A SUMMER TO DISCOVER DODGE YMCA Summer Day Camp 2012
Is your child ready for a summer of adventure? The Dodge YMCA is about to embark on yet another fun and exciting summer of Day Camp. Welcome to all of our returning and new campers to our 2012 Day Camp Program. Y Day Camp uses hands-on learning through indoor and outdoor educational activities. Thank you for choosing our Summer Day Camp and we look forward to getting to know your child. Sincerely, Ruth Chan & Nayira Polanco The Youth & Family Department
YMCA Day Camp Through programs like Day Camp, we nurture your child’s sense of selfconfidence and introduce them to positive, fun experiences that build leadership and social skills. Well-trained, qualified staff serve as positive role models for campers. Y Day Camp enhances camper’s selfconfidence, self-esteem and leadership skills through structured (and fun!) activities. Campers develop a true understanding of diversity in an atmosphere of acceptance and approval of the uniqueness of others. Campers are encouraged to be creative, expressive and learn new skills. Summer learning activities offer a fun way for campers to read and learn over the summer months. All YMCA Day Camps are licensed by the NYC Department of Health and Accredited by the American Camping Association (ACA).
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WHAT YOU NEED TO KNOW OUR YMCA MISSION
CAMP LOCATION
The YMCA of Greater New York is a communitybased service organization which promotes positive values through programs that build spirit, mind, and body, welcoming all people with a focus on youth.
The Dodge YMCA Summer Day Camp operates out of 225 Atlantic Ave Brooklyn, NY 11201. We also use offsite facilities such as local parks and schools to conduct Day Camp.
OUR VALUES Caring, honesty, respect and responsibility.
YMCA DAY CAMP OBJECTIVES YMCA Summer Day Camp helps campers ages 4 1/2 – 12 years old grow mentally and physically by participating in challenging activities in both small and large group settings under the supervision of a caring and well trained staff.
DATES & HOURS OF OPERATION The Dodge YMCA Summer Day Camp is an eight-week program that runs from July 2nd, 2012 - August 24th, 2012 , 8:00am- 4:00pm. Extended day option of 4:00pm-6:00pm is also available for an additional fee.
OPEN HOUSES Saturday, March 3, 2012 Saturday, April 28, 2012 Saturday, May 19, 2012
11am – 3 pm 11am – 3 pm 11am – 3 pm
SUMMER LEARNING To succeed in school and life, children and young adults need ongoing opportunities to learn and practice essential skills. This is especially true during the summer months when children lose much of what they learn during the school year. YMCA of Greater New York Day Camps provide high-quality summer learning initiatives that give children a variety of ways to improve reading and math skills and explore music, drama, art and sports. Through fun, themed curriculum that incorporates key academic components, children will practice and further their academic skills, learn to plan and create projects, learn Teamwork, and develop new skills. To inspire reading, our program will provide books recommended by the Department of Education for summer reading.
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REGISTRATION MADE EASY • •
Registration begins January 15, 2012.
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Bring everything to the Membership Desk with payment for your child’s first session with additional deposits of $75 for each additional week. This will hold your child’s spot for the designated weeks of camp.
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Fill out all registration packet forms, following all instructions and making sure they are complete and signed.
Take advantage of the 10% Early Bird discount by paying off your entire balance by Saturday, May 19, 2012. Submit your child’s medical form, complete 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. Please note that registration is not complete until a valid medical form is on file.
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. There are no credits or refunds for camp fees due to illness, absences or missed days, or any other circumstances. Deposits are non-transferable and non-refundable. Any refund requests will be submitted to the Camp Director and will be granted under the discretion of the Sr. Director of Youth & Family. All requests should be made prior to the start of the session.
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.
PROMOTIONAL OFFERS
PARENT ORIENTATION
Siblings Discounts
Parent Orientation is mandatory. Parent or guardian must attend one mandatory meeting on : June 6th 6:00pm-7:00pm or June 9th 10:00am-11:00am
FINANCIAL ASSISTANCE The YMCA of Greater New York awards scholarships to campers based on a parent or a family’s annual income. The scholarship applications will be available by January 15th and must be submitted by March 31, 2012. Acceptance letters will be mailed out by May 5th 2012.
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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.
Early Bird Discounts 10% discount for participants who are registered by May 19 and have paid in full. 10% off each additional sibling. Discounts cannot be combined.
CAMP GEAR Each child will receive two t-shirts and a camp bag. Swim caps will be given during the camper’s first day of swimming. Additional shirts may be purchased at the membership desk for $ 8 each or 3 for $20. Swim gear must consist of a towel, swimsuit, swim cap, a change of clothing, and a plastic bag (or other receptacle for wet swim gear). Camp gear is distributed on the camper’s first day of camp.
