2021 SUMMER CAMP GUIDE - North ...
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202 1
SUMMER
CAMP
Registration Opens:
December 15, 2020
Standard Rate Begins:
GUIDE
May 2, 2021
Camp Begins :
June 7, 2021
North Suburban YMCA • 2705 Techny Rd. Northbrook, IL 60062 • 847-272-7250 • nsymca.org The NSYMCA is a 501(c)3 non-profit organization, open and accessible to all.
HOW WE WILL KEEP
CAMPERS SAFE IN 2021
• Sanitization stations
• Masks may be worn
• Increased sanitization throughout our facility
• We will continue to follow all CDC guidelines
WHAT’S NEW FOR 2021?
• New Specialty Camps
• 10-week Gymnastics Camp
• New Swim Lesson Sign-up
• Full Day Pathfinders (4 yrs)
• Field Trip Camps
• Revamped C.I.T Program
IMPORTANT DATES
Dec. 15th June 1st
Camp Deadline for
Registration full refund
Opens (minus $25 processing fee)
March 15th June 7th
HAWKS Inclusion Camp Week 1 begins
1-on-1 Camp
Registration Closes Aug 13th
Last Day of Camp
May 2nd
Standard Rate Begins
Dear NSYMCA Families, We are thrilled to announce that Summer Camp 2021 registration is open at the North Suburban YMCA! Returning families, we cannot wait to see you again this summer. New families, we are so excited to welcome you into the NSYMCA family! Our mission, vision, and values are not just words on paper; we are a Y and a camp that is truly for ALL. In 2020, we successfully facilitated camp with zero cases of COVID-19 and we received an unprecedented 100% positive experience rating through our family assessments. We are incredibly proud of these accomplishments and strive to achieve this level of success again in 2021. Explore our camp guide and browse our wide variety of camp options and programming. We understand that each family has individual needs and interests and we work hard to accommodate everyone by providing weekly registration, 3- or 4-day registration discount, 1/2-day camps, payment plans, scholarships, member discounts, multi-child discounts, and MORE! All camp information can be found on our camp website. For a deeper exploration on camp, policies and procedures please check out our 2021 Parent Guide online. Planning camp certainly has been challenging as we know there is uncertainty with our “new normal”. But as we successfully did last summer, we will follow the CDC guidelines and the Camp Field Guide. As we receive information, we will regularly update families to keep everyone well-informed. One thing we are sure about is that camp at the NSYMCA will be FUN! From everyone here at the NSYMCA family, we hope you consider joining us this year for the BEST SUMMER EVER! If you have any questions, comments or concerns, please email camp registrar Nicole Hatfield (registrar@nsymca.org) or me (rgonzalez@nsymca.org) at any time. Ricky Gonzalez Camp Director
NSYMCA CAMP AT A GLANCE!
Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10
6/7-6/11 6/14-6/18 6/21-6/25 6/28-7/2 7/5-7/9 7/12-7/16 7/19-7/23 7/26-7/30 8/2-8/6 8/9-8/13
Before 5/1 After 5/1
Camp Grade 1 2 3 4 5 6 7 8 9 10 Days Time $YM $YM $NM
PRESCHOOL DAY CAMPS
Little Pioneers 2-3 yrs • • • • • • • • • • M-F 9am-12pm $148 $163 $213
Pathfinders AM 4 yrs • • • • • • • • • • M-F 9am-12pm $164 $178 $253
Pathfinders full-day- NEW 4 yrs • • • • • • • • • • M-F 9am-4pm $239 $254 $359
Mini-Movers Camp 4-6 yrs • • • M-F 9am-12pm $195 $209 $273
TRADITIONAL DAY CAMPS
Earth Trekkers full-day • • • • • • • • • • M-F 9am-4pm $229 $244 $349
Earth Trekkers AM 5 yrs • • • • • • • • • • M-F 9am-12pm $154 $169 $229
Earth Trekkers PM • • • • • • • • • • M-F 1-4pm $144 $159 $219
Voyagers full-day • • • • • • • • • • M-F 9am-4pm $229 $244 $349
Voyagers AM 1st • • • • • • • • • • M-F 9am-12pm $154 $169 $229
Voyagers PM • • • • • • • • • • M-F 1-4pm $144 $159 $219
Trailblazers full-day • • • • • • • • • • M-F 9am-4pm $229 $244 $349
Trailblazers AM 2nd-3rd • • • • • • • • • • M-F 9am-12pm $144 $159 $219
Trailblazers PM • • • • • • • • • • M-F 1-4pm $154 $169 $229
Adventurers full-day • • • • • • • • • • M-F 9am-4pm $229 $244 $349
Adventurers AM 4th-5th • • • • • • • • • • M-F 9am-12pm $144 $159 $219
Adventurers PM • • • • • • • • • • M-F 1-4pm $154 $169 $229
Navigators full-day • • • • • • • • • • M-F 9am-4pm $259 $279 $384
Navigators AM • • • • • • • • • • M-F 9am-12pm $174 $194 $249
Navigators PM 6th-8th • • • • • • • • • • M-F 1-4pm $184 $204 $259
Navigator Lock-In* • F $30 $30 $50
Navigator Overnight* • T-W $87 $87 $128
CIT Program* • • M-F See pg 10 $500 N/A N/A
8th-9th
CIT Six Flags Trip* - NEW • $75 N/A
SPORTS DAY CAMPS
Sports Camp full-day • • • • • • • • • • M-F 9am-4pm $229 $244 $349
Sports Camp AM • • • • • • • • • • M-F 9am-12pm $144 $159 $219
1st-6th
Sports Camp PM • • • • • • • • • • M-F 1-4pm $154 $169 $229
Gymnastics Camp • • • • • • • • • • M-F 9am-12pm $146 $162 $222
Pre-Team/
1st-8th • • • • • • • • • • M-F 9am-12pm $159 $174 $234
Team Gymnastics
*Must be registered for that week of camp. All Camps are subject to CDC guidelines.
FINANCIAL Financial assistance is first-come, first-served and new applications are required
regardless of prior scholarship status. For more detailed information please see
ASSISTANCE the Parent Guide online.
AVAILABLE For scholarship information contact Heidi Busch, Membership Director at hbusch@nsymca.org.
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NSYMCA CAMP AT A GLANCE!
Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10
6/7-6/11 6/14-6/18 6/21-6/25 6/28-7/2 7/5-7/9 7/12-7/16 7/19-7/23 7/26-7/30 8/2-8/6 8/9-8/13
Before 5/1 After 5/1
Camp Grade 1 2 3 4 5 6 7 8 9 10 Days Time $YM $YM $NM
SPECIALTY AND SPECIAL INTEREST DAY CAMPS
Art Explorers* K-6th PM PM PM PM PM PM PM PM PM PM M-F 1-4pm $214 $229 $299
Amusement Park Tycoon** -
PM M-F 1-4pm $229 $244 $344
NEW!
