASBORDS? Page 8 Smorgasbord is a time during the day when campers choose from an array of activities offered by staff, allowing them to experience more than their four clinic choices. Specialized smorgasbords are additional smorgasbord choices that campers may choose to attend during one of the four smorgasbords offered. Note: There is an additional charge for Specialized Smorgasbords. Equipment will be provided by camp. Campers are not required to choose a Specialized Smorgasbord. SIGN UP FOR THESE OPTIONS ON THE SPECIALIZED SMORGASBORD FORM IN THE PARENT PACKET. BANANA BOAT Co-ed; ages 8-16; MUST RECEIVE A BLUE BAND DURING SWIM TEST Take a wet and wild ride on our Banana Boat, which holds 8-16 riders and is towed by a pontoon boat. Note: This activity takes place during siesta. GET FIRED UP! CERAMIC PAINTING Co-ed; ages 8-16 Let your imagination and artistic abilities carry you away during this Specialized Smorgasbord as you paint a ceramic piece. A wide variety of ceramic pieces are offered and may include: mugs, figures of animals, money banks, etc. Ceramics are fired in a kiln and delivered on Friday just in time to pack up and take home. O RD S GLADIATOR ZIP Co-ed; ages 8-16; Weight limit of 280 lbs. A zip line with a twist - jousting! You will step up to the platform, be harnessed in and then run off the ramp and zip out over the valley trying to hit targets with your lance. You will have two opportunities to show off your skills. PAINTBALL PARTY Co-ed; ages Perfect for beginners or those who are advanced to test their skills on our wooded paintball course! Each session includes a safety orientation and instruction on a variety of games to play. We will provide the paintball gear. Each paintball session will last up to 1 1/2 hours. VALLEY TRAIL RIDE Co-ed; ages 7+; at least 44 tall, weight limit of 250 lbs. The Valley Trail Ride is a one-mile ride designed to show off our beautiful hardwood forest. The trail winds through the peaceful forest and crosses the Fourchè Renault Creek. The ride is approximately 30 minutes long (depending upon the size of the group and weather permitting). Note: This trail ride may happen during cabin activity time, siesta or smorgasbord. WATER BLAST ZIP Co-ed; ages 8-16; Weight limit of 280 lbs. Imagine a water gun fight crossed with a zip line! Step up to the platform, get harnessed in and then run off the ramp! You ll then be blasted with water while you zip! What a great way to cool down from the heat of a warm summer s day. It s so awesome, we ll let you do it twice in a row.

10 S C H ED U LE DAILY SCHEDULE 7:00 am Wake Up 7:45 am Flag and Morning Watch 8:00 am Breakfast 8:40 am First Clinic 9:40 am Second Clinic 10:40 am Cabin Activity /Swim Time/ Unit activity/all-camp Game 12:00 pm Lunch 12:40 pm Siesta 1:40 pm Smorgasbord* /World Service Carnival 3:00 pm Pop Stop** 3:45 pm Third Clinic 4:45 pm Fourth Clinic 5:50 pm Flag and Evening Watch 6:00 pm Dinner /Overnights 7:00 pm Unit Activity /All Camp Game /Cabin Activity 9:00 pm Lights Out for Main Camp 10:00 pm Lights Out for East Camp Page 9 *Smorgasbord is a time during the day when campers choose from an array of activities offered by staff, allowing them to experience more than four clinic choices. (See pg 8 for more information) Swimming is an option during this time, except during inclement weather. ** Pop Stop is snack time each day when campers have the option of getting one drink and one snack. DISCOUNT & BONUS DISCOUNT FOR RETURNING CAMPERS RECRUIT NEW CAMPER FOR SUMMER 2017 AND RECEIVE $100 OFF RETURNING CAMPER S PROGRAM FEE! Referring camper has to have attended Camp Lakewood for at least one summer. New camper cannot be in the same household. New camper must be paying a portion of program fees and not under full scholarship. New camper has to list only your camper on the Referred By line when signing up. Credit only applies toward cost of program fees. Discount will not be applied until new camper has registered and listed your camper on the referral program line of their registration form. Credit will not be extended beyond the value of your child or children s program fee. Referral credit will be awarded on a first-come basis; if two families refer the same camper, credit will be awarded to the family whose form is received first at the camp office. Credit will be split for forms that arrive in the mail the same day. Credit cannot be transferred to children of other families. BONUS SAVINGS FOR Y MEMBERS YMCA MEMBERS RECEIVE $100 OFF CAMPER S PROGRAM FEE! WOW What a great savings! Y members receive a $100 discount off program fees for sessions 1-3, and a $45 discount for sessions 4-10.

