meAdoWlAnds AreA YmCA UnplUg Camp/… · SUMMER CAMP A LICENSED CHILDCARE PROGRAM TRAINED &...

SUMMER CAMP

A LICENSED CHILDCARE PROGRAM TRAINED & CERTIFIED STAFF

UnplUg & ConneCt

Where Kids UnplUg from eleCtroniCs And ConneCt With eACh other

sUmmer CAmpmeAdoWlAnds AreA YmCA

2015 Bergen CoUntY BroChUre

rAin or

shine

Y CAmps Are Anti-BUllY zones

WWW.YmCAinfo.org201.955.5300

•CampRock-Non-TravelCamp•ExtendedCampHours&Dates•LunchOptions•NewSiteLocations•AirConditionedSites•OpenHousesatCampSites•EasyPayments•RegisterEarly&Save

WhAt’s neW in 2015

Cool off With oUr

“frozen” CAmp fees

WelCome to CAmp! Forthelast90yearswehavebeencreatingmemoriesthataresuretolastalifetime.Summerdaycampistheperfectplacetoexplorethegreatoutdoors,learnnewskills,fosterindependence,andmeetnewfriends!

Whetherthisisyourfirstsummerwithusoryourseventh,eachsummerguaranteesyoufun,laughter,andnewadventures.Weknowthatyouhavealotofchoicesforsummercampandwehopethatyouchooseus.

Friendshipisattheheartofourcampfamily.Fromthemomentcampersstepintoourprogram,counselorsfocusonhelpingthembuildfriendshipsandimprovetheirsocialskills.Activitiesbecomemorefunwhendonewithfriends.Askourcampersforthe#1reasontheycomebacktocampeachyear.They’lltellyouthattheyareenthusiasticallyreturningtoseetheiroldfriendsandmakenewfriends!That’swhatoursummercampisallabout!

Anincrediblecampexperienceiscreatedbyouramazingstaff,manyofwhomwerecampersthemselves.Ourdedicatedandwell-trainedstaffmembersaimtomakethesummercampexperiencememorableandtransformativeforeverycamper.

Caring,Honesty,Respect,andResponsibility.TheYMCA’scorevaluesarethefoundationofourprograms.Assuch,eachcounselorunderstandsthathisorherjobisnotonlytoteachactivityskills,butalsotohelpourcampersdeveloplifeskills.Throughawiderangeofactivities,staffteachproblemsolving,communication,compromise,sportsmanship,persistence,andself-reflection.

OurcampsrunfrommidJunethroughSeptember4th(seeschedule),wewouldlovetotalkwithyouaboutcamp.

Please call us at 201 955-5300 and our experienced office staff can answer all your camp questions!

let’s hAve A greAt sUmmer together!

WhAt’s inside:page

Kiddie Kamp 4-5how to register 6Kiddie Kamp registration 7Youth day Camp 8-9Youth Camp registration 10-11teen/tween travel Camp & registration 12-13specialty Camps & registration 14-15

CAm

p dir

eCtor

s

oUr CAmp stAffOurstaffisacarefullyselectedgroupofindividualswhodemonstratealoveandabilitytoworkwithchildren.TheprogramissupervisedbytheMeadowlandsAreaYMCAChildCareDepartment,whowelcomeyourquestionsaboutYouthandTeenCamp.

TheYmaintainsaspecialcommitmenttotherecruitmentprocess,whichincludescomprehensivetrainingandbackgroundchecks.AlargepercentageofourLeadStaffareyear-roundemployeeswithmanyyearsofexperienceandtraining.

