STATEN ISLAND YMCA Summer Camp 2015
VOTED BEST SUMMER DAY CAMP ON STATEN ISLAND BY SILIVE.COM READERS!
WE’RE READY FOR A SUMMER OF GROWTH AND FUN! Dear Parents/Guardians, We welcome all of our returning and new campers to our 2015 Summer Camp Programs. We are excited to embark on another summer of fun and learning with you and your children. From sports and swimming to arts and culture, YMCA camps span a broad range of interests, while focusing on developing young minds and bodies. In 2014 the YMCA served over 10,000 campers in communities throughout New York City. We are proud that in our borough the Staten Island YMCA will be able to engage your child in a summer of new friendships, skills and exploration. Thank you for choosing our Y summer camp. We look forward to getting to know your camper! Sincerely, Staten Island YMCA Day Camp Staff South Shore YMCA
Robert Palmeri, Camp Director, Day Camp at Pouch Camp - rpalmeri@ymcanyc.org Christopher Ostrow, Camp Director, South Shore Stars - costrow@ymcanyc.org Bonnie Schiuma, Early Childhood Camp Director - bschiuma@ymcanyc.org Michael Creegan, Swim Camp Director - mcreegan@ymcanyc.org
Broadway YMCA
James Zito, Camp Director, Broadway Summer Fun - jzito@ymcanyc.org Allison Sicuranza, Early Childhood Camp Director - asicuranza@ymcanyc.org Romulus Staton, Swim Camp Director - rstaton@ymcanyc.org
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In 1885 the YMCA helped to invent summer camp to provide children with positive and fun experiences that build confidence and new friendships. YMCA camp staff have served as positive role models for generations of campers and helped build future leaders. The centerpiece of YMCA camps are activities that excite and engage your child, giving them a summer filled with fun and adventure. Whether learning a new sport, discovering arts and culture or exploring the best of New York City, YMCA Summer Camps offer an opportunity to build wonderful lifelong memories and a feeling of community that will last beyond the summer. “She loves camp and doesn’t want to leave at the end of the day. I feel good knowing she is safe and happy while I am at work” - YMCA Summer Camp Parent
Each of our camps is accredited by the American Camping Association (ACA) and our staff go through rigorous training to ensure the safety and positive experience of each child.
PROGRAMS
OUR CAMP LOCATIONS
Our YMCA camps have something unique to offer for every age group from our Early Childhood to Kindercamp Programs to Counselor-In-Training. Our goal is to meet your child’s developmental needs and provide a foundation for continued learning during the summer months.
The Outdoor Adventure Day Camp operates out of Pouch Camp, located at 1465 Manor Road, Staten Island, NY 10314.
Alongside sports, swimming and arts programs, the YMCA offers academic enrichment that is infused throughout the camp day. These programs include summer reading, journal writing and science activities. Each session you will be given a schedule of activities so you can follow your child’s course of learning and adventure over the summer.
We also offer programs at our Broadway YMCA located at 651 Broadway, Staten Island, NY 10310, and our South Shore YMCA, 3939 Richmond Avenue, Staten Island, NY 10312. Our Summer Sleepaway Camp is for youth ages 6-16 from all over the world and is located outside NYC in Huguenot, NY. There is a Counselor-In-Training (CIT) program for 16 year olds, as well as two villages, McAlister (ages 6-12) and Talcott (ages 12-15), that are located on 1,150 acres of forests and lakes.
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WHAT PARENTS NEED TO KNOW ABOUT DAY CAMP
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DATES & HOURS OF OPERATION Staten Island YMCA Summer Day Camp is an eight-week program that runs from June 29th - August 21st. Camp hours are from 9:00 am - 4:00 pm Extended Day hours are from: 7:15 am - 9:00 am or 4:00 pm - 6:15 pm
DAY CAMP OPEN HOUSES AT OUR BRANCHES AND POUCH CAMP •
Saturday, February 28th: 10:00 am - 3:00 pm
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Saturday, April 25th:
10:00 am - 3:00 pm
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Saturday, May 16th:
10:00 am - 3:00 pm
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Saturday, June 13th
10:00am - 3:00 pm
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Saturday, June 20th
10:00am - 3:00 pm
REGISTRATION MADE EASY •
Register at Pouch Camp during our Open Houses or Parent Orientation.
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Visit the Broadway or South Shore YMCA’s Member Services Desk.
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Select your camp.
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Submit a $100 deposit per session you would like your child to attend. This will hold your child’s spot for the designated sessions of camp.
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Take advantage of the 10% Early Bird discount by paying off your entire balance by May 16, 2015.
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Submit your child’s medical form completed with parent information and signature as well as the doctor’s information, signature and stamp as soon as possible. It’s a good idea to keep extra copies of the medical form for your records.