Battle Robots** - NEW! PM M-F 1-4pm $229 $244 $344
Builders & Destroyers* - NEW! 1st-6th AM M-F 9am-12pm $194 $209 $314
Candy Chemistry* - NEW! PM AM M-F 9am-12pm/1-4pm $194 $209 $314
Chess Wizards** PM M-F 1-4pm $229 $244 $344
Cheer/Poms/Dance 2nd-6th PM PM PM PM M-F 1-4pm $194 $209 $314
Cooking Camp** 1st-6th PM PM PM M-F 1-4pm $229 $244 $344
Dance Intensive 4th-8th PM PM PM PM M-F 1-4pm $230 $245 $300
Engineer Self-Driving Cars**
AM M-F 9am-12pm $229 $244 $344
- NEW!
Expedition Mars** - NEW! AM M-F 9am-12pm $229 $244 $344
Jokin' Around* - NEW! 1st-6th AM M-F 9am-12pm $194 $209 $314
Magic & Balloon Camp** AM AM M-F 9am-12pm $229 $244 $344
Movie Makers* - NEW! PM M-F 1-4pm $198 $213 $318
Ozaria Coding Camp* - NEW! PM AM M-F 9am-12pm/1-4pm $194 $209 $314
3rd-6th
Pokemon Camp* AM M-F 9am-12pm $214 $229 $334
Rock Band** PM PM M-F 1-4pm $229 $244 $344
Slime Camp* AM AM PM M-F 9am-12pm/1-4pm $194 $209 $314
1st-6th
Star Wars* - NEW! PM M-F 1-4pm $194 $209 $314
Whodunnit?* - NEW! AM M-F 9am-12pm $194 $209 $314
FIELD TRIP CAMPS
Go Kart Camp** - NEW! FD M-F 9am-4pm $266 $281 $386
3rd-6th
Water Park Camp** - NEW! FD M-F 9am-4pm $266 $281 $386
Navigator Adventure
6th-8th FD M-F 9am-4pm $266 $281 $386
Camp** - NEW!
Ultimate Adventure Camp**
3rd-6th PM AM M-F 9am-12pm/1-4pm $231 $246 $351
- NEW!
SPECIAL SERVICES CAMP
HAWKS Inclusion1:1 K-8th • • • • • • • • • M-F 9am-4pm $545 N/A N/A
HAWKS High School Camp 9th-12th • • • • • • • • • M-F 12pm-4pm $300 N/A N/A
CAMP ADD-ONS***
11:25, 11:40 am,
Summer School Package WHEN NORTHBROOK SUMMER SCHOOL IS IN SESSION M-F $179 $199 $279
12:55, 12:30 pm
Lunch Bunch All • • • • • • • • • • M-F 12-1pm $49 $69 $84
Extended AM- Before Camp • • • • • • • • • • M-F 7:30-9am $79 $99 $124
Extended PM- After Camp • • • • • • • • • • M-F 4-6pm $79 $99 $124
Extended AM/PM K-8th • • • • • • • • • • M-F 7:30-9am/4-6pm $119 $139 $184
$15/
Swim Lessons • • • • • • • • • • Tu/ W AM $15/wk $15/wk
wk
$75/ $85/
Fall Explorers 8/16 - 8/20 M-F 9am - 4pm $65/day
day day
* These camps will not be prorated. **Financial assistance & proration do not apply to this camp. *** See page 6 for more info.
BEST SUMMER EVER | NORTH SUBURBAN YMCA | SUMMER CAMP 2021 | NSYMCA.ORG 5
NSYMCA CAMP AT A GLANCE!
Camp At A Glance Info
Leaders Please see the parent handbook for detailed information
• Membership – Must have 6 months of consecutive membership for member rates.
Kathy Fielding
Chief Executive Officer • Financial Assistance – If you are interested in financial assistance, please see the Guest
kfielding@nsymca.org Services desk for an application or go online!
• Payment Plans – For NSYMCA members only.
Ricky Gonzalez
Camp Director • Age Requirement – Must be the grade they are entering in Fall 21.
rgonzalez@nsymca.org • Special Accommodations & ADA information – The Y is open to all people. For more
information, on accommodations, contact Ellen Mirochnick at emirochnick@nsymca.org.
Nicole Hatfield
• Requests - Friendship Requests must be reciprocal.
Program Coordinator
registrar@nsymca.org • Medication Policy - Medications at camp requires a health form.
Shannon Sliwinski
Assistant Camp Director/
Youth Education Director
ssliwinski@nsymca.org Camp Add-On Programs & Services
Missy Contri
EXTENDED CAMP (Before and After Camp)
Aquatics Director
The Before and After Camp atmosphere is relaxed, safe, and fun! Activities range from indoor and
mcontri@nsymca.org
outdoor free play to organized activities such as crafts and games. Before Camp is from 7:30–8:45
Shannon Mundorf am and After Camp is from 4:10–6:00 pm. You can register for one or both. Extended Camp is
Sr. Director of Arts for Kindergarten and older. No minimum days required. If your camper requires an one-on-one
sparry@nsymca.org inclusion counselor contact Ellen Mirochnick for more information at emirochnick@nsymca.org.
Ellen Mirochnick SUMMER SCHOOL
Special Services The summer school package includes transportation from Westmoor, Maple and Northbrook Jr. High
Coordinator to the NSYMCA and lunchtime supervision before transitioning to an afternoon camp. Campers
emirochnick@nsymca.org must be registered for a NSYMCA PM camp. Campers must bring a lunch Monday–Thursday, while a
special lunch is provided on Fridays. One combined fee pays for both transportation and lunch for
Dawn Irelan
the duration of summer school. Minimum of 3 days required.
Gymnastics Coach
direlan@nsymca.org
LUNCH BUNCH
Heidi Busch Add Lunch Bunch and extend your camp day! Campers from 2 years old through grade 8 can enjoy
Membership Director lunch time with their friends and be supervised by well-trained staff. Lunch Bunch is open to all
hbusch@nsymca.org campers registered for an AM or PM camp. Campers must bring a lunch Monday–Thursday, while a
special lunch is provided on Fridays. No minimum days required.
FALL EXPLORERS
Special camp added for those last five days of summer vacation on 8/16 through 8/20. We will
have planned activities, field trips, and free swim. No minimum days required.
SWIM LESSONS
Add Swim Lessons to your camp day. It is available for 1-day a week on Tuesday or Wednesday.
You cannot choose which day. Available only in the mornings. $15 per lessons, per child for
sign up.
PRESCHOOL CAMPS
Week
Week 11 Week
Week 22 Week
Week 33 Week 44
Week Week
Week 55 Week
Week 66 Week
Week 77 Week
Week 88 Week
Week 99 Week 10
Week 10
6/7-6/11
6/7-6/11 6/14-6/18
6/14-6/18 6/21-6/25
6/21-6/25 6/28-7/2
6/28-7/2 7/5-7/9
7/5-7/9 7/12-7/16
7/12-7/16 7/19-7/23
7/19-7/23 7/26-7/30
7/26-7/30 8/2-8/6
8/2-8/6 8/9-8/13
8/9-8/13
LITTLE PIONEERS
Ages: 2-3 years. Days: M-F. Session length: 1 week.