PreschoolDirector

Ms.Ellen

KiddieKamp

Wood-RidgeDirector

Ms.Claire

CampBelieve

EastRutherfordDirector

Ms.Vanessa

CampRockCampRoll

RutherfordDirector

Ms.Yolanda

CampStars

CliffsideParkDirector

Ms.Patti

CampTwizzler

Teen/TweenDirector

Ms.Michelle

CampVoyagers

3

Kiddie KAmpAges 3-5 YeArs (pottY trAined)

Choose 2, 3, 4 or 5 dAYs A WeeK!

rAin or shineKiddie Kamp provides an introduction to a camp experience on an intimate scale for our youngest campers, encouraging all children to reach their full potential. our staff creates a positive learning environment, encouraging every camper to make new friends, become more independent and gain a new understanding of the world around them.

CampLocation: NorthArlington-436RidgeRoad(Near7-Eleven)

CampHours: FullDay-8:30am-5:30pmORHalfDay-9:00am-NOON

CampDirector: EllenDaly,[email protected]

At Kiddie Kamp your child will:

learn new skills: Whether it’s practicing the fundamentals of a new sport, working on an art project, or trying their hand at baking, campers develop new skills in a supportive environment.

experience a program rich in literacy and numbers: daily story time and Y interactive circle time with music, drama, movement and songs, continually reinforce the lessons learned in camp in a fun, playful way.

gain a new understanding of the world: through themed activities, nature walks and gardening projects, campers will have the chance to experience the world around them in new ways.

Be active! Camp is full of opportunities to play both inside and outside. movement and sports are part of our camp adventure, as well as friday swim day!

Kid

die K

Am

p

A

ges 3

-5

Week dates theme What they Will learn

1 6/22-6/26hoW does YoUr gArden groW

let’s start planting! We need the sun, the rain, and the rest of Mother Nature’s wonders to grow plants, flowers, and even food. We’ll have the seeds and all you need is a green thumb.

2 6/29-7/3no CAmp 7/3 islAnd life

Life’s a beach on the islands! We’ll find out what’s under the sea and what floats on top of the sea. Pineapple and coconut snacks will be sampled during our trip to fiji. pack a bathing suit for our island adventure!

3 7/6-7/10 Wild Westhowdy partner! Cowboys and cowgirls are what we’ll be pretending to be this week! smores will be the treat of the week while we pretend to be camping under the stars.

4 7/13-7/17 CreepY CrAWlers

spiders, ants, and worms are just a few of the creepy crawlers. They are not always pretty but we will find out why we need those bugs in this great big beautiful world. Come find out which one bugs you the most!

5 7/20-7/24 tool time

We’re going to be like Bob the Builder this week. We’ll learn about construction and how some tools work. We will assemble a tool belt with our favorite ones on it for our art project.

6 7/27-7/31 sports of CoUrse

take me out to the ball game, soccer game, hockey game, football game! grab your sports gear and let’s play.

7 8/3-8/7 AArrgh! pirAtes

Yo ho ho and a bottle of fun! pirate ships, eye patches, and voyages across the sea. Come sail along, but no walking the plank!

8 8/10-8/14 sillY sCienCe

What sinks? What floats? Why does ice melt? We’ll investigate rocks and minerals, dinosaurs, and see rainbows form in a bowl of milk! Curios minds come see the wonders of science.

9 8/17-8/21 it’s A JUngle oUt there

We will explore the wilds of the jungle! lions and tigers and monkeys, oh my! there will be many projects and songs. Come join us on a safari.

10 8/24-8/28 tWilight zone

Calling all future astronauts! let’s blast off in our spaceships and explore our amazing universe. how many planets are there? Where is pluto? how big is Jupiter? let’s travel into space and find out!

11 8/31-9/4 goodBYe sUmmer

oh no! summer is over. We will review the things we’ve done as we complete our 2015 summer Camp scrapbook! We will end the week with an “end of summer party”!

See Page 7 For Fees and Registration Form. 5

hoW to registerALLREGISTRATIONSWILLBEACCEPTEDONAFIRSTCOME,FIRSTSERVEDBASIS.

• Complete and submit the appropriate registration form to the YMCA office with your deposit which includes a $50 non-refUndABle tuition per session payment, a $25 processing fee per child, additional field trip fees, and a $20 annual youth membership if your child’s membership is not current through the camp season. All children attending camp must be members of the YmCA.