EXPLORE PLAY AND GROW Each week of camp provides your child hands-on activities including educational field trips and theme days.
DAY CAMP (AGES 4.5 – 12) Day Camp at the Dodge YMCA is an all inclusive camp experience. Using a themed-based curriculum throughout the summer, we make learning engaging and fun. Campers also participate in swimming three times a week, arts and crafts, health and fitness, and group games. Campers also have the opportunity to participate in weekly excursions to museums, playgrounds and cultural events. As a part of Day Camp, campers learn how to develop long-lasting friendships and build solid social skills by learning about and utilizing our four core values. Children must have completed Kindergarten to attend day camp.
MEDICAL INFORMATION If your child is injured, the Basic Life Support and First Aid Certified Director and camp staff will take whatever steps necessary to administer care and or / obtain emergency medical care. These steps include but not limited to: 1. 2.
SUMMER SPORTS COMPONENT During each 2-week session your child will also be engaged in a structured sport program with the opportunity to develop and learn about different sports. Our sports components include swimming three times a week through all four sessions, and specialized sports three times a week at various locations including the Dodge YMCA, Local schools, and community parks. The following is a brief description of what campers will walk away with: Session I– July 2nd—July 13th Session II– July 16th—July 27th Session III– July 30th—August 10th Session IV– August 13th– August 24th
trained in standard first aid and CPR. All pool staff are certified lifeguards. Safety procedures are part of on-going staff training and are reviewed throughout the summer. All staff undergo background checks and drug testing. We are licensed by the New York City Department of Health and accredited by the American Camping Association.
[Soccer] [Basketball] [Baseball] [Tennis]
RULES & REGULATIONS The Dodge YMCA upholds its values of caring, honesty, responsibility and respect. Our goal is for all campers and staff to have safe and fulfilling summer while exercising our four core values. Parents are also a crucial part of our YMCA community in modeling behavior consistent with our values.
SAFETY CONCERNS Health and safety are the highest priorities for summer camp activities. All staff persons are
3.
Administering First Aid. If necessary, an ambulance will be called and a staff member will accompany the child to the emergency room of the nearest hospital (Long Island College Hospital) until the parent / guardian arrives. Contact parent / guardian or emergency contact person.
CONTACT US For more information or have questions, please contact: Ruth Chan, Sr. Director, Youth & Family, rchan@ymcanyc.org, 718.625.3136
A D AY
AT C
A MP 8:00-9 :00 A rr ival & 9:00-1 Camp 0:00 Cheers Scienc 10:00e Expe 11:00 riment Swimm 11:00ing 12:00 Art Ac 12:00ti vit y 1:00 Lunch 1:00-2 :00 Sports 2:00-3 :00 V ocabula 3:00-4 ry Rela :00 y (gym Snack ) and Jo urnal
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A SUMMER OF FUN 2012 Summer Day Camp Sessions and Fees
CAMPS (AGES 4.54.5-12) Session
Dates
Payment Due Date*
I
July 2 – July 13 (closed July 4)
June 1st
II
July 16 – July 27
June 1st
III
July 30– August 10
July 1st
IV
August 13– August 24
July 1st
* Payment must be paid in full by due date before child can attend camp.
DAY CAMP FEES SESSION I (9 days /closed July 4) Member Fee
$445 (Week 1:$200 week 1, Week 2:$245)
NonNon-member fee
$550 (Week 1:$250 week 1, Week 2:$300)
SESSION IIII-IV (2 weeks per session) Member Fee
$ 490 ($245 per week )
NonNon-member fee
$ 600 ($300 per week )
EXTENDED HOURS Extended hours are available to parents from 4:00pm-6:00pm at $50 per week. Extended hours are not prorated.
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THE NEXT ADVENTURE New York YMCA Sleepaway Camp Boys and Girls (Ages 6 – 16) Located 86 miles northwest of Manhattan, the New York YMCA Camp is a globally diverse community built upon the YMCA core values of caring, honesty, respect and responsibility. Here each child enjoys adventures, new friendships and joyful experiences. Campers are secure in our bully-free camp from day one. Children are always supervised by highly trained counselors. Friendships are immediately fostered through teambuilding and cabin activities. By supporting each camper and cabin group, our counselors help campers form the life-long relationships for which our camp is known.
• Sports
• Horseback Riding
• Performing Arts
• Outdoor Life Skills
• Swimming
• Boating
• Waterskiing
• Tubing
• Arts
Call us toll free at 877-30-YCAMP or visit us online www.newyorkymcacamp.org to learn more.
