2018 Day Camp Registration Packet Camp Destiny - NORTHPARK YMCA
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
2018 Day Camp Registration Packet Camp Destiny NORTHPARK YMCA
CAMP DESTINY INFORMATION
FUN IN THE SUN CAMP!
Our Outdoor Day Camp is a fun place to enjoy summer where campers play games, create arts and crafts,
explore science and technology, swim, participate in weekly field trips, appreciate nature and discover and
value our many cultures. It also provides youth with supervised activities that teach core values, conflict
resolution and leadership skills.
Campers in our camp spend at least 80% of the day engaging in outdoor activities. If your child loves
being outdoors, then this is the camp for them.
LOCATION:
Our camp will operate on-site at the Northpark YMCA – 9100 N Beach St., Keller, TX 76244.
DATES & HOURS:
Camp is open Monday- Friday each week from June MONDAY
4th - August 10th (closed July 4th). IN-HOUSE/OUTDOORACTIVITIES
MORNING
7:00a-8:30a- Pre Camp- Included in your weekly OPENING ASSEMBLY TUESDAY
& OUTSIDEACTIVITIES THEMEDAY!
rate!
This is the designated drop off time. Campers will
have Opening Ceremony at 8:30am.
8:30-4:00p- Camp Time
This is the time camp activities and rotations will
begin. We ask that parents have kids dropped MID-DAY WEDNESDAY
off by this time each day. If not, parents will be LUNCH,GAMES FIELDTRIPDAY!
OUTSIDE/SWIMMING
responsible for taking their child to his/her
group. Campers cannot be dropped off after
10:00am.
4:00-6:00p- Post Camp- Included in your weekly THURSDAY
rate! IN-HOUSE/OUTDOORACTIVITIES
This is the designated pick up time. If you need AFTERNOON FRIDAY
to pick up your camper prior to this time, please ART &SCIENCE AFTERNOON
ACTIVITY SHOWCASES
notify camp in advance.
AGES:
Day Camp is for children 5-12 yrs old. Children are divided into age appropriate groups with an overall camp
ratio of 1 staff per 10 campers.
REGISTRATION FEE:
All participants are required to pay a one-time $50 non-refundable camp registration fee. Discounts/Scholarship
may not be applied to this fee.
WEEKLY FEES:
YMCA Member Rate- $140/per week including field trip fees
Non-Member Rate- $190/per week including field trip fees
Full weekly payments are due on the Wednesday before camp. Anyone who has not paid for camp as of Thursday
the week before camp begins will forfeit their spot in camp for the week.
CAMP DEPOSITS:
Weekly deposits ($20) are non-refundable and required to reserve your child’s place in camp. Full weekly
payments are due on the Wednesday before camp. Failure to pay on time will result in a $25.00 late fee or loss
of your child’s place in camp.
2
PAYMENT DETAILS
Due Dates:
All Day Camp payments are due Wednesday prior to camp starting.
Payments made after the due date will be assessed a $25.00 late fee.
Drafts:
All Day Camp payments must be set up on a scheduled draft in order to register for future weeks.
Payments can be made before your due date to avoid drafting however, a draft will still need to be set
up. A fee of $25.00 will be assessed for all returned drafts. In the event of a returned check or an EFT
bank draft, all future payments must be made by money order, cash or credit card.
How to Pay:
If you choose to pay before your scheduled draft, then payments may be made online, over the phone
(with credit card), or at the branch (cash, check, debit or credit). Anyone who has not paid for camp as
of Thursday the week before camp begins, will forfeit their spot in camp for the week.
Cancellations:
No refunds will be given after the start of the camp week. Refunds for Day Camp must be requested in
writing, two weeks prior to the registration deadline, or only a partial refund will be applicable.
Registration fees will not be refunded for any reason.
Weekly deposits will not be refunded for any reason.
YMCA FINANCIAL ASSISTANCE/ SCHOLARSHIP PROGRAM
At the YMCA, our goal is to ensure that no one is turned away from the YMCA due to
their financial situation.