11 REGISTRATION INFORMATION Page Page R E G I S T R A TI PRICING TIERS We realize families have differing abilities to pay, so we offer a voluntary three-tiered pricing for most programs. The price you choose in no way influences the quality of experience each child receives. The Actual Cost to send a child to camp includes direct expenses and long-term wear and tear. The Partially Subsidized rate is available for families who can pay a little more and more accurately accounts for the true direct cost of camp. The Subsidized Rate does not reflect the true cost of camp. As always, we still offer scholarships to those who qualify to ensure that all children have this wonderful opportunity. O N

12 REGISTRATION INFORMATION Page 11 R E G I S T R A TI O N CONFIRMATION Once your registration and deposit is received and processed, we will mail or you a Parent Packet. Registrations are processed in the order they are received. If the session you prefer is filled, we will contact you to determine if you ll enroll in another session or be placed on the waiting list. If you register for camp online, your Parent Packet will arrive electronically. PARENT INFORMATION PACKET The Parent Packet includes health forms (doctor s signature required) and personal information forms. You will also receive the Parent Handbook, which will provide useful information regarding your child s camping experience, and a packing list for each child registered for Camp Lakewood. If you register for camp online, you will receive all of this information electronically. Please return your forms at least three weeks prior to your camper s session to ensure the smoothest check-in possible. Parent Packet and Handbook is on our website at: Session packing lists can be found online at ymcaoftheozarks.org/stay/camp-lakewood/sessions. FINANCIAL ASSISTANCE To ensure that any child can attend camp regardless of financial limitations, YMCA Camp Lakewood provides assistance through our Endowment Funds and the YMCA Annual Support Campaign. For information on receiving financial assistance, contact your local branch of the Gateway Region YMCA or the Camp Lakewood office. To contribute to our scholarship fund, please contact the camp office at ext INCLUSION SERVICES The YMCA welcomes and encourages individuals of all abilities to experience Camp Lakewood. Our Inclusion Services Department takes applications and conducts assessments. This process provides us with the information needed to allow us to arrange for appropriate staffing or other reasonable accommodations. Parents/guardians must notify Camp Lakewood by May 1 st to ensure that the YMCA has time to evaluate and prepare appropriately for your camper s visit. Providing accurate information regarding a child s needs is an important part of the application process. Any inaccuracies or omissions on the application will put the camper s participation in YMCA programs in jeopardy. Please call for an application. Because of the generous donations to our Capital Campaign, Camp Lakewood s cabins and lounge are more accessible than ever for children with disabilities. Call the Lakewood office at ext. 572 for more information. TIPS FOR A SMOOTH REGISTRATION PROCESS We do not have a registration deadline, but you should register early space is limited and sessions fill quickly. Online registration is the quickest method you can use. We do not take registrations over the phone. Sending all required forms in early makes the check-in process go smoothly. In order to get your child s health form in on time, make sure you schedule your child s physical early! Your child will need a physical within 12 months of attending camp. DISCLAIMER The YMCA is an inclusive, family-friendly organization. We expect all our members, program participants and guests to model our core values - caring, honesty, respect & responsibility - in their conduct and language. We have the right to deny application for participation in programs and to terminate/suspend existing participation in all YMCA programs/ activities at our sole discretion if actions or behaviors are not deemed to be in the best interests of the organization. If a program is terminated or suspended, all fees already paid will be forfeited. The YMCA has sole discretion to reinstate participation privileges in YMCA programs and activities.

