BEST SUMMER EVER 2016 Day Camp Registration Packet Camp Whatchawannabe TLC/Teen Camp NORTHWEST YMCA
CAMP WHATCHAWANNABE INFORMATION DATES & HOURS: Camp is open Monday- Friday each week from June 6th- August 18 th. Camp will be closed Friday, August 19 th for staff development. 7:00am-8:30am- Pre Camp- Included in your weekly rate! This is the designated drop off time. Campers will eat snack between 7:30a 8:30a and have Opening Ceremony at 9:00a. 9:00am-3:30pm- Camp Time This is the time camp activities and rotations will begin. We ask that parents have kids dropped off by this time each day. If not, parents will be responsible for taking their child to his/her group. Campers cannot be dropped off after 10:00am. 3:30pm-6:00pm- Post Camp- Included in your weekly rate! This is the designated pick up time. All campers will rotate through self-guided activities. If you need to pick up your camper prior to this time, please notify camp in advance. REGISTRATION FEE: All participants are required to pay a one-time $60 non-refundable camp registration fee. Discounts/Scholarship may not be applied to this fee. WEEKLY FEES: YMCA Member Rate- $120/per week (TLC) -$90/per week (Teen Camp) Non-Member Rate- $140/per week (TLC) - $115/per week (Teen Camp) Full weekly payments are due on the Saturday before camp. Weekly camp fee must be paid in full by the Monday camp begins or the space will be forfeited for camp that week. AGES: Day Camp is for children 5-12yrs old. Children over 12 years may qualify for our Teen Camps. (Teen Leadership Camp is for children in 6 th grade; Teen Camp is for children in 7 th, 8 th, & 9 th grade). For more information please contact Brenda Martinez at bmartinez@ymcafw.org. Weekly payment due dates: PAYMENT DETAILS DAY CAMP OPEN HOUSE Thursday, June 2 nd from 7:00-8:30pm at Lake Pointe Elementary! Join us for an informative open house! Parents and campers can meet the 2016 Camp Whatchawannabe staff, see camp, participate in camp activities, and ask any questions you may have about the program! 2
WEEKLY PAYMENTS: Due Dates: All Day Camp payments are due the Saturday prior to camp starting. Payments made after the due date will be assessed a $10.00 late fee. Any payments that are returned or declined will also be assessed a $25 fee. Drafts: All Day Camp payments must be set up on a credit/debit card draft in order to register for future weeks. Cancellations: No refunds will be given after the start of the camp week. Week Dates of Camp Payment due date Week 1 June 6-10 June 4 Week 2 June 13-17 June 11 Week 3 June 20-24 June 18 Week 4 June 27-July 1 June 25 Week 5 July 4-8 July 2 CLOSED July 4TH Week 6 July 11-15 July 9 Week 7 July 18-22 July 16 Week 8 July 25-29 July 23 Week 9 August 1-5 July 30 Week 10 August 8-12 August 6 YMCA FINANCIAL ASSISTANCE/ SCHOLARSHIP PROGRAM At the YMCA our goal is to ensure that no one is turned away from the YMCA due to their financial situation. The YMCA offers financial assistance to those who qualify. Applications are available at our YMCA branch. Please ask our staff for more details or visit our website! Week 11 August 15-18 CLOSED Aug. 19 August 13 www.northwestymcafw.org 3
DATES, THEMES & FIELD TRIPS: Week Dates Theme Field Trip Week 1 June 6-10 ROCKAPALOOZA June 8 th - Rock Climbing Wall June 10 th - Waterslide & Cookout Week 2 June 13-17 ADVENTURE TIME June 16 th - Fort Worth Zoo Week 3 June 20-24 LIGHTS CAMERA ACTION! June 24 th - Kids Who Care Theater Week 4 June 27-July 1 SLIME AND GRIME June 28 th & 29 th - HTHT Crazy Chemical Concoctions Week 5 July 4-8 MYSTERY WEEK @ NWYMCA July 6 th - Perot Museum Dallas *CLOSED July 4th Drop Off & Pick up at The Y! Week 6 July 11-15 WATER WARS July 13 th - Hawaiian Falls - Mansfield Week 7 July 18-22 DRAGON, KNIGHTS, & PRINCESS July 20 th & 21 st - Medieval Times - Dallas Week 8 July 25-29 HOLIDAY HOOPLA July 27 th - TBA Week 9 August 1-5 GAME ON Aug. 2 nd & 3 rd Altitude Trampoline Park Week 10 August 8-12 CAMP COMICON @ NWYMCA Drop Off & Pick up at The Y! Week 11 August 15-18 ALOHA TO SUMMER @ NWYMCA *CLOSED Aug 19th Drop Off & Pick up at The Y! Aug. 10 th & 11 th Main Event Aug. 17 th Family Picnic Aug 18 th Water Slide *Check camp calendar & communication board for updates & detailed information about field trips. FIELD TRIP REMINDERS: During weekly field trips, all campers must wear their current year s Day Camp t-shirt to camp. Campers receive shirts during their first week of camp. Unless requested, please do not allow your child to bring additional money to any field trips. All campers must arrive by 8:00am on field trip days in order to assure campers are accounted for and loaded on the bus properly. Campers are not allowed to be dropped off at a field trip location. If camper does not arrive on time, they will not be able to attend camp that day. All staff will attend field trips. Pack light during field trips unless campers are requested to bring additional items to camp. Campers usually have to carry their belongings with them on field trips. Bring a lunch! All field trips will require a sack lunch unless stated otherwise. 4