• All balances are due by June 1st. if you are registering after June 1st then you must include payment in full unless you’ve chosen easy payment plan 2.

• When your registration is accepted, you are responsible for completing an information packet that must be returned by June 9th. packets are available on our website www.YmCAinfo.org. no child is permitted to begin camp without a completedinformation packet.

• There are NO REFUNDS or CREDIT given past June 1st. days missed due to illness, etc. cannot be made up in subsequent sessions.

• Please select your session schedule carefully. The YmCA will try it’s best to accommodate changes within reasonable working limitations.

there Will Be An AdministrAtive fee for AnY ChAnges.

finAnCiAl AssistAnCethe meadowlands Area YmCA is committed to helping people grow into strong families and strong communities. We want to provide everyone with the opportunity to participate in the YmCA summer Camp program. financial Assistance is available based upon personal income level, individualized circumstances and YmCA scholarship funds availability. please call 201.955.5300 ext 28 for a scholarship application or download from our website. Applications must be received by June 1st with all required documentation.

eAsY pAYment plAns *neW*

each week of camp can be reserved with a $50.00 non-refundable deposit plus any additional fees.

Balances can be paid in the following ways:plan 1: Balance paid in full by June 1st, 2015plan 2: pay balance of each week of camp 10 days prior to the start of that week. AUto drAft mAndAtorY for this option.

Auto draft can be set up using masterCard, visa, American express or eft through a checking or savings draft.

deposits are non-refundable. registration fees, membership, t-shirts and field trip fees must be included in your initial deposit at time of registration.

if you have any questions please call 201 955-5300.

speCiAl offers - sAve moneY!visit www.YmCAinfo.org for further information and take advantage of any of these valuable offers:

10% siBling disCoUnt: 10% discount for each additional child in the family that is deducted from session fees only and for the lower rate per session.

10% militArY disCoUnt: Applies to children of military personnel. military id must presented at time of registration.

open hoUse speCiAl: register between now and the night of the open house (April 24th) and we will waive your $25.00 registration fee. must register for 4 weeks or more.

register todAY

Kid

die K

Am

p reg

istrA

tion

20

15

2015 sUmmer CAmp registrAtion form - Kiddie KAmpone form for eACh Child - pleAse print

Camper’s First Name____________________________________________________ Last Name __________________________________________ Gender (Circle) M/FAddress __________________________________________________________________________________________________ Date of Birth ___________________________________City ___________________________________________________________ State _______________ Zip ________________ Grade (9/1/15) ____________Mother (Guardian) Name ____________________________________________________________________________ Date of Birth ____________________________E-mail _____________________________________________________________ Home#___________________________ Work#_________________Cell#_______________________Father (Guardian) Name _____________________________________________________________________________ Date of Birth______________________________E-mail _____________________________________________________________ Home#___________________________ Work#_________________Cell#_______________________Parents’ Authorization and Registration agreement - In order to meet all legal requirements, I hereby authorize representatives of the Meadowlands Area YMCA to give consent for any and all emergency medical care for my child while the said child attends programs sponsored by the Meadowlands Area YMCA. I acknowledge that I must complete all required forms prior to my child starting a program sponsored by the Meadowlands Area YMCA. I give permission for my child to be transported by bus to and from special activities.

X______________________________________________________________________________________________________________________________D Signature (Adult/Parent/Guardian) Date

full day: 8:30am - 5:30pm half day: 9:00am - 12:00pm Days Total

5 Days 4 Days 3 Days 2 Days 5 Days 4 Days 3 Days 2 Day

Week 1: 6/22-6/26 ☐$237 ☐$203 ☐$155 ☐$123 ☐$130 ☐$113 ☐ $85 ☐ $62 ☐Mo ☐Tu ☐We ☐Th ☐Fr $