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DODGE SUMMER CAMP REGISTRATION FORM PARTICIPANT INFO Child Name _____________________________________________________________ Age ______________ D.O.B _____________________ M □ F □ Address _________________________________________________________________________________________________ Apt # _______________________ City _______________________________________________________________ State ___________________________ Zip ____________________________ School Name _______________________________________________________________ Grade starting in Sept 2012 ______________________ Y Member? Y □ N □
T-Shirt Size
Child: S □
M□
L□
Adult: S □
M□
L□
XL □
PARENT/GUARDIAN INFO Guardian1 Name _____________________________________________
Guardian 2 Name _______________________________________________
Relation _______________________________________________________
Relation __________________________________________________________
Work Tel # _____________________________________________________
Work Tel # _______________________________________________________
Mobile Tel # ___________________________________________________
Mobile Tel # ______________________________________________________
Home Tel # _____________________________________________________
Home Tel # ________________________________________________________
Email ____________________________________________________________
Email _______________________________________________________________
AUTHORIZED PICK UP AND EMERGENCY CONTACT INFO At Dismissal and/or in case of an emergency, the following people are authorized to pick up my child: 1.
Parent 1: Yes □
No □
2.
Parent 2: Yes □
No □
3.
Name _______________________________________________ Relation ______________________________ Tel _________________________________
4.
Name _______________________________________________ Relation ______________________________ Tel _________________________________
5.
Name _______________________________________________ Relation ______________________________ Tel _________________________________
DISMISSAL OPTIONS (Choose One)
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I, _________________ will be picking up my child from Dodge Y between 3:30pm and 4:00pm
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I, _________________ will be picking up my child from Dodge Y between 5:30pm and 6:00pm (extended day)
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I, _________________ give my permission for my child (10+yrs) to walk home from the program unattended at
(initial)
(initial)
(initial)
□ 3:30pm
□ 5:30pm (extended day fee applies)
CAMP PROGRAM SCHEDULE Select weeks. Select extended day if desired (optional). Summer Camp Regular Hours- 8:00am-4:00pm, Extended Hours– 4:00pm-6:00pm SESSION II
SESSION I Summer Camp
Extended Day
Summer Camp
Extended Day
Week 1* 7/2-7/6
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Week 3 7/16-7/20
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Week 2 7/9-7/13
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Week 4 7/23-7/27
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* No Summer Camp on 7/4
SESSION III
SESSION IV Summer Camp
Extended Day
Summer Camp
Extended Day
Week 5 7/30-8/3
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Week 7 8/13-8/17
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Week 6 8/6-8/10
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Week 8 8/20-8/24
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PAYMENT INFORMATION Fees & Discounts For fees, please see page 5. For discounts, please see page 3 Child membership fee: 5-11yrs: $128/yr; 12-17yrs: $158/yr Financial Assistance deadline: March 31, 2012
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Payment Deadlines Sessions I & II: Friday, June 1, 2012 Sessions III & IV: Sunday, July 1, 2012 Credit Card Information
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I will be paying manually for camp fees at the Dodge Membership Desk
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I authorize Dodge YMCA to charge my credit card on Fri June 1 for the full amount due for Sessions 1&2
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I authorize Dodge YMCA to charge my credit card on Sun July 1 for the full amount due for Sessions 3&4
Visa □
Mastercard □
Amex □
Authorized Signature ______________________________________________________________
CC# ______________________________________________________________________ Expiration _______/________ Security Code: ____________
PARENT/GUARDIAN AGREEMENT I, the undersigned, give permission for my child to participate in all summer camp activities for the days he/she attends. I understand that no refunds or credits will be given for missed days under any circumstances. I understand that a completed medical form signed by the physician is required before my child may begin camp. In addition I am fully aware that all balances are due by the due date listed above before my child may begin camp. I also hereby give authority to YMCA staff to obtain necessary emergency medical treatment for my child with the understanding that the family will be notified as soon as possible. In addition, in consideration of the good will, public service, and community aid provided by the YMCA of Greater New York, I hereby grant permission to the YMCA to use my child’s name, to take and publish photographs, video of him/her which include his/her voice and image, in any media for YMCA purposes. I release all rights to such photographs and video. I acknowledge that the YMCA will be the sole owner of all rights arising out of their use for all purposes. I understand that I shall receive no compensation from their use from any source whatsoever.
