2018 SUMMER CAMP CHAMBERSBURG YMCA

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1 2018 SUMMER CAMP CHAMBERSBURG YMCA

2 Weekly Summer Camp Fee: $45.00 Members / $60.00 Non-member a week Registration and Payment Options: Early Bird Registration ends April 30, 2018 * Receive a $10.00 discount per week * Must register for 3 weeks or more Payment in full must be received by April 30, 2018 Camp T-shirts can be purchased for $7.00

3 CHAMBERSBURG YMCA 2018 BIDDY CAMP REGISTRATION Child s Name: Age: Birthdate: Address: All Biddy Camps for Children ages 3 to 5 years of age. Camps Meet: Monday Thursday 9:15a.m. to 11:45a.m. Soccer Camp - June 4-7 Secret Mission - June Going Green - June Everyday Heroes - June Diggin for Dinosaurs - July 9-12 Summer Splash - July Simple Science - July Under the Sea - July 30-Aug 2 All Sports Camp - Aug 6-9 Would you like to purchase a YMCA Camp T-shirt? Cost per shirt is $7.00. Yes / No Child s Size Parent or Guardian's Name: Address: Address: Phone (H) (W) (C) Emergency Contacts: 1. (C) 2. (C) Is your child currently being treated for any illness, injury or allergies? Yes or No If so, please explain: Is your child currently taking any medication? Yes or No If so, please explain: Please give names of people who will be authorized to pick up your child: 1: 2:

4 ADVENTURE 2018 Summer Day Camp Monday - Friday 8:30 AM - 4:00 PM YMCA Day Camp gives kids ages 5-16 the chance to expand their knowledge, explore nature, discover new talents, try new activities, gain independence and make lasting friendships and memories. Summer Camp is an amazing way to spend your summer. Each week campers have real life learning experiences through activities and trips such as bowling, hiking, team building activities, outdoor activities, swimming at the Y and visiting various community pools and parks. Summer Camps meet weekdays from 8:30 AM to 4:00PM. Extended care hours are available from 6:30-8:30 AM and 4:00-6:00 PM at no additional charge. Registration Fee: Registration Information One time fee of $15.00 per child. Includes a camp t-shirt. Additional t-shirts may be purchased at a later date. Weekly Summer Camp Fee: $ a week for YMCA Members $ a week for non-members

5 2018 YMCA SUMMER DAY CAMP REGISTRATION FORM Name: Grade Completed: Age: D.O.B.: Address: Mother/Guardian: Cell# Work #: Home #: Father/Guardian: Cell# Work #: Home #: Select T-Shirt Size: Youth Size: Small Medium Large Adult Size: Small Medium Large X-Large Emergency Numbers: List in the order that you wish person to be called. 1. Name: # 2. Name: # Name of Health Insurance Coverage Policy Number (Required in case of an emergency) Is your youth currently being treated for any illness or injury? Yes or No If so, Please explain Is your youth currently taking any medication? Yes or No If so, please explain Does your youth have any allergies? Yes or No If so, please explain Attach additional pages if more space is necessary. I,, give the Chambersburg YMCA permission to care for my child should an emergency arise. I give the YMCA permission to take my child to the hospital in the case of injury for treatment. I understand that the YMCA staff will make every effort to contact me prior to authorizing emergency transportation or medical attention for my child and hereby release the YMCA, it agents and employees from any liability in connection with this granted authorization. Parent Signature Date Names and phone numbers of people who are authorized to pick up your youth: Name: # Name: # Name: #

6 Registration Fee $15.00 Early Bird Registration ($15 Discount) (Must register for 5 weeks and balance paid in full by 4/30/16 Member Weekly Rate $ Non-Member Weekly Rate $ ***Thanks to our wonderful families, we are experiencing growth in our youth programs! Therefore camp breakdown will be different this summer, and we appreciate your patience as our staff place your child in the appropriate camp below. Age as of June 1st, 2018 SFC 1: ages 5-younger 6 SFC 2: age older 6 SFC 3: age Younger 7 SFC 4: age older 7-younger 8 SFC 5: age older 8 SFC 6: age 9 Trek 1: age younger 10 Trek 2: older 10 younger 11 Trek 3: ages older Trek 4: age 13+ All campers MUST have completed Kindergarten by the Chambersburg School District standards Please check the weeks your child will be attending and circle the days each week. May 30-June 1 Wk 1 W Th F July 9-13 Wk 7 M Tu W Th F June 4-8 Wk 2 M Tu W Th F July Wk 8 M Tu W Th F June Wk 3 M Tu W Th F July Wk 9 M Tu W Th F June Wk 4 M Tu W Th F July 30-August 3 Wk 10 M Tu W Th F June Wk 5 M Tu W Th F August 6-10 Wk 11 M Tu W Th F July 2-6 Wk 6 M Tu Th F August Wk 12 M Tu W Certain trip days may require an additional fee. Photo Consent: I give the Chambersburg YMCA permission to take pictures of my child, and use them for release of YMCA publications, media, website, and Facebook and if necessary the picture may be released to the newspaper. Parent/Guardian Signature Date Camper Signature Date ***Teen Trek 4 Only*** PG 13 Movie Permission Slip: I give my child permission to watch PG13 Movies while in Summer Camp. The movie will be carefully selected by the YMCA staff. Parent/Guardian Signature Date Camper Signature Date

7 Counselor in Training (CIT) WHERE LEADERS ARE MADE Counselor in Training is perfect for teens who: Are between years old Are a member of the Chambersburg YMCA Enjoy being active all day Want to make new friends and lifetime memories Are looking to gain skills as camp counselors CIT Weeks/Fees: $15.00 one Time Registration fee $25.00 per week of being a CIT. CIT will run each week of summer, with a leadership training each week. CIT BACKPACK Here are items CITs will need every day. Lunch, sunblock, water bottle, swim suit & towel, and comfortable sneakers. The camp environment provides a unique opportunity for youth to build leadership skills, particularly in assisting counselors with younger campers. The goal of the CIT program is to teach the general skills of leadership that can be used at school, home and community. There is an interview process for this position as it is reserved for mature individuals with a passion for working with youth. All interested participants will need to contact Abby Cutler at or at

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