Week 2: 6/29-7/3NO CAMP 7/3 ☐$203 ☐$155 ☐$123 ☐$113 ☐ $85 ☐ $62 ☐Mo ☐Tu ☐We ☐Th $

Week 3: 7/6-7/10 ☐$237 ☐$203 ☐$155 ☐$123 ☐$130 ☐$113 ☐ $85 ☐ $62 ☐Mo ☐Tu ☐We ☐Th ☐Fr $

Week 4: 7/13-7/17 ☐$237 ☐$203 ☐$155 ☐$123 ☐$130 ☐$113 ☐ $85 ☐ $62 ☐Mo ☐Tu ☐We ☐Th ☐Fr $

Week 5: 7/20-7/24 ☐$237 ☐$203 ☐$155 ☐$123 ☐$130 ☐$113 ☐ $85 ☐ $62 ☐Mo ☐Tu ☐We ☐Th ☐Fr $

Week 6: 7/27-7/31 ☐$237 ☐$203 ☐$155 ☐$123 ☐$130 ☐$113 ☐ $85 ☐ $62 ☐Mo ☐Tu ☐We ☐Th ☐Fr $

Week 7: 8/3-8/7 ☐$237 ☐$203 ☐$155 ☐$123 ☐$130 ☐$113 ☐ $85 ☐ $62 ☐Mo ☐Tu ☐We ☐Th ☐Fr $

Week 8: 8/10-8/14 ☐$237 ☐$203 ☐$155 ☐$123 ☐$130 ☐$113 ☐ $85 ☐ $62 ☐Mo ☐Tu ☐We ☐Th ☐Fr $

Week 9: 8/17-8/21 ☐$237 ☐$203 ☐$155 ☐$123 ☐$130 ☐$113 ☐ $85 ☐ $62 ☐Mo ☐Tu ☐We ☐Th ☐Fr $

Week 10: 8/24-8/28 ☐$237 ☐$203 ☐$155 ☐$123 ☐$130 ☐$113 ☐ $85 ☐ $62 ☐Mo ☐Tu ☐We ☐Th ☐Fr $

Week 11: 8/31-9/4 ☐$237 ☐$203 ☐$155 ☐$123 ☐$130 ☐$113 ☐ $85 ☐ $62 ☐Mo ☐Tu ☐We ☐Th ☐Fr $

A. Kiddie Kamp Total $

B. $50 Non Refundable Deposit X ________ Weeks $

C. Processing Fee ($25 Non-Refundable) Included T-shirt $ 25.00

D. Membership Fee ($20 if not current member) $

E. Additional T-shirts @ $13 each $

F. TOTAL ENCLOSED AT REGISTRATION (B+C+D+E) $

G. BALANCE DUE - June 1 (Unless Using Easy Payment Plan 2) $

PAYMENT METHOD□ Visa □ MasterCard □ American Express □ EFT Draft -____ Checking or ____ Savings

Credit Card Number

Expiration Date

Signature ___________________________________________________________________________________________________________

MANDATORY AUTO-PAY FOR WEEKLY PAYMENT OPTION:I authorize the Meadowlands Area YMCA to automatically charge this payment method, for the weekly balance. I understand I will be charged10 days prior to the start of each weekly session.

Signature___________________________________________ Date______/______/_____

Attach copy of VOIDED check or a Bank Specification letter to form.

Print Name as it appears on Credit Card Print Name on Account

Bank Name:

Account #

Routing #

7

mail to: meadowlands

Area YmCA p.o. Box 252

rutherford nJ 07070or fax registrations accepted with credit card

payments to 201.955.2055.

YoUth dAY CAmpsAges 5-11 YeArs

Choose 3, 4 or 5 dAYs A WeeK! rAin or shine

Yourchildrenwillbeindoors,outdoorsandontheroadthissummerwiththeMeadowlandsYCamp!Theywillswim,hike,skate,ride,bounce,jump,tossandflip.Theywillcreateart,memoriesandfriendships.Thissummerisallaboutdiversity,leavingnocampexperienceunturned.Bepreparedtobetakenbacktoyourownchildhoodasyoulistentoyourchildblurtoutandgiggleaboutthefuntheyhadatcampwiththenewfriendstheymade!PleaseusecautionwhenenrollingyourchildinourYDayCamp,theydon’teverwanttoleave!