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Submit two passport size photos of your child.
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The YMCA accepts all major credit cards or you may sign up for automatic billing to ensure payments are made on time with no late fees incurred.
FINANCIAL ASSISTANCE The YMCA of Greater New York awards scholarships to campers based on the family’s annual income. Pick up a scholarship application at the Branch or download an application online at ymcanyc.org.
DAY CAMP DISCOUNTS •
10% Early Bird Discount for those who register before the end of the day on Saturday, May 16th and have paid in full.
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10% Sibling Discount is available for all siblings of the first child registered at full price.
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Discounts cannot be combined and are available only on the cost of camps per session, not on extended day or transportation fees.
GOVERNMENT & UNION VOUCHERS* We accept ACD, HRA, TWU Local 100, and 1199 SEIU vouchers. You must have your confirmation letter with you at the time of registration. (*Participation varies by Branch.)
REFUNDS AND CREDITS If your child cannot attend camp for a period of time paid, you may submit a request for credit along with documentation to the Camp Director. Credits can be used for camp or other programs throughout the year. Any credit requests will be submitted to the Camp Director and will be granted under the discretion of the Youth and Family Director. All requests should be made prior to the start of the session.
PARENT ORIENTATION Attendance at one Parent/Guardian orientation meeting is mandatory for Outdoor Adventure Camp. The meetings will be held at Pouch Camp on the following dates and times: June 11th, June 18th & June 25th at 5:00 pm
CAMP GEAR Each camper will receive two t-shirts and a camp bag. Swim caps will be provided on the camper’s first day of swim. Camp t-shirts must be worn every day. Additional shirts can be purchased for $10 each or three for $25. Swimmers must have a towel, swimsuit, change of clothing, water shoes and a plastic bag for wet swim gear.
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EXPLORE! PLAY!
GROW!
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SUMMER DAY CAMP OUTDOOR ADVENTURE DAY CAMP at Pouch Camp Ages 5-13 Kindercamp at our Outdoor Adventure Camp is designed for children entering into kindergarten in September 2015. Structured day camp activities support the transition to kindergarten by building social and emotional skills in a fun and nurturing environment; including a focus on classroom structure, transitional activities, and group play. Kindercampers will participate in instructional swimming, indoor and outdoor physical fitness, interactive science, literacy activities, theme-based arts and crafts, and local outings. To prepare our young campers for their transition into kindergarten and develop their skill sets and comfort level with city travel, Kindercampers will participate in one field trip by bus each session. Traditional Day Campers (ages 6-11) will engage in activities that enhance their social and emotional skills, help keep their academics on track, keep them physically active and challenge them to learn new things. They will have the opportunity to make new friends and take exciting trips throughout New York City. Campers will participate in a wide range of sports, instructional swimming, arts and crafts, and weekly themed days such as Crazy Hat Day. In addition, campers will engage in a variety of science, technology, engineering and math activities through each session. Traditional day campers will be divided into age groups with children no more than 1-2 years apart in age. Day camp activities are designed to help children retain and build upon the academic skills they have developed during the school year. Research has shown that children can lose a half grade of learning over the summer months. To help mitigate summer learning loss, the YMCA offers interactive programs such as Book of the Week which gives campers the opportunity to read books and participate in facilitated discussions. In addition, activities such as journaling and ageappropriate science experiments will expand their literacy, math and science skills, and promote their ability to critically think. Field trips to museums and science centers will link to the camp-based activities and maximize educational enrichment. We also offer a Middie Camp at our Outdoor Adventure Camp for young people (ages 12-13) who are currently enrolled in middle school. It is designed to immerse campers in a variety of fun
activities that will keep them active, learning and engaged during the summer months. Through a variety of hands-on activities, campers will explore science, the arts, and sports, all with a focus on building skills, confidence and strong peer relationships. Outdoor Adventure is an eight-week camp program that runs from June 29th - Aug. 21st. *Lunch must be brought from home every day. *Cost per 2 week session for Outdoor Adventure Day Camp at Pouch Camp: # DAYS MEMBER: NON-MEMBER 5 DAYS $558 $620 3 DAYS $352 $383 Extended day fees per 2 week session: 5 DAY AM: $189 PM: $189 BOTH: $278 3 DAY AM: $116 PM: $116 BOTH: $173 CAMP TRANSPORTATION: Per 2 week session; available for 5-day campers. Bus stops will be available at convenient, designated stops for faster transportation. One-way AM or PM: $300 Both AM & PM: $400
COUNSELOR-IN-TRAINING Ages 14-16 The Counselor-In-Training program at our Outdoor Adventure Camp is for 14-16 year olds enrolled in high school. The program motivates teens through hands-on programming that fosters development of educational and career goals. Along with sports, arts and cultural programs, teens will have the opportunity to participate in college and career readiness programs. Field trips will allow teens to explore some of New York City’s key landmarks and cultural institutions. Counselor-In-Training is a 5-day-a-week, eightweek camp that runs from June 29th - Aug. 21st. *Cost per 2 week session for the Counselor-InTraining Program: Member: $367 Non-Member: $430
For more information about our Outdoor Adventure Day Camp or CIT program, contact Camp Director Robert Palmeri at rpalmeri@ymcanyc.org or 718-2273200 ext. 1330.