The YMCA offers financial assistance to those who qualify. Applications are available at our YMCA
branch and must be completed 7-10 days in advance. Please ask our staff for more details or visit
our website!
www.northparkymcafw.org
3DATES, THEMES & FIELD TRIPS:
Week Dates Theme Field Trip
Week 1 June 4-8 Camp Destiny’s Got Talent Alley Cats
Payment due May 30 Wednesday, June 6th
Week 2 June 11-15 Where the Wild Things Live Fort Worth Zoo
Payment due June 6 Tuesday, June 12th
Week 3 June 18-22 Motion of the Ocean Hawaiian Falls Mansfield
Payment due June 13 Friday, June 22nd
Week 4 June 25-29 Super Heroes Camp Carter
Payment due June 20 Wednesday, June 27th
Week 5 July 2-6 Red, White and Blue On Site Activity
*Closed July 4
Payment due June 27
Week 6 July 9-13 The Great Barrier Reef Splash Dayz
Payment due July 4 Wednesday, July 11th
Week 7 July 16-20 Carnival Week Altitude
Payment due July 11 Wednesday, July 18th
Week 8 July 23-27 Imagine the Possibilities Skatetown
Payment due July 18 Wednesday, July 25th
Week 9 July 30- August 3 Mystery Week Tornado Terrys
Payment due July 25 Wednesday, August 1st
Week August 6-10 Hasta Luego Summer Alley Cats
10 Payment due August 1 Wednesday, August 8th
FIELD TRIP REMINDERS:
During weekly field trips, all campers must wear their current year’s Day Camp t-shirt
to camp. Campers receive shirts during their first week of camp.
Unless requested, please do not allow your child to bring additional money to any
field trips.
All campers must arrive by 8:30am on field trip days in order to assure campers are
accounted for and loaded on the bus properly. Campers are not allowed to be
dropped off at a field trip location. All children are expected to participate in field
trips as there is no alternative care available for those who wish not to attend.
Pack light during field trips unless campers are requested to bring additional items to
camp. Campers usually have to carry their belongings with them on field trips.
Bring a lunch! All field trips will require a sack lunch unless stated otherwise.
4YMCA MEMBERSHIP
ADVANTAGES
Potential childcare savings:
Value Family/Household Membership Without Membership
Joining Fee $20 Camp $50 Camp $50
Registration Registration
Fee Fee
June Dues $77 Week 1 $140 Week 1 $190
Week 2 $140 Week 2 $190
Week 3 $140 Week 3 $190
Week 4 $140 Week 4 $190
July Dues $77 Week 5 $140 Week 5 $190
Week 6 $140 Week 6 $190
Week 7 $140 Week 7 $190
Week 8 $140 Week 8 $190
Week 9 $140 Week 9 $190
Aug. Dues $77 Week 10 $140 Week 10 $190
Total Fees: $1,701 Total Fees: $1,950
In addition to your savings you could take advantage of the following:
Free weights
Group exercise classes (Zumba, Spin, BodyPump, etc.)
Resistance equipment
Treadmills & stationary bikes
Cross trainers and elliptical
Free Child Care while you work out
Free Wellness Consultations with a personal trainer
Outdoor pool available
Discounts on programs such as summer basketball &
swim lessons
52018 POLICY REVIEW & ACKNOWLEDGMENT
Parent/ Guardian Initials CHECK IN/OUT Campers can be checked in between 7:00-8:30am daily. Parents must sign their campers
into the camp each day. Campers dropped off after 8:30am will need to be taken to their group by the
parent. Campers may be picked up between 4:00-6:00pm. When leaving the program, children must be
signed out by an authorized adult, and will not be permitted to leave the program area without the
authorized adult being present. If campers need to be picked up early, advance notice must be given.
Camp Contact number 817-823-0195.
Parent/ Guardian Initials ILLNESS In the case that your child becomes ill during the program, you will be contacted as soon as
possible. If the parent/guardian is unable to be reached, the emergency contacts will be notified in the
order listed on the enrollment form. It is the parent’s responsibility to arrange for the camper to be
picked up as soon as possible.
Parent/ Guardian Initials MEDICATION POLICY Medication (including inhalers) must be submitted directly to the Camp Staff or the
Camp Director in its original container that shows the date, name of the child, doctors contact
information, directions for use, and quantity of dosage. All medication, with the exception of EpiPens
and inhalers, will be kept in a locked first-aid kit and administered by YMCA Staff. Expired Medication
will not be administered.