Children entering KindergArtenToattendYouthCamp,childrenmustbeenteringKindergarteninSeptember2015.

CAmp ACtivitiesSwimmingHikingBowlingSkatingBasketballWaterParks

MiniatureGolfThemeDaysBoardGamesFashionShowsSandcastlesBBQ’s

NYCityTripsArts&CraftsBumperBallsVelcroDodgeball

for more information about our schedules, please check our website: www.YmCAinfo.org

don’t WAnt YoUr Kids to trAvel?

CAmp roCK - neW non-trAvel CAmp! CAmp roCK day Camp is located at mcKenzie school in eAst rUtherford. this camp facility is fully air conditioned with use of a gymnasium as well as a park and field right outside its doors. It is a full-day camp experience that provides a morning and afternoon snack for your child and offers a lunch option for your convenience. this camp is designed with a wide range of activities guaranteed to expand your child’s horizons. Kids have fun while making new friends, developing new skills, learning core values, building self-confidence, appreciating team work and growing in self-reliance. during the course of a session, campers will participate in a variety of experiences both inside and outdoors based on weekly themes. Water fun, recreation, arts and crafts, and special projects and activities. this is the perfect camp for those parents who don’t want their child traveling on a bus.

neW

Camp

Yo

Uth

dA

Y CA

mp

A

ges 5

-11

CoUnselor -in- trAining (Cit)for teens Ages 14-15 Many of our staff were once CITs! In the CIT Program, teens learn the skills necessary to be a counselor: leadership, organization, problem solving and being a team player. Choose your camp. Specific camp can be requested but will not be guaranteed. Field trips not subject to discount. For additional information, please visit www.ymcainfo.org.

hoW to ApplY: Choosefrom4to8weeks(minimumof4weeks) of Youth Camp at 50% off the weekly fee. TheCITprogramparticipantsareONLYeligibletoattendtheYouthCampfortraining. To apply please complete the CIT program application downloaded from our website www.YMCAinfo.org and return it to the Meadowlands Area YMCA. Limited space available.

CAmp sitesCampStartsasearlyasJune22ndandendsaslateasSeptember4th.

CAmp tWizzler - ms. pAttiCliffsidePark“head start”-263LafayetteAveA:7:30am-6:00pmorB:8:30am-4:30pmorC:7:00am-6:30pm(5DaysONLY)

CAmp Believe - ms. ClAire*piCKUp/drop-off site onlY*Wood-RidgeCivicCenter-495HighlandAvenueA:7:30am-6:00pmorB:8:30am-4:30pm

CAmp stArs - ms. YolAndARutherfordUnionSchool,359UnionAveA:7:30am-6:00pmorB:8:30am-4:30pmorC:7:00am-6:30pm(5DaysONLY)

CAmp roll - ms. vAnessAEastRutherford-McKenzieSchool(HomeBase):135CarltonAveA:7:30am-6:00pmorB:8:30am-4:30pmorC:7:00am-6:30pm(5DaysONLY)

CAmp roCK - ms. vAnessA*non-trAvel CAmp site*EastRutherford-McKenzieSchool(HomeBase):135CarltonAveA:7:30am-6:00pmorB:8:30am-4:30pm

rCC (RutherfordCongregationalChurch)-ExtensionWeeks8/17-9/4251UnionAveA:7:30am-6:00pmorB:8:30am-4:30pmorC:7:00am-6:30pm(5DaysONLY)

See Page 10-11 For Details, Fees and Registration Form.

9

on-siteopen hoUses see details on the back.