13 2017 CAMP LAKEWOOD REGISTRATION FORM Page 12 Please print legibly. You may also register on-line at 1. CAMPER INFORMATION Last Name: First Name: M.I.: Nickname: Gender (check one): M F Birth date: Years at Camp Lakewood including Summer 2017: Home Address: City: State: Zip: School attended in : Grade: Is camper a YMCA Member? Yes No If Yes, which branch? (In order to receive member discount, you must enclose a copy of membership card or letter from YMCA branch as proof of membership.) How did you hear about Camp Lakewood? Referral Program (see page 9) Who referred you?: (Please provide camper s name) 2. PARENT/GUARDIAN INFORMATION How would you prefer to be sent the Parent Packet? (check one) Via (The packet will be sent to the 1st parent address.) Via postal mail 1st Parent/Guardian s Name: Relationship: Home #: ( ) Work #: ( ) Cell #: ( ) 2nd Parent/Guardian s Name: Relationship: Home #: ( ) Work #: ( ) Cell #: ( ) With whom does the child reside? 3. CABINMATE REQUEST Last Name: First Name: Only ONE cabinmate request is allowed. TO GUARANTEE the request, the campers must request each other, be within one year of age, be the same gender, and enrolled in the same program and session. NOTE: If there are 10 or 12 children who would all like to be together, ask about the possibility of booking an entire cabin. 4. BUS INFORMATION All buses pick-up and return campers to the South County YMCA in St. Louis. (Check one) Round Trip Bus - $60 Bus to Camp Only - $35 Bus from Camp Only - $35 No Bus 5. INCLUSION SERVICES (check all that apply) YMCA Camp Lakewood welcomes participation by children of all abilities. All children with any type of diagnosis and/or specialized documents will be referred to the Inclusion Services Department for assessment. For more information, contact YMCA Inclusion Services at Has your child been diagnosed with: ADD/ADHD OCD Cerebral Palsy Tourette s MR/D PDD Down s Bi-Polar Disorder Rett s Syndrome Fragile X Autism ODD DD Asperger s Other:

14 2017 CAMP LAKEWOOD REGISTRATION FORM Page 2 Page INCLUSION SERVICES (Continued) Are there any behavioral medications or psychological issues of which the camp should be aware? Yes No If yes, please describe: Are there any physical limitations that might hinder the camper s participation in camp events? Yes No If yes, please describe: Does your child have an IEP, Section 504 Student Accommodation Plan, or Behavior Management Plan? Yes No Does your child currently use YMCA Inclusion Services? Yes No If so, which branch? *Please note, you MUST submit a current IEP/BMP/Section 504 Student Accommodation Plan with this registration form and complete and return the Inclusion Information Forms before program participation is authorized. Forms must be received by the camp office at least four weeks prior to participation. Enrollment will NOT be considered final until all required processes have been met and reviewed. Although every effort is made to provide reasonable accommodations, there may be instances where a child s needs may exceed the parameters of the scope of our program. All camp forms are available to download at under Forms + Parent Information. Note: Space is limited so the earlier paperwork can be turned in and processed, the better chances your camper has to come to camp. 6. ALLERGIES Does your child have any allergies? NO KNOWN ALLERGIES THIS CHILD IS ALLERGIC TO: Describe what the camper is allergic to and the reaction seen: 7. DIET Check those which apply. We can work effectively with most medically prescribed diets but cannot cater to individual food preferences. Please call if you have a question about diet. This camper eats a regular and varied diet This camper is lactose-intolerant of this type (select one): This camper uses a product like Lactaid and/or can self-manage the intolerance This camper needs lactose-free diet that includes no lactose in baked items (ie. breads, cookies, etc.) This camper is a vegetarian of this type (select one): Semi-vegetarian (no pork or beef) Lacto-ovo (no beef, pork, chicken, seafood or fish) Pesco (no pork, beef or chicken) Vegan (no meats, eggs or dairy) 8. MEDICATIONS (check all that apply) The medications listed below, stocked in the YMCA Camp Lakewood TLC, are used to manage illness or injury, and dispensed as directed by our medical protocols. Check all those which your camper should NOT be given: Acetaminophen Aleve Aloe Vera After Sun Benadryl Caladryl Calamine Lotion Chloraseptic Throat Spray Generic Cough Drops Generic Cough Syrup Ibuprofen Immodium AD Ivy Dry Maalox Multi-Symptom Cold Tabs Mylanta Nighttime Cold Formula Pepto Bismol Silvadene (burn creme) Sudafed Swimmer s Ear Tinactin Triple Antibiotic Cream Tums