Parent/ Guardian Initials PHOTOGRAPHY/ VIDEO RELEASE I, the undersigned, consent to the use of my child’s likeness
(photographic, nonphotographic or otherwise), actions and appearance by the YMCA in connection with
any publication, program or in any and all media, including the YMCA website, authorized by, made or
published by the YMCA, and to the advertising and publicity in any and all media now known or
hereafter devised. The results and proceeds of my services in connection with the photographs, tapes,
films or drawings shall be and remain solely the property of the YMCA.
Parent/ Guardian Initials LATE PICK-UP PENTALTY Our camp closes at 6:00pm. There is a late pickup penalty charge for those
who pick up after 6:00pm. There is a grace period up until 6:05pm. Each five minutes after closing will
result in a $10 penalty per child (i.e. picking up between 6:06PM- 6:10PM = $10, picking up between
6:11PM-6:15PM = $20, etc.). Reoccurring late pickup may result in disenrollment.
Parent/ Guardian Initials PERSONAL BELONGINGS Personal belongings (Game Boys, Nintendo DS, trading cards, cell phones,
iPods, cameras, trading cards and other valuable items) cannot be brought to the program. YMCA staff
will hold items not appropriate, based on their judgment. The YMCA is not, and cannot be held
responsible for the loss or damage of any personal belongings.
Parent/ Guardian Initials PAYMENTS & ABSENCES Payments are to be made the week prior to your child’s attendance in the
program. Failure to make payments may result in your child not being able to attend the program.
Weeks are not pro-rated and we do not make adjustments based on attendance.
Parent/ Guardian Initials SHOT DATES
The YMCA Day Camp must have the dates of each camper’s shots on file prior to their attendance in
camp. Dates should be provided upon registration. In the event the dates are not provided, participants
have until the child begins camp to provide a copy.
Parent/ Guardian Initials MOVIES
I give permission for my child to view a Director approved movie, though it is not part of regularly
scheduled lesson plans.
Parent/ Guardian Initials T-SHIRT/ FIELD TRIP POLICY As a safety precaution all campers must wear their current year’s YMCA
Day Camp t-shirt on all field trips. If your camper does not bring their t-shirt, you may bring it to them
before we depart for our trip or purchase another one for $10.00. Field trips are subject to change with
advance notice given. Campers will receive t-shirts during their first week of camp.
These policies along with other YMCA policies and procedures are available in writing in your Day Camp
Parent Handbook. Please be sure to obtain one of these upon registration or via our website at
www.northparkymcafw.org
Parent Signature: _____________________________________________________________ Date: __________________________________
6YMCA Day Camp
Authorization to Draft Credit Card
Name of child (ren): ______________________________________________________
Parent/ Guardian Name: _________________________________________________ Member number_____________________________________
Parent E-mail: _____________________________________________________ (Please provide a valid email address to receive payment receipts)
Please read and initial the following:
_____________ I authorize the YMCA to charge my credit card, or bank account, for Day Camp. I understand that I am responsible for
having the agreed upon amount available for automatic draft.
_____________ Your account will be drafted weekly on Wednesday prior to the week of camp.
_____________ If a return draft occurs on an account, your account will be charged a $25.00 NSF fee.
_____________ A seven day written notice is required to make changes to my draft information or to cancel the draft authorization.
_____________ If payment is not received by noon on the Thursday before camp starts you will lose your spot for the next week.
____________ I understand if I cancel the YMCA Summer Day Camp Program after the draft date (Wednesday prior to week of care) I will
not be eligible for a refund regardless of my child’s attendance in camp. Refunds will not be issued to those who do not
cancel their camp registration before the draft date.
___________ I understand if I cancel the YMCA Summer Day Camp Program and my account has a past due balance, the balance will be
drafted at the time of cancellation and the YMCA will continue to draft outstanding balances until the past due amount
is paid in full.
___________ I understand registration fees and weekly deposits are non-refundable or transferable. The registration fee is only
discounted during a promotional period prior to May 2018 and will only be applied to those with the promotional code.
___________ I understand that space is limited and if I choose not to pre-register then space is not guaranteed.
___________ I understand if my draft returns, I have until Thursday to take care of my past due balance. If my account is not taken
care of by then, my child’s space at camp will be forfeited. A late payment fee of $25.00 will be assessed to any late
payments.
___________ I have reviewed the YMCA 2018 Draft Schedule and understand that I will be charged according to the weeks I have
selected for my child to attend Camp, regardless of absences or lapses in attendance.
_____________ Payment made after Thursday will be assessed a late fee of $25.00.
Credit Card Information:
Credit Card type: ___________________________ Expiration date: _____________________ Verification Code _________________
Last 4 digits of card: ______________________ Name on card: _________________________________________________________________________
Bank Account Information:
__________ Checking account Routing number ____________________________________________________________________
__________Savings account Account number ____________________________________________________________________
Please check the days you would like your child to attend – Payment is due at the time of registration for single days.
__________ May 29th __________ May 30th ___________May 31st __________ June 1st
Please check the weeks you would like your child to attend:
________Week 1, June 4-8 ________ Week 5, July 2-6 __________ Week 9, July 30-August 3
________Week 2, June 11-15 ________ Week 6, July 9-13 __________ Week 10, August 6-10
________Week 3, June 18-22 ________ Week 7, July 16- 20
________Week 4, June 25- 29 ________ Week 8, July 23-27
Cardholder’s Signature: ______________________________________________________________ Date: ___________________________________
7PARENT CODE OF CONDUCT
The following guidelines have been created to meet the standards, policies and procedures of the
YMCA, Minimum Standards for Child Care Centers and the Texas Family Code. All YMCA staff and
volunteers are knowledgeable of these standards, policies and procedures.
Please read the Parent Code of Conduct below and sign.
1. Please communicate with the staff daily, if possible.
2. Please come visit our program and have fun with your child; you are always welcome.
3. Please give detailed information to the Program Director if custody situations arise.
4. People whose behavior and/or health status pose an immediate threat or danger to the health
and safety of the children must not be present when children are in care.
a. Please do not confront any child in a threatening manner, or confront children from other
families.
b. Using profanity in the presence of a minor is prohibited and against the law.
c. In the event of threatening behavior towards a YMCA staff member or child, 911 will be
called.
5. Consumption, and/or possession of alcohol in any form is strictly prohibited by the YMCA of
Metropolitan Fort Worth. Controlled substances/ medications must be accompanied by a written
Doctor’s prescription when used during the program, during transportation, or on field trips.
People must not be under the influence of or impaired by alcohol or controlled substances in the
program, during transportataion, or on field trips.
a. Children will not be released to parents, guardians or other authorized individuals if the
YMCA staff feels as though the inividual is consuming, under the influence or impaired by
alcohol or a controlled substance.
6. People must not smoke or use tobacco products at the child-care center, on the premises, on the
playground, in transportation vehicles or during field trips.
CONSEQUENCES OF PARENT MISBEHAVIOR:
Any adult misconduct will result in a warning and documentation of the incident. The maximum
pentalty of any of the above violations would be the parent’s removal from the building, police being
contacted, or the child’s removal from our program.
Parent Signature: _____________________________________________________________
Date: _____________________________________
8YMCA CAMPER BEHAVIOR CONTRACT
A high quality program can only take place in an orderly, mutually respectful, caring environment. Child
guidance is a process where children take increasing responsibility for their own actions. At the YMCA, we
take the happiness and safety of our participants seriously. Therefore, we work very hard at creating a safe
and fun environment. Along with our efforts, we need the children to help us by following some simple rules.
Below is our behavior agreement.
Please read this Behavior Contract with your child (also provided in your Parent Handbook) and ensure they
understand our camp’s behavior policies.
I will listen to the staff and follow directions. I will act in a caring way, and I will not hit,
I will respect other people’s belongings by not fight, bite, tease, harass or bully others.
touching/using their belongings without I will use my indoor voice when speaking
permission. inside.
I will respect all property and help clean I will use appropriate language, which does
personal messes and assist in leaving areas not include swear words or negative remarks
better than I found it. (i.e. “shut up”, “stupid”, “dumb”).
I will respect other people’s personal space by Before leaving the room or program space, I
keeping my hands and feet to myself. will ask a staff member for permission. I will
I will respect other people’s feelings by having never leave an area without adult
a positive attitude when talking to them. supervision.
Not abiding by these rules may result in suspension and/or termination from the program.
All incidents will be handled on a 3 incident system, except hitting, fighting, and inappropriately touching
another camper.
Hitting, fighting, and inappropriately touching another camper will be an immediate 1-3 day suspension from
the program.
All other incidents will be handled as follows:
1st Incident= Verbal Warning
2nd Incident= Written Warning & Parent Contact
3rd Incident= 1 to 3 day Suspension & Parent Meeting
More than 3 incidents will be subject to camper dismissal from the program.
YMCA staff and management reserve the right to dismiss/disenroll a child from the day camp program if the
child’s behavior is disruptive to the program and/or compromises the safety of themselves, other children
and/or staff. Children suspended/terminated from the program will not qualify for a refund.
By signing I agree to partner with the YMCA in making my child’s Day Camp
experience positive and safe for all children and families involved.
Parent Signature: _______________________________________________ Date: _________________
92018 NORTHPARK YMCA CAMP ENROLLMENT FORM
PARTICIPANT INFORMATION
Child’s Name _________________________________________________________________ School Grade in Fall ___________________________
Birth Date ____________________________ Age ________________ T-Shirt Size ______________ ☐ Male ☐ Female
Child’s Address ______________________________________________________________ City _________________________ Zip ______________
PRIMARY PARENT/ GUARDIAN (Authorized to pick up) ☐ Mother ☐ Father ☐Other: _________________
Name _______________________________________________________ Birth Date __________________________ DL # _________________________
Home Address ________________________________________________________________ City _________________________ Zip ______________
Home Phone ____________________________ Cell Phone ____________________________ Work Phone _____________________________
Custodial Parent: ☐ YES ☐NO Email Address __________________________________________________________
SECONDARY PARENT/ GUARDIAN (Authorized to pick up) ☐ Mother ☐ Father ☐Other: _____________
Name _______________________________________________________ Birth Date __________________________ DL # _________________________
Home Address ________________________________________________________________ City _________________________ Zip ______________
Home Phone ____________________________ Cell Phone ____________________________ Work Phone _____________________________
Custodial Parent: ☐ YES ☐NO Email Address __________________________________________________________
EMERGENCY CONTACTS (Authorized to pick up)
Name ___________________________________________ Relationship to Child ___________________________ DL # _______________________
Home Address ________________________________________________________________ City _________________________ Zip ______________
Home Phone ____________________________ Cell Phone ____________________________ Work Phone _____________________________
OTHER PERSONS AUTHORIZED TO PICK UP CHILD- Must be 18yrs or older to pick up.
Name _________________________________________ DL # ______________________________ Phone ______________________________________
Name _________________________________________ DL # ______________________________ Phone ______________________________________
Name _________________________________________ DL # ______________________________ Phone ______________________________________
ENROLLMENT AGREEMENT (INITIAL EACH) DATES OF IMMUNIZATION:
________PHOTOGRAPHY ______________ Tetanus Booster ______________ DPT
The YMCA is hereby granted permission to use any ______________ Tuberculin (TB) _______________ MMR
individual or group photograph and/or videotape showing
my child in YMCA activities for use in public relations, _______IMMUNIZATION CONFIRMATION:
promotional or advertising purposes. Participant is current with all necessary immunizations
required by TDSHS, the county public health office, and local
________TRANSPORTATION school district (check one): _____ YES ______ Participant does
I give permission for my child to be transported in an not receive immunizations for religious/medical reasons
authorized YMCA Vehicle for YMCA events, field trips or to
the YMCA Day Camp Program location. Parent/Guardian will ________WATER ACTIVITIES
be informed of all planned field trips. I give permission for my child to participate in water
activities during program hours at predetermined time.
________HANDBOOK/ADULT & CAMPER CODE OF CONDUCT
I have received and read a copy of the YMCA Camp ________CUSTODY YMCA staff is not trained to review legal
Handbook and understand all policies and procedures. I have documents or court decrees. Decisions regarding who is
also received and read the Adult and Camper Code of authorized to pick up a child will be governed by the Primary
Conduct. Parent/Guardian information listed on this document.
10
Parent/Guardian Signature ____________________________________________________________ Date _______________________________2018 NORTHPARK YMCA CAMP ENROLLMENT FORM
Child’s Name _____________________________________________________________________________________ Age ___________________________
Height ______________________ Weight _____________________ Hair Color ____________________ Eye Color _____________________
ALLERGIES
Does your child have any severe allergies to food, medications, or insect bites? If so, what are the allergies and what
are the treatments for them? ______________________________________________________________________________________________________________
Will this treatment be left in the YMCA? ☐ Yes ☐ No *ALLERGY ACTION PLAN- If your child has an allergy you
must complete an Allergy Action Plan upon registration. These must be turned in prior to your child attending camp.
MEDICATIONS Is your child currently taking any medications? ☐ Yes ☐ No
Name of Medication: ____________________________________________________________________ Dosage: __________________________________________
Times to Administer: ______________________________________ Instructions to administer medication: __________________________________
_____________________________________________________________________________________________________________________ __________________________________
*PLEASE NOTE OUR MEDICATION POLICIES:
Non-Prescription medications REQUIRE WRITTEN NOTE AND INSTRUCTIONS by a physician
We require a MEDICATION FORM signed by parent(s) for any medication.
Medication must be CURRENT. We will not accept or administer expired medications.
We require medication to be in its ORIGINAL CONTAINER.
We allow the self-carry of Emergency Medications ONLY for children diagnosed with asthma or anaphylaxis.
Self-carry is only permitted with the PRESCRIBING PHYSICIAN’S WRITTEN PERMISSION.
SPECIAL CONSIDERATIONS/ NEEDS - Please list any SPECIAL CONSIDERATIONS relevant to your child, such as
existing illnesses, previous serious illnesses, injuries or hospitalizations within the past 12 months, activity
restrictions, developmental age, chronic health concerns, any medication prescribed for long-term continuous use and
any other information which caregiver’s should be aware of: ________________________________________________________________________
___________________________________________________________________________________________________________________________ ___________________________
AUTHORIZATION FOR MEDICAL TREATMENT
In the event that I cannot be reached to make arrangements for medical treatment, I authorize YMCA Staff to
administer first aid/or transport to the nearest hospital or emergency care facility.
☐ Cook’s Children’s Hospital at 801 7th Avenue, Fort Worth, Texas
☐ Name of Licensed Physician or Emergency-Care Facility: __________________________________________________________________
Street Address: _______________________________________________City: _____________________________________ State: _____________
Zip: __________________ Phone:____________________________________
I certify that ____________________________ has been examined by a licensed physician in the past 12 months, is able to
participate in the YMCA Day Camp Program. The Health History is correct as far as I know, and the person herein
described has permission to engage in all prescribed activities and fieldtrips, except as noted by the examining
physician and me. Parent Signature: _________________________________________________________ Date: _____________________________
YMCA OF METROPOLITAN FORT WORTH RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT
The YMCA of Metropolitan Fort Worth will not assume responsibility for any injury incurred while participating in
athletic events, childcare programs, parent/child event and outings, special events, sports programs, or any related
YMCA sponsored activity. Certain risks of injury are inherent during participation in these programs and events. Nor
will the YMCA of Metropolitan Fort Worth be responsible for any lost or stolen items while members and/or program
participants are using the YMCA facilities, on YMCA premises, or on off-site YMCA program locations. I, the
undersigned for myself and my heirs, do hereby release the YMCA of Metropolitan Fort Worth and its employees and
agents from any and all claims for injury, loss, or damage I may suffer as a result of my participation. This includes
any injury caused by negligence, if any, of the YMCA, its officers, employees, agents, volunteers, or the negligence of
anyone else. I give permission to the YMCA of Metropolitan Fort Worth to use photographs, film footage, or tape
recordings, which may include my image or voice, for purposes of promoting or interpreting YMCA programs for no
compensation.
The undersigned has read and voluntarily signs the release and waiver of liability and indemnity agreement, and
further agrees that no oral representations, statements, or inducement apart from the foregoing written agreement
have been made.
11
Parent/Guardian Signature ____________________________________________________________ Date _______________________________You can also read