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BROADWAY SUMMER FUN
Each week features a different theme revolving around popular literature, science and more.
Ages 7-12
Broadway Summer Fun is an eight-week camp program that runs from June 29th - Aug. 21st.
at the Broadway YMCA
For working parents, our Broadway YMCA is ready to provide a summer filled with awesome (and structured) games and activities, all led by welltrained, qualified staff. This YMCA summer camp is the perfect place to meet new friends, participate in sports and creative arts, explore science and technology, swim, learn about nature, build core values, apreciate culture and diversity and - of course - have fun. This camp allows children to explore their creative talents as they make new friends while dabbling in art and science, participating in trips and playing their favorite sports. Each day in camp is an adventure that teaches campers the four core YMCA values of Caring, Honesty, Respect and Responsibility.
SOUTH SHORE STARS
at the South Shore YMCA Ages 7-12 Looking for a place where your child can have fun and learn over the summer? Look no further than South Shore Stars. The camp offers a variety of supervised, fun activities including arts and crafts, health and fitness, group games, science and nature, music and drama, sports and more. Each session features a new theme to spark your camper’s curiosity and broaden their horizon as they explore art, music, science and the natural world through hands-on learning and camp trips. Campers also will learn to express themselves in a safe, bully-free environment while developing strong citizenship and integrity with the help of our four core values: Caring, Honesty, Respect and Responsibility.
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Hours for Broadway Summer Fun are 9:00am4:00pm. Lunch must be brought from home every day. *Cost per 2 week session for Broadway Summer Fun: # DAYS MEMBER: NON-MEMBER 5 DAYS $515 $593 3 DAYS $315 $362 2 DAYS $215 $247
For more information on Broadway Summer Fun, contact Camp Director James Zito at jzito@ymcanyc.org or 718-981-4933.
South Shore Stars will give your camper a variety of new experiences along with memories and lifelong friendships. South Shore Stars is an eight-week camp program that runs from June 29th - Aug. 21st. Hours for South Shore Stars are 9:00am-4:00pm. Lunch must be brought from home every day. *Cost per 2 week session for South Shore Stars: # DAYS MEMBER: NON-MEMBER 5 DAYS $515 $593 3 DAYS $315 $362 2 DAYS $215 $247
For more information on South Shore Stars contact Camp Director Christopher Ostrow at costrow@ymcanyc.org or 718-227-3200.
SWIM CAMP
at the South Shore and Broadway YMCAs Ages 5-13 Our Swim Camp helps children and teens develop important swimming skills and a lifetime love of the water, while instilling values around water safety and responsibility. Swim Camp groups are divided by swimmer ability. The program goals and philosophies of Swim Camp are: • Swimmers are given an opportunity to build swimming skills. • Stroke development and training is tailored by age and skills level. • Swim campers participate in core traditional camp activities. • Activities and interactions emphasize building self-esteem and self-confidence.
*Cost per 2 week session for South Shore Swim Camp: Member: $368 Non-Member: $420
For more information on Swim Camp at the South Shore YMCA, contact Swim Camp Director Michael Creegan at mcreegan@ ymcanyc.org or 718-227-3200. Swim Camp at the Broadway YMCA is a twohour camp that runs from June 29th - July 10th. Campers ages 5-8 will have swim instruction from 12:15pm to 2:15pm; campers ages 9-13 will have swim instruction from 1:15pm-3:15pm. *Cost per 2 week session for Broadway Swim Camp: Member: $263 Non-Member: $315
Swim Camp at the South Shore YMCA is a threehour camp that runs from 12:15pm-3:15pm from June 29th - Aug. 21st.
For more information on Swim Camp at the Broadway YMCA, contact Swim Camp Director Romulus Staton at rstaton@ ymcanyc.org or 718-981-4933.
COMBO SWIM CAMP
SPORTS CAMP
at Outdoor Adventure Camp and the South Shore YMCA Ages 5-13 This camp combines our Outdoor Adventure and Swim Camps. Your camper will arrive at Outdoor Adventure Camp at 9:00am where he or she will spend the first half of their day. Your camper will be transported by bus to Swim Camp and returned to Outdoor Adventure for regular dismissal each day at 4:00pm. Campers will be divided into skill levels. This camp runs from June 29th - Aug. 21st. *Cost per 2 week session for Combo Swim Camp: Member: $667 Non-Member: $720
For more information on Combo Swim Camp, contact Swim Camp Director Michael Creegan at mcreegan@ymcanyc.org or 718-227-3200.
at the South Shore YMCA Ages 7-12 Our Baseball and Basketball camps are designed to enhance various sports skills and fundamentals. Campers learn rules and skills while practicing their techniques as well as teamwork and good sportsmanship. Camp staff have a background in coaching their respective sports. Baseball Camp runs during Session 3 and Basketball Camp runs during Session 4 from 9:00am-3:00pm. Lunch must be brought from home every day. *Cost per 2 week session for Sports Camp: Member: $315 Non-Member: $368
For more information on Sports Camp, contact Camp Director Christopher Ostrow at costrow@ymcanyc.org or 718-227-3200.
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A SUMMER OF FUN
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EARLY CHILDHOOD CAMP
at the South Shore and Broadway YMCAs Ages 3-6 The Staten Island YMCA’s Early Childhood Day Camp program - Camp Broadway at the Broadway YMCA and Camp Rainbow at the South Shore YMCA - focuses on providing a safe, nurturing environment where children can thrive. Kids have fun while building self-confidence, appreciating team work and gaining independence. These camps offer air-conditioned classrooms, outdoor playgrounds, indoor pools and gyms. Children are divided into the following age groups: 3-4 year olds and 5-6 year olds. Our primary goal is for each child to develop a positive self-image. The staff is made up of carefully selected teachers and assistant teachers who will provide guidance and supervision so that each child can achieve self-confidence and awareness. Children are encouraged to develop self-help skills that foster independence and a positive self-image. Our campers participate in a wide variety of activities, including arts and crafts, swim, gym, music and organized games. Each week will feature a special theme and all activities are geared to meet individual needs, abilities and interests. This camp offers half-day and full-day options.
Day Camp Hours: Full Day: 8:45am-3:15pm Half Day AM: 8:45am-11:30am Half Day PM: 12:30pm-3:15pm Extended Hours AM: 7:30am-8:45am Extended Hours PM: 3:15pm-6:00pm *Cost per 2 week session for Early Childhood Camp: # DAYS MEMBER: NON-MEMBER 5 FULL $441 $473 3 FULL $331 $362 2 FULL $242 $263 5 HALF $300 $362 3 HALF $184 $215 2 HALF $137 $168 Extended day fees per 2 week session: 5 DAY AM: $63 PM: $110 BOTH: $147 3 DAY AM: $53 PM: $90 BOTH: $115 2 DAY AM: $42 PM: $63 BOTH: $84
For more information on Camp Broadway at the Broadway YMCA, contact Early Childhood Camp Director Allison Sicuranza at asicuranza@ymcanyc.org or 718-981-4933. For more information on Camp Rainbow at the South Shore YMCA, contact Early Childhood Camp Director Bonnie Schiuma at bschiuma@ymcanyc.org or 718-227-3200.
* Please note: Campers must be completely potty trained to attend Camp Broadway or Camp Rainbow. For full-day campers, lunch from home is required; snacks are included. This camp runs from June 29th-Aug. 21st. NEW! Transition Camp: Please join us for this fiveday camp that runs from June 22nd-June 26th. Please check with your branch for complete details. *Cost for Transition Camp: Member: $220 Non-Member: $236
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2015 SUMMER DAY CAMP SESSIONS AND FEES CAMP OFFERINGS (AGES 3-16) CAMP SESSIONS Session Session 1 Session 2 Session 3 Session 4
Start Date June 29, 2015 July 13, 2015 July 27, 2015 August 10, 2015
End Date July 10, 2015 July 24, 2015 August 7, 2015 August 21, 2015
Payment Due Date June 15, 2015 June 29, 2015 July 13, 2015 July 27, 2015
CAMP FEES PER SESSION (every two weeks) Payment in full for each session is due prior to session start date. CAMP
AGES
SESSION
# DAYS PER WEEK
MEMBER
NONMEMBER
EXTENDED DAY & TRANSPORTATION
5-13
SESSION 1 SESSION 2 SESSION 3 SESSION 4
5 FULL 3 FULL
$558 $352
$620 $383
5 DAY AM: $189 5 DAY PM: $189 5 DAY AM & PM: $278 3 DAY AM: $116 3 DAY PM: $116 3 DAY AM & PM: $173 BUS AM: $300 BUS PM: $300 BUS AM & PM: $400
COUNSELORIN-TRAINING
14-16
SESSION 1 SESSION 2 SESSION 3 SESSION 4
5 FULL
$367
$430
Not Available
BROADWAY SUMMER FUN OR SOUTH SHORE STARS
7-12
SESSION 1 SESSION 2 SESSION 3 SESSION 4
5 FULL 3 FULL 2 FULL
$515 $315 $215
$593 $362 $247
Not Available
SOUTH SHORE Y SWIM CAMP
5-13
SESSION 1 SESSION 2 SESSION 3 SESSION 4
5 DAYS
$368
$420
Not Available
BROADWAY Y SWIM CAMP
5-13
SESSION 1
5 DAYS
$263
$315
Not Available
COMBO SWIM CAMP
5-13
SESSION 1 SESSION 2 SESSION 3 SESSION 4
5 DAYS
$667
$720
See Outdoor Adventure Day Camp Options
SPORTS CAMP
7-12
SESSION 3 (Baseball) SESSION 4 (Basketball)
5 DAYS
$315
$368
Not Available
3-6
Transition Camp-5 FULL ONLY SESSION 1 SESSION 2 SESSION 3 SESSION 4
5 FULL 3 FULL 2 FULL 5 HALF 3 HALF 2 HALF
$220 $441 $331 $242 $300 $184 $137
$236 $473 $362 $263 $362 $215 $168
5 DAY AM: $63 5 DAY PM: $110 5 DAY AM & PM: $147 3 DAY AM: $53 3 DAY PM: $90 3 DAY AM & PM: $115 2 DAY AM: $42 2 DAY PM: $63 2 DAY AM & PM: $84
OUTDOOR ADVENTURE DAY CAMP AT POUCH CAMP
CAMP RAINBOW OR CAMP BROADWAY (EARLY CHILDHOOD CAMP)
Payment Information Check