YMCA MEMBERSHIP ADVANTAGES Here is your potential childcare savings: Branch Family Membership Joining Fee $0 (waived) Camp Registration Fee $60 Camp Registration Fee Without Membership May Dues $65 Week 1 $120 Week 1 $140 Week 2 $120 Week 2 $140 Week 3 $120 Week 3 $140 Week 4 $120 Week 4 $140 July Dues $65 Week 5 $120 Week 5 $140 Week 6 $120 Week 6 $140 Week 7 $120 Week 7 $140 Week 8 $120 Week 8 $140 Week 9 $120 Week 9 $140 Aug. Dues $65 Week 10 $120 Week 10 $140 Week 11 $120 Week 11 $140 Total Fees: $1,575 Total Fees: $1,600 $60 In addition to your savings you could take advantage of the following: Free weights Group Exercise classes (Zumba, Spin, Body Pump etc.) Resistance Equipment Treadmills & Stationary bikes Cross trainers and elliptical Free Child Watch while you work out Free Wellness Consultations with a Personal Trainer Outdoor pool with lap lanes available Discounts on programs such as Summer Basketball & Swim lessons 5
DAY CAMP POLICIES AND WAIVERS Camper Name: Parents/Guardians please read and initial that you agree to these terms: CHECK IN/OUT Campers can be checked in between 7:00-8:30am daily. Parents must sign their campers into the camp each day. Campers dropped off after 8:30a will need to be taken to their group by the parent. Campers may be picked up between 4:00-6:00p. When leaving the program, children must be signed out by an authorized adult, and will not be permitted to leave the program area without the authorized adult being present. If campers need to be picked up early, advance notice must be given. Contact YMCA 817-237-7237, Lake Pointe 817-822-8504, Parkview 817-822-8866. ILLNESS In the case that your child becomes ill during the program, you will be contacted as soon as possible. If the parent/guardian is unable to be reached, the emergency contacts will be notified in the order listed on the enrollment form. It is the parent s responsibility to arrange for the camper to be picked up as soon as possible. MEDICATION POLICY Medication (including inhalers) must be submitted directly to the Camp Staff or the Camp Director in its original container that shows the date, name of the child, doctors contact information, directions for use, and quantity of dosage. All medication, with the exception of EpiPens and inhalers, will be kept in a locked first-aid kit and administered by YMCA Staff. Expired Medication will not be administered. PHOTOGRAPHY/ VIDEO RELEASE I, the undersigned, consent to the use of my child s likeness (photographic, non-photographic or otherwise), actions and appearance by the YMCA in connection with any publication, program or in any and all media, including the YMCA website, authorized by, made or published by the YMCA, and to the advertising and publicity in any and all media now known or hereafter devised. The results and proceeds of my services in connection with the photographs, tapes, films or drawings shall be and remain solely the property of the YMCA. LATE PICK-UP PENALTY Our camp closes at 6:00 pm. There is a grace period of 5 minutes. There is a late pickup penalty charge for those who pick up after 6:05 pm. The penalty is $1 per minute until the child is picked up. Children will be unable to attend Summer Day Camp until late fees are paid. PERSONAL BELONGINGS Personal belongings (Game Boys, Nintendo DS, cell phones, ipods, cameras, trading cards and other valuable items) cannot be brought to the program. YMCA staff will hold items not appropriate, based on their judgment. The YMCA is not, and cannot be held responsible for the loss or damage of any personal belongings. CCMS PARTICIPANTS As a CCMS participant, it is your responsibility to swipe your attendance card daily. If your child is absent, the missed swipes must be corrected the first day that your child is back in care. CCMS allows 3 absences and a 6 day back swipe option. Failure to comply with CCMS attendance policy will result additional fees (daily rate of $10 per day, per child) and/or dis-enrollment from the day camp program for any missed attendance swipes. PAYMENTS & ABSENCES Payments are to be made the week prior to your child s attendance in the program. Failure to make payments may result in your child not being able to attend the program. Weeks are not pro-rated and we do not make adjustments based on attendance. T-SHIRT/ FIELD TRIP POLICY As a safety precaution all campers must wear their current year s YMCA Day Camp t-shirt on all field trips. If your camper does not bring their t-shirt, you may bring it to them before we depart for our trip or purchase another one for $5.00. Field trips are subject to change with advance notice given. Campers will receive t-shirts during their first week of camp. These policies along with other YMCA policies and procedures are available in writing in your Day Camp Parent Handbook. Please be sure to obtain one of these upon registration or via our website at www.northwestymcafw.org. Parent Signature: Date: 6