This is the perfect program to introduce little ones to camp. Daily activities
include songs, crafts, stories, games, outdoor play, and more! Campers will develop
friendships, learn independence, and practice sharing and teamwork in a safe,
supervised, and caring environment. Swimming not available. They do not need to be
toilet trained. Minimum of 3 days required.
Weeks Counselor/ $YM $YM
!
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
ADD LUNCH BUNCH
Little Pioneers AM 1-10 9am-12pm 1:6 $148 $163 $213
TO THESE CAMPS TO
EXTEND THE DAY!
PATHFINDERS
Ages: 4 years. Days: M-F. Session length: 1 week.
This camp is packed with a variety of indoor and outdoor activities from art, crafts,
sports, games and more! Swim lessons are included for Pathfinders only. They
will swim twice a week (mornings only). Each swim session begins with formal lessons
facilitated by our aquatics & Camp staff and ends with open swim. Children must be
toilet trained. Minimum of 3 days required.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
!
Pathfinders AM 1-10 9am-12pm 1:6 $164 $178 $253
Pathfinders Full-Day 1-10 9am-4pm 1:6 $239 $254 $359 ADD LUNCH BUNCH
TO THESE CAMPS TO
EXTEND THE DAY!
MINI-MOVERS CAMP NEW
Ages: 4-6 years. Days: M-F. Session length: 1 week.
Through creative movements and choreography, campers will learn dance concepts and
techniques while having tons of fun and getting the wiggles out! Performances will be held the
last day of the week. For more information contact Shannon Mundorf at sparry@nsymca.org.
Minimum 3 days required.
!
Weeks Counselor/ $YM $YM
Camp Name Time $NM ADD LUNCH BUNCH
Offered Child Ratio Before 5/1 After 5/1
TO THESE CAMPS TO
Mini-Movers AM 3,5,7 9am-12pm 1:6 $195 $209 $273 EXTEND THE DAY!
BEST SUMMER EVER | NORTH SUBURBAN YMCA | SUMMER CAMP 2021 | NSYMCA.ORG 7
TRADITIONAL DAY CAMP
Grades: K-5. Days: M-F. Session length: 1 week.
These camps are perfect for children who like a bit of
everything— from sports to crafts, games to art, they will
experience it all! Traditional Day Camp is a comprehensive and
quality program focused on providing fun and safe enrichment
opportunities for campers. Campers will learn new things while
making friends and having fun along the way. Each week is
themed and jam-packed with intentional, age-appropriate,
and engaging activities. Activities include weekly field trips,
art projects, sports, games and outdoor activities, and open
swim., special events, crafts, large group games, and so much
more. Check the calendar in this guide for themes! Minimum EARTH TREKKERS TRAILBLAZERS
of 3 days required. KINDERGARTEN GRADES 2-3
AM DAY CAMP PM DAY CAMP
• Earth Trekkers & Voyagers • Sports, Trailblazers,
will open swim 3 times Adventurers,
a week Navigators will swim
• Will not have field trips 3 times a week
• Will have a weekly art class • Will not have
• Swim lessons field trips
sign-up optional
FULL DAY CAMP
• Will have weekly art class
• Will open swim 3x a week
• Will have weekly field trips on
Thursdays
• Will receive special lunch on Fridays VOYAGERS ADVENTURERS
1ST GRADE
• Swim lessons sign-up optional
GRADES 4-5
Grade/ Counselor/ $YM $YM
Camp Name Time $NM
Age Child Ratio Before 5/1 After 5/1 NEW
Earth Trekkers Full-day 9am-4pm $229 $244 $349
Earth Trekkers AM 5 yrs 9am-12pm $154 $169 $229
Earth Trekkers PM 1pm-4pm $144 $159 $219
SWIM LESSONS SIGN UP
Voyagers Full-day 9am-4pm $229 $244 $349 $15 per lesson (per child)
Voyagers AM 1 9am-12pm 1:8 $154 $169 $229 1 Day a Week (Tues or Wed) -
Voyagers PM 1pm-4pm $144 $159 $219
Swim lesson day is determined by swim
Trailblazers Full-day 9am-4pm $229 $244 $349 levels and student to instructor ratios.
Trailblazers AM 2-3 9am-12pm $144 $159 $219
Trailblazers PM 1pm-4pm $154 $169 $229 The official swim schedule and times will
be made available in Parent Guide 2021.
Adventurers full-day 9am-4pm $229 $244 $349
Adventurers AM 4-5 9am-12pm 1:10 $144 $159 $219
Adventurers PM 1pm-4pm $154 $169 $229
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CAMPS FOR MIDDLE SCHOOLERS
Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10
6/7-6/11 6/14-6/18 6/21-6/25 6/28-7/2 7/5-7/9 7/12-7/16 7/19-7/23 7/26-7/30 8/2-8/6 8/9-8/13
NAVIGATOR CAMP
Grades: 6-8. Days: M-F. Session length: 1 week.
Preteens need to discover who they are and what they can achieve. This NSYMCA program
NEW
combines day camp with leadership and service. The Navigator Camp will cultivate values
and skills that promote positive behaviors and good relationships. In this well-rounded camp
experience, our weekly activities will range from leadership development and volunteer/community
service projects to games, crafts, and field trips. Minimum of 3 days required. SWIM LESSONS SIGN UP
$15 per lesson (per child)
MORNING DAY CAMP LOCK-IN 1 Day a Week (Tues or Wed) -
• Service projects; leadership training; • Navigators will enjoy a fun lock-in at the
traditional camp activities Y. Swimming, games, movies, dinner and Swim lesson day is determined by swim
levels and student to instructor ratios.
lots of fun.
AFTERNOON DAY CAMP The official swim schedule and times will
• will swim 3x a week OVERNIGHT be made available in Parent Guide 2021.
• Enjoy an adventure at Camp Duncan
FULL-DAY CAMP (RECOMMENDED) with swimming, high ropes, camp fires,
• will have a weekly art class and more!
• will swim 3x a week in the afternoon will
have weekly field trips on Thursdays
• will receive a special lunch on Fridays
Weeks Time/ Counselor/ $YM $YM
Camp Name $NM
Offered Day Child Ratio Before 5/1 After 5/1
Navigators Full-Day 9am-4pm $259 $279 $384
Navigators AM 1-10 9am-12pm $174 $194 $249
Navigators PM 1-4pm 1:10 $184 $204 $259
Navigator Lock-In 4 F $30 $30 $50
Navigator Overnight 8 Tu-W $87 $87 $128
Scholarship does not apply for Lock-in and Overnight. We recommend that you register for the full-day camp in
order to participate in the full Navigator Camp experience.
BEST SUMMER EVER | NORTH SUBURBAN YMCA | SUMMER CAMP 2021 | NSYMCA.ORG 9
COUNSELOR
IN-TRAINING
(C.I.T.)