Credit Card Bank Draft Money Order Credit Card #_______________________________________________________________ Exp. Date_____________________________ Bank Name____________________________________________________ Account #____________________________ Routing #____________________________ Authorized Signature:______________________________________________________________________________________________
PARENT AGREEMENT
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I, the undersigned, give permission for my child to participate in the camp for the day he/she attends. I am aware that a completed medical form signed by a physician is required before my child may begin camp. In addition, I am fully aware that to reserve a space, I must make a deposit of $100 per two-week session and submit a registration form. I am fully aware that should my child change camps after the start of the session there is a $25 change fee. I fully understand and approve of my child being photographed for Staten Island YMCA publicity. Lastly, I fully understand that my child is responsible for his/her possessions. I have read, signed, and agreed to the registration requirements. Signature of Parent/Guardian____________________________________________________________________________________________________ Date:__________________________________ There is a non-refundable $100 deposit per session per child which is applied to session fee.
CAMP REGISTRATION FORM Branch:________________________________ Camp Site:___________________________________ Camp Type:_____________________________________________
CAMPER INFORMATION Child’s Name__________________________________________________________________________________________________ Age_______________________________ D.O.B.________________________ Gender_______________ Grade in September 2015_______________ School____________________________________ Mailing address______________________________________________________________________________________________ Apt #_____________________________ City______________________________________________________________________ State_______________________________ Zip________________________________ Home Phone (________)_____________________________________ Email Address_____________________________________________________________________ My child will: Be Picked Up Walk home (Only 10 yrs. or older, please sign bottom of page) T-Shirt Size Child: S M L XL Adult: S M L XL
PARENT/GUARDIAN INFO Name of Parent/Guardian Registering child________________________________________________ Home Phone_______________________________ Work Phone (_______)__________________________ Cell Phone (_______)___________________________ Email__________________________________________ Name of Parent/Guardian_______________________________________________________________________ Home Phone_______________________________ Work Phone (_______)__________________________ Cell Phone (_______)___________________________ Email__________________________________________
EMERGENCY CONTACT INFOPlease list two (2) contacts on this form to be used if the parents/guardians cannot be reached Name_____________________________________________ Relation_____________________________________ Home Phone_________________________________ Work Phone_____________________________________ Cell Phone__________________________________ Name_____________________________________________ Relation_____________________________________ Home Phone_________________________________ Work Phone_____________________________________ Cell Phone__________________________________
PHYSICIAN INFO Name_______________________________________________________ Telephone Number (______)_______________________________________________________ Address____________________________________ City__________________________________ State_______________ Zip_____________________________________
AUTHORIZATION/CONSENT EMERGENCY AUTHORIZATION: I understand that in the event of an emergency affecting my child while participating in a YMCA program, a designated employee of the YMCA will attempt to contact me and inform me as soon as possible. In the event I cannot be reached, I hereby give permission for my child to be treated or hospitalized by a licensed physician or hospital selected by the YMCA. ________________________________________________________________________ ____________________________________________________________________________ Parent/Guardian Name Parent/Guardian Signature _____________________________________________________________________________________________ _______________________________________________________ Participant Signature Date
PERMISSION FORM I hereby grant permission for my child to use all equipment and participate in all activites of the Staten Island YMCA. I hereby grant permission for my child to leave the Staten Island YMCA premises, under proper supervision of the Staten Island YMCA staff, for neighborhood walks, park activities and field trips. It is my understanding that these trips will be taken over the camp session without further consent from me. ________________________________________________________________________ ____________________________________________________________________________ Child’s Name Camp Type ____________________________________________________________________________________________ ________________________________________________________ Parent/Guardian Signature Date
AUTHORIZED PICK-UP FORM
The following individuals are 18 years old or older and are allowed to pick up my child from Staten Island YMCA Programs:
Name
Relationship
Phone Number
Parent/Guardian
I understand that no one else will be allowed to pick up my child unless I notify Staten Island YMCA staff in advance in writing. This person will be asked for their photo ID for verification.
___________________________________________________________________________________________ Parent/Guardian Signature
______________________________________________________ Date
UNESCORTED DISMISSAL AUTHORIZATION My child is ten years of age or older and may go home without an escort at the end of the day. ____________________________________________________________________________________________ _______________________________________________________ Parent/Guardian Signature Date
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STATEN ISLAND YMCA MEDICAL FORM
(This side to be filled in by parent before presentation to physician) Please submit both pages 14 and 15 ____________________________________ __________________________ _____/____/____ M___ F___ ___________________________ Child’s Last Name First Name Date of Birth Sex Name of program Home Address:__________________________________________________________________ Phone____________________________________ Parent or Guardian_____________________________________________________________ Phone____________________________________ Place of Employment Father (Guardian)____________________________________ Phone____________________________________ Place of Employment Mother (Guardian)___________________________________ Phone____________________________________ In case of emergency, notify:_________________________________________________ Phone____________________________________ If Parent or Guardian is not available in an emergency, please notify: 1.____________________________________________________________________ Phone__________________________________________________ 2.____________________________________________________________________ Phone__________________________________________________ Important: Has this camper been exposed to any communicable disease during the three weeks prior to attendance?____Yes ____No If yes, please state type of exposure:___________________________________________________________________________________ HEALTH HISTORY (Circle, giving approximate dates below) Rheumatic Fever Diabetes Allergies to: Hay Fever Penicillin Seizures Asthma Poison Ivy Other Drugs Chicken Pox Insect Stings Food Dates___________________________________________________________________________________________________________________________ Other Past Illnesses_________________________________________________________________________________________________________ Operations or Serious Injuries & Dates_________________________________________________________________________________ Hospitalization (Dates)______________________________________________________________________________________________________ Chronic or Recurring Illness_______________________________________________________________________________________________ Any specific activities to be encouraged?______________________________________________________________________________ Conditions that require activity to be restricted?_____________________________________________________________________ Permissions for all program activities unless otherwise noted by Dr.____________________________________________ Appliance worn (glasses, contacts, etc.)________________________________________________________________________________ Medication taken_____________________________________________________________________________________________________________ Suggestion from Parent/Guardian________________________________________________________________________________________ CONSENT FOR EMERGENCY MEDICAL TREATMENT I do hereby give authority to the Staten Island YMCA Summer Camp staff to obtain necessary emergency medical treatment for my child with the understanding that the family will be notified as soon as possible. NAME_________________________________________________ SIGNATURE________________________________________________________ RELATIONSHIP______________________________ DATE________________ TELEPHONE_______________________________________ Department of Health and Mental Hygiene - The City of New York - Bureau of Food Safety and Community Sanitation
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STATEN ISLAND YMCA MEDICAL FORM (To be filled out by your physician) Please submit both pages 14 and 15
The purpose of this health record is to provide the staff with pertinent information which will help to serve the needs of this child in Summer Camp.
IMMUNIZATION HISTORY This is a record of dates of basic immunizations and most recent booster doses.
Type Date DtaP, DTP or TD Polio MMR Hem. Influenza Type B Hepatitis B Varicella Pneumococcal Conjugate (PCV) Other (Specify):
Date
Date
Date
Date
MEDICAL EXAMINATION To be filled out by licensed physician. Examination is acceptable when performed no more than 6 months prior to arrival at camp. Codes: S = Satisfactory X = Not Satisfactory (Explain) 0 = Not Examined General Appearance_________________________________________________________________________________________________________ Height____________ Weight____________ Blood Pressure____________ Hgb. Test (Date)_________________________ Urinalysis (Date)____________ Eyes____________ Vision____________ w/Glasses________________________________ Posture & Spine____________ Throat/Tonsils____________ Heart____________ Ears___________________________ Hearing____________ Extremities____________ Feet____________ Lungs____________ Skin___________________ Nose___________ Teeth___________ Hernia___________ Abdomen___________ Genitalia____________________ Neurological Findings_______________________________________________________________________________________________________ Describe Abnormal Finding and/or Handicapping Conditions_______________________________________________________ Has child ever received products containing horse serum?_________________________________________________________ Allergy (please specify)_____________________________________________________________________________________________________ Recommendations and restrictions while in camp____________________________________________________________________ Special Diet___________________________________________________________________________________________________________________ Special Medicine (dose, route of administration, when it should be administered)____________________________ __________________________________________________________________________________________________________________________________ Is parent/guardian sending special medicine?_________________________________________________________________________ Swimming_______________________________________________ Activity Restriction__________________________________________ General appraisal_____________________________________________________________________________________________________________ I have examined the person herein described, reviewed his/her health history and it is my opinion that he/she is physically able to engage in Summer Day Camp, except as noted above. ___________________________________________M. D. Examining Physician (signature)
Telephone_________________
_________________________________________________________________ Physician’s Name (please print)
Address__________________________________
Date of Examination___________________________________
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SAFE. OVERNIGHT. ADVENTURES.
The New York YMCA Camp is located 86 miles outside of NYC on 1,150 forested acres. We are a safe, inclusive and diverse camp community in which children can develop friendships, lifelong skills and cherished memories. Programs offered at New York YMCA Camp are Summer Sleepaway Camp, Specialized Summer Sports Camps (Gymnastics, Rhythmic Gymnastics & Power Tumbling, Volleyball, and Judo), Day Camp for Hudson Valley residents, Outdoor Education, customizable Retreat Groups, and Special Retreat Weekends (Women’s Wellness Weekend, Family Camp). For more information on any of these programs please call 877-30-YCAMP or visit our website at www.nyycamp.org.
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STATEN ISLAND YMCA
SLEEPAWAY CAMPS FAMILY CAMP Summer 2015 | September 4 - 7
Winter 2015 | February 13 - 16
Strengthen family bonds and have fun at our all-inclusive Summer or Winter Family Camps. Enjoy a weekend with sports, crafts, and special themed activities. In the summer, have fun in the sun on our beautiful beaches where families can swim, tube, and water-ski. When winter gives us snow, XC-skiing, snow-shoeing, and snow-tubing are always family favorites.
STATEN ISLAND YMCA SUMMER SLEEPAWAY CAMP Have an unforgettable summer at New York’s YMCA Camp! Our Summer Sleepaway Camp is for youth ages 6-16 from all over the world and is located outside NYC in Huguenot, NY. There is a CounselorIn-Training (CIT) program for 16 year olds, as well as two villages, McAlister (ages 6-12) and Talcott (ages 12-15), that are located on 1,150 acres of forests and lakes. Just a sample of activities that we offer are swimming lessons, a wide variety of sports, arts and crafts, outdoor living skills, media program, canoeing, Wibit, and our ropes courses. We also offer specialty programs that include water skiing, horseback riding, and rafting trips for a small additional fee.
Session 1 Session 2 Session 3 Session 4 Session 5
June 28 – July 3 July 5 - 17 July 19 - July 31 August 2 – 7 August 9 - 21
Tier 1 1 Week 2 Weeks $869 $1599
Tier 2 1 Week 2 Weeks $769 $1399
Tier 3 1 Week 2 Weeks $699 $1199
Why three prices? New York YMCA Camp realizes that families have differing abilities to pay, so we offer a voluntary 3-tier pricing program. This is strictly an honor system; select the fee you feel is appropriate to what you can pay. The program is voluntary, and in no way influences the experience children receive. Tier 1 – Is the actual cost of camp for a child to participate Tier 2 – Is our partially subsidized fee for temporary or minor financial need Tier 3 – Is our heavily subsidized fee for those in need of more financial assistance *We offer need-based financial assistance.
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NATIONAL GYMNASTICS TRAINING CAMP
Session 1 Session 2
Girls ages 7 - 17
July 5 - 10 July 12 - 17
We offer world class training for dedicated and determined gymnasts from around the world. Our focus is to support each gymnast to develop new skills and improve existing ones. Every gymnast has the opportunity to train closely with our world class coaches. Our camp includes 16,000 sq feet of training space, 6 vault stations, 12 beam stations, 4 sets of competition bars, 2 full floor exercises, certified athletic trainers, medical staff available 24/7, and more. Team rates are available.