YMCA CAMPER BEHAVIOR CONTRACT A high quality program can only take place in an orderly, mutually respectful, caring environment. Child guidance is a process where children take increasing responsibility for their own actions. At the YMCA, we take the happiness and safety of our participants seriously. Therefore, we work very hard at creating a safe and fun environment. Along with our efforts, we need the children to help us by following some simple rules. Below is our behavior agreement. Please read this Behavior Contract with your child (also provided in your Parent Handbook) and ensure they understand our camp s behavior policies. I will listen to the staff and follow directions. I will respect other people s belongings by not touching/ using their stuff without permission. I will respect all property and help clean personal messes and assist in leaving areas better than I found it. I will respect other people s personal space by keeping my hands and feet to myself. I will respect other people s feelings by having a positive attitude when talking to them. I will act in a caring way, and I will not hit, fight, bite, tease, harass or bully others. I will use my indoor voice when speaking inside. I will use appropriate language, which does not include swear words or negative remarks (i.e. shut up, stupid, dumb ). Before leaving the room or program space, I will ask a staff member for permission. I will never leave an area without adult supervision. Not abiding by these rules may result in suspension and/ or termination from the program. All incidents will be handled on a 3 incident system, except hitting, fighting, and inappropriately touching another camper. Hiting, fighting, and inappropriately touching another camper will be an immediate 1-3 day suspension from the program. All other incidents will be handled as follows: 1 st Incident= Verbal Warning 2 nd Incident= Written Warning & Parent Contact 3 rd Incident= 1 to 3 day suspension & Parent Meeting More then 3 Incidents will be subject to camper dismissal from the program. YMCA staff and management reserve the right to dismiss/dis-enroll a child from the day camp program if the child s behavior is disruptive to the program and/or compromises the safety of themselves, other children and/or staff. Children suspended/terminated from the program will not qualify for a refund. By signing I agree to partner with the YMCA in making my child s Day Camp experience positive and safe for all children and families involved. Parent Signature: Date: 7
2016 YMCA CAMP ENROLLMENT FORM PARTICIPANT INFORMATION Child s Name School Grade in Fall Birth Date Age T-Shirt Size YS YM YL AS AM AL AXL Mailing Address City Zip Home Phone Male Female PRIMARY/EMERGENCY CONTACT Name Birth Date Relationship to Child Primary Custody Mother Father Grandparent Other Home Address City Zip Place of Employment Email Home Phone Cell Phone Work Phone OTHER PERSONS AUTHORIZED TO PICK UP CHILD Name Relationship Phone Name Relationship Phone CAMP LOCATION: Lake Pointe Elementary (5501 Park Drive) Teen Leadership Camp (TLC 6 th Grade) June 6 th - 10 th Rockapalooza June 13 th - 17 th Adventure Time June 20 th - 24 th Lights Camera Action! June 27 th - July 1 st Slime and Grime July 4 th - 8 th Mystery Week @ NW YMCA Teen Camp (7 th, 8 th, & 9 th Grade) July 18 th 22 nd Dragon, Knights & Princess July 25 th - 29 th Holiday Hoopla August 1 st - 5 th Game On August 8 th - 12 th Camp Comicon @ NW YMCA August 15 th - 18 th Aloha to Summer @ NW YMCA July 11 th - 15 th Water Wars ENROLLMENT AGREEMENT (INITIAL EACH) ENROLLMENT/PAYMENT AGREEMENT I understand that I am responsible for paying every week my child is enrolled in the Summer Day Camp Program. Payment due dates are located in the parent handbook. The YMCA of Metropolitan Fort Worth does not prorate for holidays, vacations, or days your child does not attend. PHOTOGRAPHY I understand that my child may be photographed, videotaped, and/or interviewed for the purpose of YMCA promotional use. TRANSPORTATION I give consent for my child to be transported by the YMCA of Metropolitan Fort Worth for field trips or emergency care. HANDBOOK/CODE OF CONDUCT I have received and read a copy of the YMCA Camp Handbook. I have also received and read the Parent and Camper Code of Conduct. IMMUNIZATION CONFIRMATION: Participant is current with all necessary immunizations required by TDSHS, the county public health office, and local school district (check one): YES NO or Immunization History (include dates): Tetanus Booster Tuberculin (TB) MMR DPT *Please initial here if you choose to not immunize your child for personal or religious reasons. Parent/Guardian Signature Date 8