*CAMP BELIEVE: Due to construction at the Catherine E Doyle School this summer, the Wood-Ridge YMCA Camp program will be bused to our sister camp in Rutherford at Union School. The bus will leave WRCC promptly at 8:35 am and return at 4:25 pm on a daily basis (unless noted otherwise on our online camp schedule).

Yo

Uth

dA

Y C

Am

p r

egis

trA

tio

n

pAg

e 1 2015 sUmmer CAmp registrAtion form - YoUth dAY CAmp

one form for eACh Child - pleAse printCamper’s First Name____________________________________________________ Last Name __________________________________________ Gender (Circle) M/FAddress __________________________________________________________________________________________________ Date of Birth _________________________________City ___________________________________________________________ State _______________ Zip ________________ Grade (9/1/15) ____________Mother (Guardian) Name ____________________________________________________________________________ Date of Birth ___________________________E-mail _____________________________________________________________ Home#_________________________ Work#_________________Cell#_______________________Father (Guardian) Name _____________________________________________________________________________ Date of Birth____________________________E-mail _____________________________________________________________ Home#_________________________ Work#_________________Cell#_______________________Parents’ Authorization and Registration agreement - In order to meet all legal requirements, I hereby authorize representatives of the Meadowlands Area YMCA to give consent for any and all emergency medical care for my child while the said child attends programs sponsored by the Meadowlands Area YMCA. I acknowledge that I must complete all required forms prior to my child starting a program sponsored by the Meadowlands Area YMCA. I give permission for my child to be transported by bus to and from special activities.

X_____________________________________________________________________________________________________________________________Date Signature (Adult/Parent/Guardian) Date

CAmp AvAilABilitY WeeKsW

eek

1: 6

/22

Wee

k 2

: 6/2

9

Wee

k 3

: 7/6

Wee

k 4:

7/1

3

Wee

k 5

: 7/2

0

Wee

k 6

: 7/2

7

Wee

k 7

: 8/3

Wee

k 8

: 8/1

0

Wee

k 9

: 8/1

7

Wee

k 1

0: 8

/24

Wee

k 1

1: 8

/31

Camp stars -Rutherford UnionCamp Starts 6/25

Camp twizzler - Cliffside ParkCamp Starts 6/22

Camp Believe -WR Civic Centerpickup/drop-off site onlYCamp Starts 6/23

Camp rock - East RutherfordstAY At home CAmp *neW*Camp Starts 6/22

Camp roll - East RutherfordCamp Starts 6/22

rCC - Rutherford Congregational ChurchCamp Starts 8/17

t-shirt (Check size)☐ Youth Medium ☐ Youth Large

☐ Adult Small ☐ Adult Medium ☐ Adult Large

☐ Adult X-Large ☐ Adult XX-Large

AdditionalT-Shirts

Quantity ________ X $13.00 = $____________ (add to line F on next page)Note: If T-shirt is ordered after June 1st size is not guaranteed. Ordersupplieswhiletheylast.


Credit Card Number

Expiration Date

Signature ___________________________________________________________________________________________________________


Signature___________________________________________ Date______/______/_____



Bank Name:

Account #

Routing #

pleAse fill oUt Both pAges of forms to Complete YoUth dAY CAmp registrAtion.

Yo

Uth

dA

Y CA

mp r

egistr

Atio

n

pAg

e 22015 sUmmer CAmp registrAtion form - YoUth dAY CAmp (Cont’d)one form for eACh Child - pleAse print

Camper’s First Name____________________________________________________ Last Name __________________________________________ Gender (Circle) M/FAddress __________________________________________________________________________________________________ Date of Birth ___________________________________City ___________________________________________________________ State _______________ Zip ________________ Grade (9/1/15) __________