Tier 1 Tier 2 Tier 3 $899
$799
$699
Team Camp 1 week 2 week $799 $1598
WORLD VOLLEYBALL TRAINING CENTER Ages 10 - 18
We offer progressive training techniques for all skill levels, position specific training, and video training with personal feedback. We also offer plyometric and weight training opportunities for qualified campers. The Volleyball Select program is for advanced players looking to experience training on the collegiate level.
Session 1 Session 2 Session 3 Team Mini Camp 1 Team Mini Camp 2
July 19 – 24 July 26 - 31 August 2 – 7 July 19 - 22 July 26 - 29
Our camp includes 6 indoor courts with all new sport court, 5 outdoor grass courts, a training room, certified athletic trainers, and medical attention available 24/7. We offer team packages for full week and half week rates.
Tier 1 $849
Tier 2 $799
Tier 3 $749
Team Mini Camp $395
Team Weekly Camp $799
RHYTHMIC GYMNASTICS & POWER TUMBLING Ages 7 - 17 | June 28 – July 3 RGPT Camp includes cardio conditioning and fitness, choreography, beginning and advanced element training, equipment and body mastery, and routine and creative dance development. Our philosophy is to develop the athlete on every level-technically, physically, artistically, and emotionally – and to create a fun, safe, and memorable summer experience.
Our camp includes 2 Rhythmic Gymnastics floors, stall and ballet bars, power tumbling and DMT equipment, full rod floor with run-up and regulation landing area, two Euro DMT with competition run and landing area, trainers and medical staff onsite 24/7. Camp Rate: $599
INTERNATIONAL JUDO CAMP For players of all ages starting at age 6 | August 9 – August 15 We offer world class training for athletes from around the world. During daily practice and evening Randori, our coaches evaluate skills to develop an individualized, training program for every camper. Our focus is to support each child and adult to learn new skills and to perfect their existing ones. Our camp includes Olympic quality Tami mats, 2 inch Swain flexi-roll mats, weightlifting and cardiovascular training equipment, trainers and medical staff on site 24/7. Apply before July 1st:
18
$649
Apply after July 1st:
$699
nyycamp.org
160 Big Pond Rd.
2015 Sleepaway Camp Summer Showcase Dates April 12th April 26th May 31st June 7th Join us for a tour. Sign up at nyycamp.org
OUTDOOR ADVENTURE TRIPS Ages 10 - 15
We offer one or two-week adventure trips where campers experience safe, outdoor activities including mountain biking, hiking, camping, canoeing, whitewater rafting, kayaking, surfing, tubing, high-team adventure and so much more.
Trip Delaware River Adventure Empire State Adventures Southeast Adventures Introductory Adventures Great Lakes Adventures
Ages 12-15 12-15 12-15 10-12 12-15
Date June 28 - July 3 July 5 -17 July 19 - July 31 August 2 - 7 August 9 - 21
Fee $719 $1829 $1889 $719 $1889
RETREAT CENTER
Year Round, Upstate New York The Greenkill Retreat Center at the New York YMCA Camp is open year-round with options for day trips, overnights, or multiple-night stays. From activity choices and breakout sessions to lodging, recreation, team building, and meals, we work closely with each group to design a retreat that meets group goals.
OUTDOOR EDUCATION CENTER
September to June, Upstate New York The Greenkill Outdoor Education Center at the New York YMCA Camp provides safe and educational programs for students through a holistic approach that tailors each trip to a school’s specific needs. Educational programs range from social and emotional development to recreation, to experiential environmental education. Our professional staff focuses on the needs of students and encourages learning in the natural environment.
WOMEN’S WELLNESS WEEKENDS Spring 2015 | May 15 – 17
Fall 2015 | October 16 - 18
Immerse yourself in nature at one or both of our women’s-only retreat weekends. Activities include arts and crafts, guided hikes throughout our picturesque property, health and wellness sessions, yoga, and more.
Huguenot, NY
877-30-YCAMP
19
YMCANYC.ORG/CAMP TO LEARN MORE!
* DOES NOT APPLY TO SLEEPAWAY CAMP PROGRAMS VISIT
Pick up a scholarship application at the Branch or download an application online at ymcanyc.org.
FINANCIAL ASSISTANCE AVAILABLE*
10% off each additional sibling. Discounts cannot be combined.
SIBLING DISCOUNTS*
10% discount for participants who are registered by May 16, 2015 and have paid in full.
EARLY BIRD DISCOUNTS*
DAY CAMP PROMOTIONAL OFFERS!
3939 Richmond Avenue Staten Island, NY 10312 718.227.3200 www.ymcanyc.org/statenisland
Staten Island YMCA PAID
Permit No. 24 Staten Island, NY
Non-Profit Organization US Postage