2016 YMCA CAMP ENROLLMENT FORM Child s Name Age Height Weight Hair Color Eye Color Primary Care Physician Phone No. Dentist Phone No. Does your child have any allergies to food, medications, or insect bites? If so, what are the allergies and what are the treatments for them? Will this treatment be left in the YMCA First-Aid box? Yes No Does YMCA staff have permission to administer treatment if an allergic reaction occurs? Yes No Is your child currently taking any medications? Yes No Name of Medication: Dosage: Times to Administer: Instructions to administer medication: *Any medicine that needs to be administered must be in original packaging and given to YMCA staff prior to camp attendance. Medical History: (Please include any information that would affect diagnosis or treatment.) Does your child have any special needs? Yes No If so, what are they? MEDICAL INSURANCE INFORMATION Company Name Address Phone No. Policy No. Group No. Policy Holder Name In the event that I am unavailable to answer for my child, I hereby give permission to the YMCA of Metropolitan Fort Worth YMCA staff to seek emergency medical treatment for my child. Unless noted otherwise, your child will be taken to Cook s Children s Hospital at 801 7 th Avenue, Fort Worth, Texas. YMCA OF METROPOLITAN FORT WORTH RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT The YMCA of Metropolitan Fort Worth will not assume responsibility for any injury incurred while participating in athletic events, childcare programs, parent/child event and outings, special events, sports programs, or any related YMCA sponsored activity. Certain risks of injury are inherent during participation in these programs and events. Nor will the YMCA of Metropolitan Fort Worth be responsible for any lost or stolen items while members and/or program participants are using the YMCA facilities, on YMCA premises, or on off-site YMCA program locations. I, the undersigned for myself and my heirs, do hereby release the YMCA of Metropolitan Fort Worth and its employees and agents from any and all claims for injury, loss, or damage I may suffer as a result of my participation. This includes any injury caused by negligence, if any, of the YMCA, its officers, employees, agents, volunteers, or the negligence of anyone else. I give permission to the YMCA of Metropolitan Fort Worth to use photographs, film footage, or tape recordings, which may include my image or voice, for purposes of promoting or interpreting YMCA programs for no compensation. The undersigned has read and voluntarily signs the release and waiver of liability and indemnity agreement, and further agrees that no oral representations, statements, or inducement apart from the foregoing written agreement have been made. Parent/Guardian Signature Date 9
Northwest YMCA Authorization to Draft Automatically Site Location: Member #: I authorize the Northwest YMCA to charge my credit card, or bank card for my YMCA Afterschool program. I understand that I am responsible for having the agreed upon funds available for this draft. Select 1 of the Following: (Save 5% by choosing monthly automatic draft) Monthly 1st OR 15th Semi Monthly 1 st & 15 th Weekly Friday s OR Saturday s **Note that monthly drafts are not exactly 4 weeks of care, as every third month has a 5 th week. If during a month you choose to use a week of vacation, you will need to turn in a vacation form to the Business Office 2 weeks prior to your draft date, otherwise your draft will be for the full amount, and you would receive a credit on the next months draft. ** Please note a $25.00 Fee will be charged for drafts that are returned or declined. You may also be charged a $10.00 Late Payment Fee for your child s week of care. Name of child(ren): Parent/Guardian Name: Primary Phone: Parent/Guardian Email: Credit Card Type: Last 4 digits of card: Name as it appears on card: Exp: Zip: Signature: Date: NORTHWEST YMCA 10 5315 Boat Club Road, Fort Worth, TX 76135 817-237-7237 www.northwestymcafw.org