The Counselor-in-Training (CIT) program is a 5-week intensive, hands-
on training experience that gives teens valuable insight into the role of
a camp counselor.
Our CIT program is designed to offer qualified young people an
opportunity to prepare for positions as camp counselors or recreation
leaders. Emphasis is placed upon developing leadership skills,
appropriate childcare, and program skills.
Guided by an experienced CIT Program Coordinator, CITs will develop
their decision-making and problem-solving skills by assisting with daily
activities and camper care.
CITs will be trained to work alongside our counselors, implement games
and activities, and assist on field trips. They will work with various
camp groups, allowing them to experience a wide array of opportunities
throughout the summer. CITs will participate in leadership workshops
and trainings throughout the summer.
Applicants must be an NSYMCA member, fill out a CIT application,
provide two references and complete an interview. Not all applicants
who apply and interview will be accepted.
Only accepted participants will be provided registration information.
For more information regarding the CIT program, please contact Camp
Director Ricky Gonzalez at rgonzalez@nsymca.org.
SESSION INFORMATION
Participants accepted into the program must choose between the two
sessions below. Participants may not work both sessions and cannot
!
adjust their schedules. If you have previously completed the
NSYMCA CIT program, you are invited to
apply for our NEW Leaders-in-Training
Camp Name Grades Weeks Offered Days Time Capacity $YM program (LIT). Visit our camp page
CIT Program online to apply & for more information!
8-9 1-5 M-F
(Session 1)
9:00 am- $500 Participation and/or completion of the CIT program does
CIT Program 12
8-9 6-10 M-F 4:00 pm NOT automatically guarantee you a camp counselor
(Session 2) position with the NSYMCA in future summers.
CIT Six Flags Trip 8-9 9 TBD $75SPORTS & GYMNASTICS CAMPS
Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10
6/7-6/11 6/14-6/18 6/21-6/25 6/28-7/2 7/5-7/9 7/12-7/16 7/19-7/23 7/26-7/30 8/2-8/6 8/9-8/13
SPORTS CAMP
Grades: 1-6. Days: M-F. Session length: 1 week.
This camp is geared for the camper who loves to play all sports and can’t get enough.
Campers will work on the fundamentals and basic skills of each sport, and coaches
will emphasize the importance of sportsmanship, teamwork, and learning from
mistakes. Sports campers will be grouped by age. Minimum of 3 days required.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Sports Camp Full-Day 9am-4pm $229 $244 $346
Sports Camp AM 1-10 9am-12pm 1:8 $144 $159 $216
Sports Camp PM 1-4pm $154 $169 $229
GYMNASTICS CAMP
Grades: 1-6. Days: M-F. Session length: 1 week.
Gymnastics Camp is open for all recreational-level gymnasts entering 1st-6th grade
and is designed to teach basic fundamentals on floor, uneven bars, balance beam,
and vault. The day includes: group warm-up, instruction through small-group skill
development work, dance, games, and snack time. Minimum of 3 days required.
PRE-TEAM/TEAM SUMMER CAMP
Grades: 1-8 with Director’s Approval.
Days: M-F. Session length: 1 week.
The Pre-Team/Team Summer Camp is for NSYMCA gymnasts currently enrolled in our
Pre-Team and Competitive Team programs or those gymnasts who will be moving
up to Pre- Team/Team next season. Competitive Team members must be NSYMCA
members. Director approval required. Minimum of 3 days required.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Gymnastics Camp AM 1-10 $146 $162 $222
9am-12pm 1:6
Pre-Team/Team
1-10 $159 $174 $234
Gymnastics AM
BEST SUMMER EVER | NORTH SUBURBAN YMCA | SUMMER CAMP 2021 | NSYMCA.ORG 11SPECIALTY CAMPS
Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10
6/7-6/11 6/14-6/18 6/21-6/25 6/28-7/2 7/5-7/9 7/12-7/16 7/19-7/23 7/26-7/30 8/2-8/6 8/9-8/13
ART EXPLORERS
Grades: K-6. Days: M-F. Session length: 1 week.
Explore art in a fun and creative way! Campers will open up their imagination
to learn new art principles, and build their artistic skill set. Proration does not
apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Art Explorers PM 1-10 1-4pm 1:6 $214 $229 $299
AMUSEMENT PARK TYCOON NEW
Grades: 1-6. Days: M-F. Session length: 1 week.
Get ready to have the most fun ever! Your child will create their own amusement
park from the name and price of admission, to the design of the rollercoasters
and the full layout of the park. Campers will learn about gear ratios, potential/
kinetic energy, and centrifugal force through an entrepreneurial lens. Proration
and Financial Aid does not apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1 IN PARTNERSHIP WITH
Amusement Park Tycoon PM 7 1-4pm 1:6 $229 $244 $344
BATTLE ROBOTS NEW
Grades: 1-6. Days: M-F. Session length: 1 week.
Come learn engineering strategies for building sturdy structures using unique
RoboThink bricks, and then apply that knowledge to build multiple robots for a
variety of friendly competitions. Your child will have a blast as they play robot
soccer, compete in robot relay races, and complete dozens of other fun challenges.
Proration and Financial Aid does not apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Battle Robots PM 8 1-4pm 1:6 $229 $244 $344 IN PARTNERSHIP WITH
BUILDERS & DESTROYERS NEW
Grades: 1-6. Days: M-F. Session length: 1 week.
Calling all creative and crafty children who also don’t mind some demolition. We
will get really hands-on to make and destroy our masterpieces. Activities include:
egg drop challenges, pinatas, pyramids, toothpick & marshmallow bridges, and
more! Proration does not apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Builders & Destroyers AM 4 9am-12pm 1:6 $194 $209 $314
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Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10
6/7-6/11 6/14-6/18 6/21-6/25 6/28-7/2 7/5-7/9 7/12-7/16 7/19-7/23 7/26-7/30 8/2-8/6 8/9-8/13
CHESS WIZARDS
Grades: 1-6. Days: M-F. Session length: 1 week.
Campers will learn to play chess in a fun atmosphere with experienced Chess Wizards.
No previous experience needed. Each day, campers will participate in a wide variety of
activities, puzzles, riddles, games and MORE! Learn everything from the basic rules and
chess notation to the popular Chess Solitaire game! Proration and Financial Aid does
not apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
IN PARTNERSHIP WITH
Chess Wizards PM 1 1-4pm 1:10 $229 $244 $344
CANDY CHEMISTRY NEW
Grades: 1-6. Days: M-F. Session length: 1 week.
Does your child love science projects and candy? Then Candy Chemistry is the perfect
place for them this summer! Campers will become mad scientists partaking in fun-filled,
hands on, science experiments and crafts using Candy! If lucky, there may even be some
leftover to take home. Proration does not apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Candy Chemistry AM 8 9am-12pm
1:6 $194 $209 $314
Candy Chemistry PM 5 1-4pm
NEW
CHEER/POM/DANCE
Grades: 2-6. Days: M-F. Session length: 1 week.
Campers will learn the basics of cheerleading such as chants and
stunting as well as Pom and Jazz/Hip Hop Dance techniques.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Cheer/Pom/Dance PM 3, 5, 7, 9 1-4pm 1:6 $194 $209 $314
COOKING CAMP
Grades: 1-6. Days: M-F. Session length: 1 week.
Kids love to play with their food and this Y camp lets them! They will make food projects,
create nutritious snacks, and enjoy fun, kid-friendly food. Proration and Financial Aid
does not apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Cooking Camp PM 3, 6, 10 1-4pm 1:10 $229 $244 $344
BEST SUMMER EVER | NORTH SUBURBAN YMCA | SUMMER CAMP 2021 | NSYMCA.ORG 13SPECIALTY CAMPS
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DANCE INTENSIVE
Grades: 4-8. Days: M-F. Session length: 1 week. NEW
Designed for campers with some previous dance training, the Dance Intensive is a week
long camp designed to give dancers a chance to improve their technique. Campers will
experience technique classes in classical styles such as ballet, jazz, modern, & MORE!
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Dance Intensive PM 2, 4, 6, 8 1-4pm 1:6 $230 $245 $300
ENGINEER SELF-DRIVING CARS NEW
Grades: 1-6. Days: M-F. Session length: 1 week.
As the head of their new car company, your child will create a brand name, logo, line of
cars and other motorized vehicles. Campers will learn about gear ratios, sensors, energy,
entrepreneurial skills, and more! Your child will learn about a few things under the hood
and much more. Proration and Financial Aid does not apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
IN PARTNERSHIP WITH
Engineer Self-Driving Cars AM 10 9am - 12pm 1:6 $194 $209 $314
EXPEDITION MARS NEW
Grades: 1-6. Days: M-F. Session length: 1 week.
Come on an adventure building functional robots using unique RoboThink bricks in this
super fun program. Kids will learn about space, space travel, stars and gravity, all while
building a variety of interstellar robots and learning entrepreneurial skills along the way!
Proration and Financial Aid does not apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
IN PARTNERSHIP WITH
Expedition Mars AM 1 9am - 12pm 1:6 $194 $209 $314
JOKIN’ AROUND
Grades: 1-6. Days: M-F. Session length: 1 week.
Jokin’ Around is the perfect camp for any child who loves to laugh and be silly! Our NEW
goofy counselors will lead campers in hilarious activities sure to crack-up any child
looking for some summer fun. Examples of activities include: writing and sharing jokes,
making hilarious crafts, creating mad libs and playing SILLY games. Proration does not
apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Jokin’ Around AM 5 9am-12pm 1:6 $194 $209 $314
14 FOLLOW US ON FACEBOOK, TWITTER, INSTAGRAM, AND DOWNLOAD THE NSYMCA MOBILE APPSPECIALTY CAMPS
Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10
6/7-6/11 6/14-6/18 6/21-6/25 6/28-7/2 7/5-7/9 7/12-7/16 7/19-7/23 7/26-7/30 8/2-8/6 8/9-8/13
MAGIC & BALLOON CAMP
Grades: 1-6. Days: M-F. Session length: 1 week.
Children will have a great time as they learn (and take home) a collection of thrilling
and entertaining magic tricks! Each day the Magic Team of Gary Kantor will teach age-
appropriate card tricks, vanishing effects, and much more. Children will also learn how to
transform ordinary balloons into fascinating balloon animals. Proration and Financial
Aid does not apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Magic & Balloon Camp AM 3,10 9am-12pm 1:10 $229 $244 $344
NEW
MOVIE MAKERS
Grades: 1-6. Days: M-F. Session length: 1 week.
In this week-long movie making crash course, your child will write, direct, act and learn
camera work using tablets to create their very own movie. All films will be edited and
screened at camp and put on flash drives to enjoy at home! Proration does not apply
to this camp.
Counselor/ $YM $YM
Camp Name Weeks Offered Time $NM
Child Ratio Before 5/1 After 5/1
Movie Makers PM 5 1-4pm 1:6 $198 $213 $318
OZARIA CODING CAMP
Grades: 3-6. Days: M-F. Session length: 1 week. NEW
Ozaria is a computer science program, an adventure game, and a fantasy story all in one,
where students master the lost magic of coding to save their world. In Ozaria, students
find themselves embedded in a new world where they master core computer science
concepts to progress within the game. Proration does not apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Ozaria Coding AM 7 9am-12pm
1:6 $194 $209 $314
Ozaria Coding PM 2 1-4pm
POKÉMON TM
Grades: 3-6. Days: M-F. Session length: 1 week.
Each day, campers will participate in a wide variety of Pokemon activities and games.
Campers will make Pokeballs, design their own Pokemon characters, play the trading card
game, and even take a trip around the YMCA to play Pokemon Go on tablets provided!
Proration does not apply to this camp. Includes a starter deck of pokemon cards.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Pokémon AM 3 9am-12pm 1:10 $214 $229 $334
BEST SUMMER EVER | NORTH SUBURBAN YMCA | SUMMER CAMP 2021 | NSYMCA.ORG 15SPECIALTY CAMPS
Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10
6/7-6/11 6/14-6/18 6/21-6/25 6/28-7/2 7/5-7/9 7/12-7/16 7/19-7/23 7/26-7/30 8/2-8/6 8/9-8/13
ROCK BAND
Grades: 1-6. Days: M-F. Session length: 1 week.
Designed for students of all levels, from beginners to seasoned artists, this program is
taught by real musicians using the unique B2R method, which will have students playing
full songs in no time! Students are placed in a band according to their age and skill.
Financial assistance and proration do not apply to this camp.
$YM $YM
Camp Name Weeks Offered Time Counselor/Child Ratio $NM
Before 5/1 After 5/1
Rock Band PM 4,8 1-4pm 1:6 $229 $244 $344
SLIME CAMP
Grades: 1-6. Days: M-F. Session length: 1 week.
Young, mad scientists get down and dirty creating a wide variety of slimey concoctions
and potions. Slime lovers will have a blast customizing their own slime creations through
color, scent, texture and more. Proration does not apply to this camp.
Counselor/ $YM $YM
Camp Name Weeks Offered Time $NM
Child Ratio Before 5/1 After 5/1
Slime Camp AM 2, 6 9am-12pm
1:6 $194 $209 $314
Slime Camp PM 9 1-4pm
NEW
STAR WARS TM
Grades: 1-6. Days: M-F. Session length: 1 week.
Your child will learn the way of the force and take down the dark side, all while having
fun! At Star Wars camp, your child will play Star Wars themed games like Light Saber tag
and Jedi Training competitions. Your child will also create Star Wars themed crafts like
designing their own droids. Proration does not apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Star Wars PM 4 1-4pm 1:6 $194 $209 $314
WHODUNNIT? NEW
Grades: 1-6. Days: M-F. Session length: 1 week.
Campers will learn how to find evidence, uncover clues and follow their hunches during
this thrilling mystery-filled week of camp! Through hands-on projects like deciphering
codes, invisible ink, and scavenger hunts, your child will use their smarts to become
camp heroes by solving one of the biggest mysteries of the summer. Proration does not
apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Whodunnit? AM 9 9am-12pm 1:6 $194 $209 $314
16 FOLLOW US ON FACEBOOK, TWITTER, INSTAGRAM, AND DOWNLOAD THE NSYMCA MOBILE APPFIELD TRIP SPECIALTY CAMPS
Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10
6/7-6/11 6/14-6/18 6/21-6/25 6/28-7/2 7/5-7/9 7/12-7/16 7/19-7/23 7/26-7/30 8/2-8/6 8/9-8/13
GO KART CAMP! NEW
Grades: 3-6. Days: M-F. Session length: 1 week.
Each day we will attend a different Go Kart track and put the pedal to the metal. All field
trip locations are TBD. Potential field trip locations include: Action Territory Park, Play
& Spin, and Enchanted Castle. As an additional bonus, we will enjoy other entertainment
options at each location outside of riding the Go Karts (example: arcades, laser tag).
Proration and Financial Aid does not apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Go Kart Camp - Full Day 3 9am-4pm 1:6 $266 $281 $386
WATER PARK CAMP NEW
Grades: 3-6. Days: M-F. Session length: 1 week.
Water Park Camp is the thrilling field trip camp where kids can enjoy different water parks
EVERY DAY! Potential field trip locations include: Rainbow Falls, Bensenville Water Park, and
Mystic Waters. Proration and Financial Aid does not apply to this camp.
Counselor/ $YM $YM
Camp Name Weeks Offered Time $NM
Child Ratio Before 5/1 After 5/1
Water Park - Full Day 8 9am-4pm 1:6 $266 $281 $386
NAVIGATOR ADVENTURE CAMP NEW
Grades: 6-8. Days: M-F. Session length: 1 week.
Your middle schooler will attend full-day field trips around the Northshore. Potential
field trip locations include: Dave & Busters and Mastermind Escape Room. Proration
and Financial Aid does not apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Navigator Adventure - Full Day 7 9am-4pm 1:10 $266 $281 $386
ULTIMATE ADVENTURE CAMP NEW
Grades: 3-6. Days: M-F. Session length: 1 week.
We take everyone’s favorite day of the week and turn it into EVERY DAY! Your child will
participate in exciting half day activities all over the Northshore. Potential field trips
include: kayaking in the Skokie Lagoon, Wanderlust Archery, and River Trails Nature
Center. Proration and Financial Aid does not apply to this camp.
Weeks Counselor/ $YM $YM
Camp Name Time $NM
Offered Child Ratio Before 5/1 After 5/1
Ultimate Adventure AM 9 9am-12pm
1:6 $231 $246 $351
Ultimate Adventure PM 6 1-4pm
BEST SUMMER EVER | NORTH SUBURBAN YMCA | SUMMER CAMP 2021 | NSYMCA.ORG 17SPECIAL SERVICES
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8/2-8/6 8/9-8/13
8/2-8/6
HAWKS
The NSYMCA actively supports inclusion and welcomes kids of all abilities. Recognizing the need
for quality, adaptive programming for individuals in the North Shore area, the HAWKS programs
help individuals gain confidence, promote independence and responsibility, foster friendships,
and nurture a healthy and active lifestyle. All programs are supervised by qualified individuals
who help promote a safe, friendly, and supportive environment. We believe that consistency is
of the utmost importance and we welcome aides provided by the family to attend camp or any If your HAWKS camper needs
of our programs with their child. All aides must be interviewed by the NSYMCA. Extended Camp, please
contact Ellen Mirochnick at
All HAWKS campers will be interviewed and screened by Ellen Mirochnick, NSYMCA emirochnick@nsymca.org.
Coordinator of Special Services. All HAWKS campers must be NSYMCA members. To be a
part of the HAWKS Camp you must fill out a HAWKS application and questionnaire, which
can be found on our website at www.nsymca.org.
HAWKS INCLUSION 1-ON-1
Grades: 1-8. Days: M-F. Session length: 1 week.
* Must sign up for at least 6 weeks
Space is limited due to staff and is based on a first-come first-served basis. HAWKS
1:1 programming is for participants that do best when individual support is provided.
The camper and their inclusion counselor will be part of our traditional camps or
sports camps for their age group and will participate to the best of their abilities.
Our 1:1 inclusion counselors work to facilitate an inclusive environment for campers
while working with the whole group. All inclusion counselors are required to attend
NSYMCA camp training workshops prior to the start of camp. All HAWKS campers will be
interviewed and screened by Ellen Mirochnick, NSYMCA Coordinator of Special Services.
All HAWKS campers must be NSYMCA members. The registration deadline is March 15th.
Camp Name Weeks Offered Time Counselor/Child Ratio $YM
HAWKS Inclusion 1-1 1-9 9am - 4pm 1:1 $545
HAWKS HIGH SCHOOL CAMP
Grades: 9 - Transition. Days: M-F. Session length: 1 week.
This social and recreational camp is for high school students and includes fitness, field
trips, and community outings. The group setting, with a maximum of 8 campers, provides
opportunities to engage with others while working toward common goals. For further
information please contact Ellen Mirochnick at: emirochnick@nsymca.org. A 1:1 aid is
available at an additional cost but must sign up for at least 6 weeks.
Camp Name Weeks Offered Time Counselor/Child Ratio $YM
HAWKS High School Camp PM 1-9 12-4pm 1:4 $300
18 FOLLOW US ON FACEBOOK, TWITTER, INSTAGRAM, AND DOWNLOAD THE NSYMCA MOBILE APPRegistration for office use only
Camp Registration Form 2021 Date
Initials
Will you be applying for Financial Assistance?* Yes No This form must be completely filled out with form of payment to be processed or the form is considered void.
Camper Full Name: Grade: Parent/Guardian Name:
(Fall 2021)
Address: City, State, Zip:
Cell Phone: Emergency Phone:
(Must be able to receive text messages)
Email 1: Email 2:
Friendship Request
(Only 1 allowed and must be reciprocal)
Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10
6/7-6/11 6/14-6/18 6/21-6/25 6/28-7/2 7/5-7/9 7/12-7/16 7/19-7/23 7/26-7/30 8/2-8/6 8/9-8/13
Days of the Week Week of Camp
Camp Name AM PM Full
M Tu W Th F 1 2 3 4 5 6 7 8 9 10
Extended Camp (Optional)
Swim Lessons (Optional)
Payment Options: Please Check One. Summer School Pick-Up (Circle One)
( Payment Plans for Members only and must end by 7/15/2021)
I would like to make a payment plan with my membership plan Northbrook Jr
Maple/ 11:25 am Westmoor / 11:40 am Maple / 12:30 pm
High / 12:00 pm
Please draft my account on: 1st of the month 15th of month
Starting on: Ending on:
I would like to pay in full Membership:
Check (A Debit or Credit Card must be on file for incidentals) Members must have a consecutive membership for
Credit Card # 6 months to receive the special member-only discount.
Exp: Name on Card I am already a member of the NSYMCA
I understand that if I fail to make a payment, my camper(s) will not be allowed to attend camp until payment is made.
If payment is not made by the Wednesday before the camp starts, my camper will lose their spot in camp. I understand
that if I incur any fees, late registrations or change requests, late pick up, t-shirt, extended camp charges, shack shack, I would like to become a member of the NSYMCA! **
and camp store, I authorize the North Suburban YMCA to charge my account using the payment information on file.
By initialing here, I hereby acknowledge that I’ve read and understand the parent handbook and
NSYMCA’s policies available online. Will you donate to our Strong Kids Scholarship Fund?
Signature: $100 $50 $25 $10 OTHER
WAIVER OF RISK & RELEASE POLICIES
I agree to abide by the facility, program, and membership policies of the NSYMCA at all times
Membership must remain current throughout the entire camp period to qualify for member
while on the premises. I give permission for the above-named participant to be included in
rates. Prices are subject to change. A full refund will be issued if you cancel prior to the
photos for publicity purposes. I understand the NSYMCA is not responsible for personal
registration deadline, or if the NSYMCA cancels camp. Refunds will be given by check or
property or personal injury sustained by the participant and I hereby agree to identify and
NSYMCA credit voucher only. Refer to the previous page & parent guide for complete
hold harmless the NSYMCA from such losses or injuries. In the event I cannot be reached
registration policy. The NSYMCA does not turn anyone away due to inability to pay. If you
in an emergency situation involving the above-named participant, I hereby give permission
need assistance, please stop by the Guest Services Desk. Policies are subject to change. By
to the program leader to seek medical treatment for the above-named participant. The
signing below, I acknowledge all of the NSYMCA’s Policies.
NSYMCA reserves the right to change or alter any program without notice.
Signature:
For office use only *Scholarship Application is required if yes. Registrations will not be Special Services:
Registration entered in CCC on processed until application is submitted and approved. Initial
**An additional application is required. Please Submit to the Front Desk
By DateOne form must be filled out for each camper and turned in at the time of registration.
For more information, please contact Camp Registrar at registrar@nsymca.org
Child’s Full Name: D.O.B School & Grade:
What should we know about your camper? Please give any information which will help us make this your camper’s best summer ever! Include behavior management
techniques that your camper responds to positively. Let us know what activities interest your camper.
Form must be submitted to complete registration.
Allergies:
Additional Health Form Required.
List any medications your child has
taken in the last 12 months:
Does you child need an Epipen? Yes No Will your child require medication during camp? Yes No If Yes, please fill our additional form.
If your child has an allergy please fill out additional allergy information and if your child has an epi-pen or inhaler, please fill out medicine adminstration form.
Medical or Physical Restrictions (If Any) Does your child have an IEP? Yes No
Please describe any additional support your child receives at school and/or during the year (E.G speech, behavior therapy, social work, counseling, etc.)
REGISTRATION FOR HAWKS CAMPS REQUIRES AN ADDITIONAL SPECIAL SERVICES QUESTIONNAIRE (Download at nsymca.org)
AUTHORIZED PARENT/GUARDIAN CONTACT INFORMATION
Parent/Guardian 1 Name:
Phone Number: Work Phone: Cell:
Parent/Guardian 2 Name:
Phone Number: Work Phone: Cell:
Emergency Contacts: (When Parent or Guardian cannot be reached)
Name: Cell:
Name: Cell:
Name: Cell:
PARENT STATEMENT OF UNDERSTANDING
Please read this form carefully. Sign this form and return to the NSYMCA. No child can attend camp 6. I understand that the North Suburban YMCA Camp Director reserves the right to dismiss a camper from
unless all completed forms are on file. camp. Such situations will mean the total loss of camper fees as paid by the parent or scholarships given to
the child.
1. I understand that the North Suburban YMCA staff and volunteers are not allowed to baby sit or transport
children at any time outside of the YMCA camp program, with the exception of relationships established 7. I have received, read, understand, and agree with the policies above and the North Suburban YMCA’s Camp
outside of the YMCA and prior to the start of the camp session. Immediate disciplinary action will be taken policies and parent handbook.
toward staff and volunteers if a violation is discovered.
8. I give the North Suburban YMCA the right to take pictures and video for marketing purposes.
2. I understand that I am not to leave my child at the North Suburban YMCA or any off-site NSYMCA location
unless a YMCA camp staff is there to receive and supervise my child. 9. I give permission for the North Suburban YMCA to transport the child named above off the property for the
purpose of medical care or program activities as deemed appropriate by the director and in the event I cannot
3. I understand that my child will not be allowed to leave the program with an unauthorized person. Any person be reached in an EMERGENCY. I hereby give permission to the physician selected by the Camp Director, to
authorized to pick up my child must be listed in my child’s registration forms or a note written and signed by a hospitalize, secure proper treatment for, and to order injection, anesthesia or surgery for my child as named
parent or legal guardian must be received by NSYMCA stagff at least one day prior to the pick up. above if I cannot be reached.
4. I understand that should a person arrive to pick up my child who is obviously under the influence of alcohol 10. I attest that this registration form in its entirety is correct to my knowledge and understand any changes
or drugs, for the child’s safety, staff may have no recourse but to contact police. Please do not put staff in a to the information must occur in writing. I give permission for the child mentioned herein to engage in all camp
position where they have to make this judgment call. activities except as noted.
5. I understand that the North Suburban YMCA is mandated, by state law, to report any suspected cases of 11. I give permission for the YMCA Staff to help apply sunscreen to my child according to the instructions on
child abuse or neglect to the appropriate authorities for investigation. the bottle.
Camper Name Parent
Date:
(Please print) SignatureNorth Suburban YMCA • 2705 Techny Road
FOR YOUTH DEVELOPMENT
Northbrook, IL 60062 • 847-272-7250 • nsymca.org
FOR HEALTHY LIVING
FOR SOCIAL RESPONSIBILITY
JOIN THE NORTH SUBURBAN YMCA COMMUNITY!
MEMBERSHIP APPLICATION
FINANCIAL ASSISTANCE IS AVAILABLE.