15 2017 CAMP LAKEWOOD REGISTRATION FORM Page 3 Page HEALTH CONCERNS (check all that apply) This camper has NO health concerns and is capable of full participation in this program This camper has the following health concerns (select all that apply): Asthma/Wheezing/Shortness of Breath Headaches Sleepwalking Diabetes Menstrual Cramps Frequent Colds Frequent Ear Infections Bedwetting Seizures Other (describe): Provide information about supportive health care needed for each checked item: 10. PARTICIPANT AGREEMENT/ REFUND POLICY I verify to the best of my knowledge that everything on the registration is correct and the child is capable of such an experience. I recognize failure to disclose, falsification or deliberate omission of information will result in termination of services. I agree to pay the balance of the program fees by May 1. The deposit is not refundable or transferable under any circumstances. Fees are not refundable without a doctor s authorized medical reason (this excludes behavioral or psychological issues). No refunds will be issued unless cancellations are made at least four weeks prior to arrival. I understand that no refunds are given if a child leaves early because of homesickness or for disruptive behavior as determined by the Director. I grant permission for the camper to participate in all planned program activities including out-of-camp trips by van or bus, hiking or horseback riding, understanding that competent leadership is provided. In case of accident or illness, the YMCA is authorized to secure emergency medical treatment. Prudent attempts will be made to contact parents immediately. I understand the related expenses for this medical attention will be (my) the camper s responsibility. The YMCA is not responsible for lost, stolen or damaged personal articles. I also authorize the YMCA to have and use photographs and videos of the camper named on this registration for promotional purposes and web site session photos (if you do not wish your child to be photographed or videoed, please check the box below). I agree to waive any claims against the YMCA, its staff, and volunteers for injuries or damages that may result from the conduct of other persons including participants in YMCA programs. Parent/Guardian Signature: Date: I do not wish my child to be photographed or videoed. (Note: No pictures/videos of your child will appear when camp photos/videos are taken and uploaded. This includes the Daily Wave.) 11. SESSION CHOICE Please enroll camper in the following session (if enrolling in more than one session, please include both sessions & programs): Session #: Program: Session #: Program: If camper is attending consecutive sessions, will they be staying over between sessions? No 12. ELECTIVE CHOICE (Optional) Yes (If yes, please add $50 for each stay over) Advanced Arts & Crafts Elective Sessions: 1-4, 6-9 (optional for Main, East Camp, Jr. Rangers - ages 8-16) $ 99 High Adventure Elective Sessions: 3, 8 (optional for East Camp only - ages 13-16) $ 99 Horsemanship Elective Sessions: 1-4, 6-9 (optional for Main, East Camp, Jr. Rangers - ages 10-16) $149 Paintball Elective Sessions: 1-4, 6-9 (optional for Main, East Camp, Jr. Rangers - ages 12-16) $200 SNAG (Starting New at Golf) Sessions: 1-4, 6-9 (optional for Main, East Camp, Jr. Rangers - ages 11-16) $ PICK-UP AUTHORIZATION For safety and security reasons, we must know if someone other than the named person(s) in Section 2 (Parent/Guardian Info.) will be picking up your child from camp. If so, please indicate below. If no one is listed in this section only the person(s) listed in Section 2 of this registration form will be allowed to pick up the camper associated with this registration. No exceptions! Name (as it appears on driver s license) Relation: Name (as it appears on driver s license) Relation:

16 2017 CAMP LAKEWOOD REGISTRATION FORM Page 4 Page PAYMENT INFORMATION If registering prior to May 1, you may choose to pay the entire balance or a non-refundable deposit of $100 for each week requested to hold space. The deposit is applied to the total camp fee. If your deposit is paid by credit card, the balance will automatically be charged to your card on May 1. If the entire balance is not paid by May 1, the reservation may be cancelled and the deposit forfeited. If you are registering after May 1, the entire balance is due upon registration. Program Price (pg. 10) $ Elective Fee (pg if applicable) $ Bus Fee (pg if applicable) $ Stay Over Between Sessions Fee (if applicable - $50) $ Donation to help send an underprivileged child to camp (optional) $ Multiple Child Discount (if applicable - $35 will be applied toward the balance for your 2nd, 3rd, etc. child) $ - YMCA Member Discount (if applicable - $45-$100 will be applied towards balance for Y members - see bottom of pg. 9) $ - Total Amount Due $ Less Deposit Amount Enclosed ($100 for each week requested) $ Balance Due Before May 1 $ Method of Payment: Check enclosed, payable to YMCA of the Ozarks. Please include driver s license number and camper s name on check. (A $25 charge will be applied for returned checks.) Visa MasterCard Discover AmEx Amount to be charged: $ Acct #: Exp.Date: Signature: 16. REGISTRATION INFORMATION Register in one of the following ways (you should receive a confirmation in 7-10 days): Register on-line at: registration form with credit card information to: camplakewood@gwrymca.org Mail registration form and deposit to: YMCA Camp Lakewood State Hwy AA Potosi, MO Fax registration form with credit card information to: Bring to your local Gateway Region YMCA (locations listed at Registrations are processed in the order received in the Camp Lakewood office. For information, call or The Parent Packet with all necessary Camp Lakewood forms and clothing lists can be found online at under Forms + Parent Information. Branch Use: Date Received: Branch: Amount: Receipt #: Initials: Camp Use: Date Received: Check #: Amount: Session #: Initials: