SUMMER DAY CAMP 2019 GREATER SCRANTON YMCA

REGISTRATION FORM CAMPER’S FIRST/LAST NAME: _______________________________________________________________________________________________________________________________________________________________________________

CAMPER’S DATE OF BIRTH: ____________________________________________________________________ CAMPER’S GRADE ENTERING IN FALL OF 2019: _________________________________________________

CAMPER’S SCHOOL DISTRICT: _______________________________________________________________________________________________________________________________________________________________________________

PARENT/GUARDIAN FIRST/LAST NAME: ___________________________________________________________________________________________________________________________________________________________________

ADDRESS: ________________________________________________________________________________________________________________________________________________________________________________________________________

CITY: _________________________________________________________________________________________________________________________________ STATE: ________________________ ZIP: ______________________________________

EMAIL: ____________________________________________________________________________________________ PHONE: ____________________________________________________________________________________________________

EMERGENCY CONTACT PERSON (FIRST/LAST NAME): _______________________________________________________________________________________________________________________

WORK PHONE: ____________________________________________________________________ PERSONAL PHONE: _______________________________________________________________________

GREATER SCRANTON YMCA SUMMER CAMP CAMP HOURS: 8AM—5PM

SUNRISE DISCOVERY PIONEER EXPLORER VOYAGER

GRADE GOING INTO FALL 2019 AGE 4-KINDERGARTEN (MUST BE 4 BY 6/10/19) GRADES 1 & 2 GRADES 3 & 4 GRADES 5 & 6 GRADES 7 & 8

FEES: YMCA MEMBER PER WEEK NON-MEMBER PER WEEK

$175 $190

$145 $185

WEEK 1: June 10-14, 2019

WEEK 2: June 17-21, 2019

WEEK 3: June 24-28, 2019

WEEK 4: July 1-5, 2019 (No Camp July 4)

WEEK 5: July 8-12, 2019

WEEK 6: July 15-19, 2019

WEEK 7: July 22-26, 2019

WEEK 8: July 29 - August 2, 2019

WEEK 9: August 5-9, 2019

WEEK 10: August 12-16, 2019

EXTENDED CARE ADD-ON OPTION The Greater Scranton YMCA offers 3 options for extended care during our summer camp; Before Care, After Care or Before & After Care. All fees are in addition to the base camp rate. Children must be enrolled in summer camp to participate in extended care. Please select which option you need; the option you choose for extended care will apply to all weeks selected. EXTENDED CARE NOT AVAILABLE FOR SUNRISE CAMP.

BEFORE CARE (6:30AM-8:00AM) AFTER CARE (5:00PM-6:00PM) BEFORE & AFTER CARE ADD FEE ADD FEE ADD FEE MEMBER: $13/week MEMBER: $13/week MEMBER: $25/week NON-MEMBER: $20/week NON-MEMBER: $20/week NON-MEMBER: $40/week

WEEKLY CAMP DEPOSIT - A $30/week NON-REFUNDABLE deposit is required at time of registration to hold your child(ren)’s spot in our program. Please submit a personal check, money order or fill out the below form for a credit card payment. Please make all checks payable to GREATER SCRANTON YMCA. ***PLEASE NOTE: If you receive an ELRC subsidy, a deposit will not be required at time of registration.*** REQUIRED DEPOSIT: $30 x ________________________________________(number of weeks) = $_____________________________________________(deposit amount due) CREDIT CARD AUTHORIZATION FORM FOR CAMP DEPOSIT PAYMENT CREDIT CARD PAYMENT INFORMATION: VISA MASTERCARD DISCOVER AMEX CARD #: _____________________________________________________________________________________________________________ SECURITY CODE: ______________________________________________ NAME ON CARD: __________________________________________________________________________________________________ EXPIRATION DATE: ___________________________________________ I herby authorize the Greater Scranton YMCA to debit my financial institution the above amount listed.

SIGNATURE: _______________________________________________________________________________________________________________________________ DATE: ___________________________________

THIS PAGE LEFT BLANK INTENTIONALLY

APPLICATION FOR SUMMER DAY CAMP SERVICES

Commonwealth of Pennsylvania Department of Public Welfare CY 320 – 8 - 78

Grade child will be entering in August/September 2019 ____________

Date of Application

Name of Child Date of Birth

Address

Mother’s name or legal guardian Father’s name or legal guardian

Mother’s home address Home phone number

Father’s home address Home phone number

Mother’s work address Work phone number

Father’s work address Work phone number

Parent’s e-mail address

Name and address of person to be contacted if parents are not available Phone number

Name and address of child’s physician or source of medical care Phone number

Special disability, if any

Does your child require any type of therapeutic support staff during the school year? – This includes any

support provided for children with attention deficit hyperactivity disorder, Tourette syndrome, autism or

other emotional support needs. ________ Yes ________ No

If yes, the YMCA requires that the support staff be present with your child the entire time they are

attending camp.

Any special medical or dietary information necessary for management in an emergency situation: allergies,

medications, special conditions

Any additional information on special needs of the child

Health insurance for child under family insurance policy or medical assistance benefits, if applicable

Signature of parent or guardian

THIS PAGE LEFT BLANK INTENTIONALLY

THIS PAGE LEFT BLANK INTENTIONALLY

THIS PAGE LEFT BLANK INTENTIONALLY

THIS PAGE LEFT BLANK INTENTIONALLY

THIS PAGE LEFT BLANK INTENTIONALLY

THIS PAGE LEFT BLANK INTENTIONALLY

Acknowledgement Page

My signature below verifies I have received, read and understand the Greater

Scranton YMCA Summer Day Camp Parent Information Packet. I agree to abide by the

policies set forth herein.

Child’s Name _________________________________________________________________________________________

Parent’s / Guardian’s Name ________________________________________________________________________________________

Parent’s / Guardian’s Signature ________________________________________________________________________________________

Person Responsible for Payment _______________________________________________________________________________________

Date _________________________________________________________________________________________

This page must be returned, along with: Registration form, Application for Day

Camp Services, Emergency Form, Agreement Form, Child Health Report Form, Behavior

Management Procedures form. Items in the Summer Day Camp Parent Information

Packet are subject to change. Written notifications of changes will be provided to par-

ents and will supersede handbook.

Summer Day Camp at the Greater Scranton YMCA

Parent Information Packet

Welcome to Summer Day Camp at the Greater Scranton YMCA! Whether you are one of our many returning camp families or new to the program, we would like to welcome you to another fun-filled, action packed summer with old and new friends! With a focus on helping campers develop character and self-confidence while having fun, Summer Day Camp activities revolve around our four core values: Caring, Honesty, Respect and Responsibil-ity. Campers are able to explore, be creative, learn teamwork and skills and develop leadership in a wide range of physically active programs that influence lifelong health. Campers will also have the opportunity to enjoy the outdoors, where they develop an appreciation of nature and an interest in community with experiences in local and global cultures. Enclosed in this Parent/Guardian Information Packet is information we hope will answer most of your questions. Your paperwork packet , registration form and deposit are required before your child begins his/her camp experience. We will not accept campers without the proper paperwork and payment. Also, please review the Camper Behavior Management Procedures with your child so you can help to set the stage for a great camp experience. Thank you for choosing the Greater Scranton YMCA’s Summer Day Camp! If you have any questions, please do not hesitate to call us at (570) 342-8115. We look forward to meeting you and your camper(s)!

GOALS OF GREATER SCRANTON YMCA SUMMER DAY CAMP

The goal of all Greater Scranton YMCA Programs is to build strong kids, strong families and strong communities. Our Summer Day Camp Program, reflects these values and is designed to help our campers grow mentally, physically and spiritually within a fun camp environment. Our trained camp staff leads campers in challenging activities that help your child grow and learn.

The goals and principles of Summer Day Camp are firmly based on the specific objectives from which our programs operate. We work on developing these principles within each child and in how they interact and develop relationships with others. The principles of Summer Day Camp are:

The achievement of personal growth in spirit, mind and body The formation and practice of socially constructive habits and attitudes

The development of an appreciation of nature and a love of the outdoor environment The strengthening of family relationships through parent/guardian participation

To continue educational development through our Summer Learning Program

GS YMCA CHARACTER DEVELOPMENT

At the GS YMCA, character development and values are a part of who we are. The GS YMCA is committed to embracing and demonstrating character through our four core values: caring, honesty, respect and responsibility. Our goal is to challenge the children and staff to believe in and act on these positive values. Caring: To love others; to be sensitive to the well-being of others; to help others Honesty: To tell the truth; to act in such a way that you are worthy of trust; to have integrity; making sure your choice match your values Respect: To treat others as you would have them treat you; to value the worth of every

person, including yourself Responsibility: To do what is right; what you ought to do; to be accountable for your behaviors

and obligations.

1.

REGISTRATION

To completed your child’s camp registration you must return to the YMCA: Your registration form, complete with each desired week of camp. Be sure to indicate if extended

care is needed. All required paperwork, including a current Child Health form completed by your child’s physician. A non-refundable deposit of $30 per registered week

2.

FEES & PAYMENT

Weekly Fee: (for grades 1-entering 8th) GS YMCA Members, $145 / Non-Members, $185

Extended Care add on: Before or after hours GS YMCA members $13 / non-members $20 Before and after hours GS YMCA members $ 25 / non-members $40

Weekly Fee for Sunrise Camp (for ages 4-5): GS YMCA Members, $175 / Non-Members, $190 Extended Care is not available for Sunrise campers

A $30 non-refundable deposit is required at the time of enrollment for each registered week. Payments are made on a weekly basis, regardless of the number of days your child attends. No

reduction in fee will be made for absence due to illnesses or emergencies. Payments are due in advance. Your full weekly payment is due by Friday for the upcoming week. If full payment is not received by Friday your child will be refused admission on Monday and your

deposit will be forfeited. Cash, checks (payable to Greater Scranton YMCA), credit and debit card payments are accepted

at the Welcome Center. You may set up payments to be drafted automatically (the form is included in your paperwork

packet). Online payments can be made at greaterscrantonymca.org. There is a $20 charge for all returned payments. If your child is picked up after 6:00pm, a late fee of $25 will be charged and must be paid for

continued attendance.

TAX ID INFORMATION

The Greater Scranton YMCA tax ID number is 24-0795516. Tax statements are available upon request after January 1, 2020.

FIELD TRIPS

SUNRISE: Boys & Girls Ages 4 to entering K DISCOVERY: Boys & Girls entering Grades 1-2 PIONEER: Boys & Girls entering Grades 3-4 EXPLORER: Boys & Girls entering Grades 5-6 VOYAGER: Boys & Girls entering Grades 7-8

Regular camp hours are 8:00 am until 5:00 pm. Extended hours are available with drop off time be-tween 6:30 and 8:00, and pick up time from 5:00 pm until 6:00 pm. An additional fee is required for extended hours. Children must be registered for extended hours. Activities include Indoor/Outdoor Play, QUEST, Arts & Crafts, Nature Projects, Swimming, Sports, Character Building, Guest Speakers, Special Events, Theme Weeks, Camp Games and more. Sample Schedule (daily schedules vary by age group and will be available on the first day of camp): 6:30 - 9:00 am Camper Drop-Off 9:00 - 9:30 am Camp Opening, Character Values 9:30 - 10:30 am Arts & Crafts 10:30 - 11:30 am Summer Learning (subjects include Math, Science, Spanish & Reading) 11:30 - 12:30 pm Lunch 12:30 - 1:30 pm Sports 1:30 - 2:30 pm Swim/Gym 2:30 - 3:00 pm Snack 3:00 - 4:30 pm Camp Games

When the GS YMCA provides transportation for field trips, the following guidelines prevail: Permission to attend is secured from each child’s parents/guardians through a written permission slip; the staff/camper ratios shall apply at all times. First Aid kits and camper emergency forms accompany the group. Field trip sites to be announced.

ACTIVITIES, SCHEDULE & MORE

FREE LUNCH PROGRAM

A free lunch and snack are provided to all campers.. Lunch will NOT be provided during week 1 of camp. Check the camp bulletin board for lunch information, including weekly menus.

3.

CAMP FORMS

CHILDREN AT RISK

DAILY CAMP NEEDS

Please remember to dress your child appropriately for camp. The GS YMCA’s Summer Day Camp uses discovery and play as a major part of our program. We encourage you to dress your child in clothing that you don’t mind getting dirty or messy. Clothing reminders: T-shirt with sleeves, shorts, socks, sneakers, bathing suit, towel. No halter or tube tops, no short shorts, no flip-flops; LABEL EVERYTHING! Sunscreen: Please ensure your child comes to camp with sunscreen. Camp staff are unable to apply lotion directly on children, therefore it is best to send in spray-on sunscreen each day to ensure your child is protected. Water: We encourage all campers to bring a LABLED, refillable water bottle each day.

Parents/Guardians who arrive at the Y in an incapacitated condition (i.e. drugs, alcohol) present a risk to their child. The staff in charge will advise the parent/guardian of their options regarding the transportation of their child to his/her home. Options include: Call the other parent/guardian, call an-other person on the child’s emergency contact list or call a taxi or Uber If a reasonable conclusion cannot be reached, the parent /guardian will be advised that either Child Protective Services or the police will be called.