APPLICANT INFORMATION
Full Name: _______________________________________________________ Address: ___________________________________________________________
Gender:_________________________ DOB: __________________________ City, State, Zip: ___________________________________________________
Parent Full Name: _______________________________________________ ______________________________________________________________________
(youth members only)
Cell: _________________________________________________________________
Spouse Full Name: ________________________________________________
Provider: ___________________________________________________________
Gender:_________________________ DOB: ___________________________ (for app text messages)
Emergency Contact and Work Phone : __________________________ Email: _____________________________________________________________
______________________________________________________________________ Member Referral Name: _________________________________________
______________________________________________________________________ _____________________________________________________________________
FAMILY MEMBERSHIP INFORMATION
FIRST DEPENDENT/ CHILD SECOND DEPENDENT/ CHILD
Full Name: ______________________________________________________ Full Name: ______________________________________________________
Gender: __________________________________________________________ Gender: __________________________________________________________
DOB: _____________________________________________________________ DOB: _____________________________________________________________
THIRD DEPENDENT/ CHILD FOURTH DEPENDENT/ CHILD
Full Name: ______________________________________________________ Full Name: ______________________________________________________
Gender: __________________________________________________________ Gender: __________________________________________________________
DOB: _____________________________________________________________ DOB: _____________________________________________________________
DEMOGRAPHIC INFORMATION ETHNICITY
To help serve you better, please fill out the following information. This
information is kept confidential and is strictly voluntary.
Asian/Pacific Islander African-American
My main interests are: Caucasian Middle Eastern
Indian Native Amerian
After-School Programs Aquatics
Latino/Hispanic Other:______________________
Art Camp
Early Childhood Family Programming
Gymnastics Performing Arts OCCUPATIONS
Personal Training Senior/Adult Programming Your Occupation: _____________________________________________
Special Needs Sports
Employer: ______________________________________________________
Volunteerism Weight Loss
Spouse Occupation: __________________________________________
How did you hear about the Y?_____________________________ Employer: _____________________________________________________
_________________________________________________________________MEMBERSHIP APPLICATION (CONTINUED)
YMCA MEMBERSHIP AGREEMENT HELP SUPPORT THE Y
PLEASE READ AND SIGN
PLEASE INITIAL YOUR CHOICE AND SIGN
• I understand that this membership will remain in effect until I give
written notice of termination. Yes, I would like to make a No, I would not like to
tax-deductible contribution. contribute at this time.
• It is to my complete understanding that if I wish to terminate
or change my membership in any way, I must give the NSYMCA a
10-day written notice in advance of my draft date. I understand $2 $5 $10 $50 Other: $_________
that I must return all of my membership cards upon termination.
This amount will automatically be deducted with my monthly member-
• The NSYMCA Board of Directors may, at their discretion, adjust the ship dues and can be cancelled with my authorization at any time.
monthly rate applicable to my category of membership. Rates are If I want to cancel this donation, I will contact the Y in writing to cancel this
subject to change at any time without prior notice. As I age into a donation.
different membership, the fee will automatically change.
SIGNATURE: __________________________________DATE:_____________
• Membership cards remain the property of the NSYMCA and must be
surrendered upon demand of that institution.
HELP COMMUNITY MEMBERS
• The NSYMCA has authorization to charge the difference be- PLEASE INITIAL YOUR CHOICE
tween member and non-member rates if I terminate my member-
Through our Strong Kids Campaign, your tax-deductible contribution
ship or if my membership expires while I am in the middle of a
helps us provide program support to families in need.
class session.
Yes, I would like to make a No, I would not like to
• If this is a corporate membership and the corporation becomes tax-deductible contribution. contribute at this time.
inactive or no longer wishes to participate, membership fees will be
adjusted to current membership fees at the time of notification. The
$2 $5 $10 $50 Other: $_________
active member must work at the company.
This amount will automatically be deducted with my monthly member-
• Applicable to draft only: I am responsible for any uncollected
ship dues and can be cancelled with my authorization at any time.
funds. My membership will be terminated if I have two (2) uncollect-
ed drafts on record at the same time or if I close my account without If I want to cancel this donation, I will contact the Y in writing to cancel this
notification, stop payment on my draft, or revoke authorization. Any donation.
penalties imposed by my bank or the NSYMCA for uncollected drafts SIGNATURE: __________________________________DATE:_____________
are my responsibility. Should any membership draft not be honored
by my bank for any reason, I realize that I am still responsible for
that payment plus a service charge applied by the NSYMCA. This is in WAIVER & RELEASE OF ALL CLAIMS
addition to any service fee my bank may charge The NSYMCA charges In applying for membership at the North Suburban YMCA, I agree to cooperate with
a $25 service fee or current banking fees for each uncollected draft. others in supporting the NSYMCA mission, goals, and objectives and to abide by the
policies and procedures set forth by the NSYMCA Board of Directors. I understand
• Aplicable to annual membership only: I agree to a 1-year member- that my NSYMCA membership dues are non-refundable and membership privileges
ship from the time of purchase. I am not able to upgrade or down- are non-transferable. I hereby allow the NSYMCA to take pictures or video (still or
motion) of myself/my family and grant permission for these images to be used in
grade or make changes to my membership. If I cancel before the term,
NSYMCA publications, presentations, publicity, social media, or promotions without
no refunds will be given. compensation to me/my family or on my behalf or my family’s. If I choose not to
be photographed, videotaped, or appear in other recorded media, it is my
SIGNATURE: __________________________________DATE:_____________ responsibility to inform the photographer and/or remove myself/my fami-
ly from the picture. In consideration of gaining membership or being allowed to
participate in the activities and programs of the NSYMCA and to use its facilities,
equipment, and machinery in addition to the payment of any fee or charge, I do
MEMBERSHIP DRAFT AUTHORIZATION hereby waive, release, and forever discharge the NSYMCA and its officers, agents,
employees, representatives, executors, and all others from any and all responsibilities
I hereby authorize the North Suburban YMCA and my financial institution to or liability for injuries or damages resulting from my participation in any activities or
begin automatic deductions from the account designated below in the amount my use of equipment or machinery in the above-mentioned facilities or arising out of
below in the amount of my membership dues and fees. my participation in any activities at said facility. I do also hereby release all of those
mentioned and any others acting upon their behalf from any responsibility or liability
PLEASE INITIAL YOUR CHOICE
for any injury or damage to myself, including those caused by the neglect, act, or
Checking Account- I am attaching a voided check or a copy of my omission of any of those mentioned or others acting on their behalf or in any way
debit card to ensure the accuracy of the routing and account num- arising out of or connected with my participation in any activities of the NSYMCA
bers for my banking institution. I understand that if any information or the use of any equipment at the NSYMCA. I understand that I am subject to a
changes, I must provide the NSYMCA with a new voided check. sex offender registry screening. The YMCA conducts regular sex offender screenings
on all members, participants, and guests. If a sex offender match occurs, the YMCA
Credit Card Account- I understand that if I recieve a replacement or
reserves the right to cancel the membership, end program participation, and remove
new card for the credit card account designated, I must provide the
visitation access. I agree to adhere to all policies set by the NSYMCA as written in
NSYMCA with updated credit card information the NSYMCA Membership Handbook. I have answered the above questions accurately
and declare myself/my family to be physically sound, and having medical approval to
Card Number: _____________________________________________________ engage in NSYMCA activities.
Exp Date: ______________________________CVV:______________________
SIGNATURE: __________________________________DATE:_____________
SIGNATURE: __________________________________DATE:_____________
FOR OFFICE USE ONLY: SIGNATURE: _________________________________________ CCC ID#:____________________________You can also read