Parent/Guardian Signature _______________________________________________________ Date __________________________________
DODGE YMCA SUMMER CAMP MEDICAL FORM PARTICIPANT INFO Child’s Name ____________________________________________________________ Age _________________ D.O.B _____________________________ Address _________________________________________________________________________________________________ Phone _______________________ Guardian Name _____________________________________________
Phone: _______________________________________________
Place of Employment (Mother) ______________________________________________________ Phone _____________________________________ (Father) _______________________________________________________ Phone _____________________________________ In Case of Emergency, notify: _________________________________________________________ Phone _____________________________________ If Parent or Guardian is not available in an emergency, notify: 1. Name _______________________________________________ Relation _______________________________ Tel __________________________________ 2. Name _______________________________________________ Relation _______________________________ Tel __________________________________ * Has this camper ever been exposed to any communicable disease during the three weeks prior to camp attendance? Yes □ No □
(If yes, state type of exposure: ______________________________________________________________)
HEALTH HISTORY (Check, giving approximate dates) ILLNESSES
□ Rheumatic Fever □ Seizures □ Diabetes □ Asthma □ Chicken Pox □ Ear Infections
ALLERGIES __________________________ __________________________ __________________________ __________________________ __________________________ __________________________
Other Past Illnesses
□ Hay Fever □ Poison Ivy □ Insect Stings □ Penicillin □ Other Drugs ____________________________________________________ □ Food _______________________________________________________________ _________________________________________________________________________________________
Operations or Serious Injuries (& dates)
_________________________________________________________________________________________
Hospitalizations (& dates)
_________________________________________________________________________________________
Chronic and Recurring Illnesses
_________________________________________________________________________________________
Any specific activities to be encouraged? _________________________________________________________________________________________ Conditions that require activity to be restricted? _______________________________________________________________________________ Permission for all program activities unless otherwise noted by Dr. _________________________________________________________ Appliance worn (glasses, contacts, etc.)
_________________________________________________________________________________________
Medication taken
_________________________________________________________________________________________
Additional Suggestion from Parent/Guardian _____________________________________________________________________________________
CONSENT FOR EMERGENCY MEDICAL TREATMENT I do hereby give authority to the Dodge YMCA Summer Day Camp to obtain necessary emergency medical treatment for my child with the understanding that the family will be notified as soon as possible. Signature ________________________________________________________
Relationship ______________________________________________________
Phone # _________________________________________________________
Date ________________________________________________________________
Department of Health and Mental Hygiene— The City of New York — Bureau of Food Safety and Community Sanitation
PHYSICAL EXAMINATION To be filled out by your child’s physician 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 Day Camp and other Dodge programs.
IMMUNIZATION HISTORY Record of dates of basic immunization and most recent booster doses
□ DTap, DTP, TD Date __________ □ Polio Date __________ □ MMR Date __________ □ Hem. Influenza type B □ Hepatitis B Date __________ □ Varicella Date __________ □ Pneumococcal Conjugate (PCV) □ Other ________________________________
Date __________
Date __________
Date __________
Date __________
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Date __________ Date __________
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Date __________
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Date __________
Date __________
Date __________
MEDICAL EXAMINATION to be filled out by licensed physician. Examination is acceptable when performed no more than 9 months prior to arrival at camp. Code: S = Satisfactory X = Non Satisfactory (explanation required) O = Not Examined General Appearance ___________________________________________________________________________________________________________________ Height __________
Blood Pressure __________
Hgb Test (Date) __________
Urinalysis (Date) _________
Vision __________
w/Glasses
__________
Posture/Spine
__________
Throat/Tonsils
_________
Heart __________
Ears
__________
Hearing
__________
Extremities
__________
Feet
_________
Lungs __________
Skin
__________
Nose
__________
Teeth
__________
Hernia
_________
Eyes
__________
Weight __________
Abdomen __________ Genitalia __________ Neurological Findings _____________________________________________________________________________________________________________________________ Describe Abnominal Findings and/or Handicapping Conditions __________________________________________________________________________ _________________________________________________________________________________________________________________________________________________________ Allergy (please specify) __________________________________________________________________________________________________________________________ Recommendations and restrictions while in camp: Special Diet _________________________________________________________________________________________________________________________________________ Special Medicine (name, dose, administration) _____________________________________________________________________________________________ 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. ____________________________________________________________M.D.
____________________________________________________________M.D.
Physician’s Name (Please Print)
Examining Physician (Signature)
Address ___________________________________________________________________________________________________________________________________ Date of Examination ______________________________________________________
Phone # __________________________________________
Department of Health and Mental Hygiene— The City of New York — Bureau of Food Safety and Community Sanitation
225 Atlantic Ave Brooklyn , NY 11201 (212) 912-2414 www.ymcanyc.org/dodge
Dodge YMCA