The following forms must be completed for Summer Day Camp registration. Please take care in filling out these forms. Enrollment will be completed by returning the following forms and making a deposit for each week of camp you are registering for. Registration form Application for Day Camp Services Emergency Form Agreement Form Child Health Report Form Behavior Management Form Electronic draft form (optional)

4.

CAMPER BEHAVIOR POLICY

Campers are expected to exhibit appropriate behavior at all times. Inappropriate behavior will be discussed with the child when it occurs. Negative behavior affects more than the camper involved in the misconduct, it affects all those around them. Each camper situation is different and therefore each situation of inappropriate behavior must be weighed against the positive and negative benefits that your child will attain from staff intervention. Parents /Guardians will be notified any time your child is involved in negative behavior, whether initiating or receiving, and your input will be vital in our decisions. Please review with your child and sign the Behavior Management Procedures Form. When a camper does not follow the behavior guidelines we will take the following steps: Staff will redirect the camper to an appropriate behavior The camper will be reminded of the behavior guidelines and day camp rules, and discussion will

take place. If the behavior persists, a parent/guardian will be notified of the problem The staff will document the situation. This written documentation will include what the behavior

problem is, what provoked the problem, and the corrective action taken Staff will schedule a conference with the parent/guardian so they can determine the appropriate

action to take Staff will schedule a progress check or a follow-up conference If the problem still persists, staff will schedule a conference that includes the parent/guardian,

camper, staff, and program director. The program director will have all documentation and the notes from the previous conference for review. If subsequent conferences have to be scheduled, a counselor may also be present

If a child’s behavior at any time threatens the immediate safety of that child, other children, or staff, the parent/guardian may be notified and expected to pick up the child immediately.

If a problem persists and a child continues to disrupt the day camp program, the YMCA reserves the right to suspend the child from the program. Expulsion from the program will be considered in extreme situations.

We do not allow weapons or drugs or any kind to be brought to camp. This includes, but is not limited to: guns, knives, fireworks, aerosol cans, cigarettes and alcohol. If found, these items will immediately be confiscated and the parents/guardians will immediately be notified, which will result in the camper’s removal from camp. Our primary concern is for the safety of campers and staff, and all necessary actions will be taken to protect their safety.

WEAPONS & DRUG POLICY

5.

INJURY & ILLNESS

CAMPER’S MEDICINE

In the case of a minor injury, the staff trained in first aid will administer to your child. An accident report will be filled out and the YMCA will retain the paperwork. Parent/Guardian will be notified of the injury. In the event of a serious accident, the parent/guardian will be notified immediately while staff are attending to the child’s needs. If a parent/guardian cannot be reached, the emergency contact per-son will be notified. If the child has to be transported to the nearest hospital, one staff person will accompany the child and will take the child’s emergency information.

PLEASE KEEP THE GS YMCA UP TO DATE ON ALL TELEPHONE NUMBERS AND OTHER INFORMATION FOR THE SAFETY OF THE CHILD.

If your child is sick, the YMCA will call and ask you to pick him/her up. If a staff member calls you re-questing that you take your child home, the policy is that you must do so promptly. Any child send home must be kept home until he/she is symptom free without medication for 24 hours. Please ad-here to this policy to establish a safe environment for all children and staff.

If your child is required to take over-the-counter or prescription medication, please adhere to the following procedures:

Medication must be handed to a camp counselor by the parent/guardian. Do not send medication with the child or place in a backpack or lunchbox.

The Medication Log must be completed and appropriately filled out by the parent/guardian each day the medication is brought to camp to be administered.

Prescription medication must be in the original prescription container with name, date, dosage and physician’s name clearly printed on the label.

Over the counter medication must be age-appropriate on the label. If the medication does not have age-appropriate dosages, a signed and dated physician’s note is required with the child’s name and proper dosage before medication can be administered.

All medications are stored out of reach of the children. If medication is requested to be kept on hand “for emergencies only”, i.e. asthma attacks, severe

allergies, seizures, etc. a Chronic Health Form must be completed by a physician. Chronic Health Forms may be obtained from the Camp Director.

6.

TOYS, MONEY & ELECTRONICS

Toys, money and all electronic devices (cell phones, tablets, and video games) are not permitted at Day Camp. The GS YMCA cannot credit or compensate for lost, damaged or stolen items.. Any elec-tronic item seen or being used will be removed from the child’s possession and held by a staff per-son until the parent/guardian arrives for pick-up.