Weekly Plan

All Travel Camps:A: 7:30am - 6:00pmB: 8:30am - 4:30pm

Travel Camps:Twizzler, Stars &

Roll ONLYC:7:00am - 6:30pm

*NEW* Camp RockStay-At-Home CampA: 7:30am - 6:00pmB: 8:30am - 4:30pm

RCC (Extension Weeks)Rutherford Congregational Church

A: 7:30am - 6:00pmB: 8:30am - 4:30pmC:7:00am - 6:30pm

A B C A B A B C

5 Days $289 $2595 Days ONLY$309/week

$225 $202 $289 $2595 Days ONLY$309/week

4 Days $274 $247 $213 $192 $274 $247

3 Days $249 $227 $194 $177 $249 $227

Camp location time slots Weekly planSee Grid

days Attending Camp totalSee Grid

Week 1: 6/22-6/26☐Twizzler ☐Rock ☐Roll☐Believe (start 6/23)

A B C 5 4 3 Days M T W Th F $

Week 1-A: 6/25-6/26 ☐ Stars ONLY☐ A- $175 ☐ B- $159

2 Days Th F $

Field Trip: LAND OF MAKE BELIEVE - Wednesday, JUNE 24h Additional $27 per child (Rain Date: 6/25) $

Week 2: 6/29-7/3NO CAMP 7/3

☐ Stars ☐Twizzler ☐Believe ☐Rock ☐Roll

A B C 4 3 Days M T W Th $

Week 3: 7/6-7/10☐ Stars ☐Twizzler ☐Believe ☐Rock ☐Roll




Field Trip: FUN PLEX - Wednesday, July 15th Additional $31 per child $







Field Trip: IMPROV 4 KIDS - Wednesday, August 5th Additional $23 per child $



Week 9: 8/17-8/21☐Twizzler ☐Believe ☐Rock ☐Roll ☐ RCC


Field Trip: CAMEL BEACH - Wednesday, August 19th Additional $47 per child (Rain Date: 8/20) $

Week 10: 8/24-8/28 ☐Twizzler ☐Believe ☐ RCC A B C 5 4 3 Days M T W Th F $

Week 11: 8/31-9/4 (Extension Week) ☐Believe ☐ RCC A B C 5 4 3 Days M T W Th F $

A. Youth Day Camp Session Total $


C. Total of Field Trip Fees $

D. Processing Fee ($25 Non-Refundable) Includes T-shirt $ 25.00

E. Membership Fee ($20 if not current member) $

F. Additional T-shirts @ $13 each $

G. TOTAL ENCLOSED AT REGISTRATION (B+C+D+E+F) $

H. BALANCE DUE - June 1 (Unless Using Easy Payment Plan 2) $

11

mail to: meadowlands Area YmCA

p.o. Box 252rutherford nJ 07070

or fax registrations accepted with credit card payments to

201.955.2055.

We try our best to keep to our schedule, but please note that bus & trip schedules may change due to external circumstances.

teen/ tWeen trAvel CAmpAges 11-15 YeArs

rAin or shine

CampDates: June 29th through september 4th

dates include teen leadership program.

CampLocation:

CAmp voYAgers:RutherfordUnionSchool359UnionAve

CampHours: 7:30am-6:00pm

TheYMCAproudlyannouncesourSensationalTeen/TweenSummerCamp.Thecampisavailableeitherfor3daysor5daysaweek.The3daycomponentisTuesday,WednesdayandThursdayfrom7:30am-6:00pmwiththeoptionofanadditionaltwodayLeadershipprogramonMondayandFridaylocatedatourUnionYouthDayCamp.

teen leAdership progrAmmondAYs & fridAYs Add-on(optional)

in addition to these outrageous three days, the YmCA also provides leadership sessions on monday and friday throughout the summer at a home base camp site. our program uses a hands-on approach with camp staff supporting them at all times! the teen/tween will assist the directors in helping lead games, initiate craft ideas and lead physical activities. You can expect them to come away with a significant amount of independence, leadership and responsibility that will follow them in the future.

CAmp trips neW YorK CitYfUnpleXimprov 4 KidslAUgh fACtorYCAmel BACK BeAChsWimminghiKingseAside heightspoint pleAsAnt

teen\tW

een tr

Av

el CAm

p A

ges 1

1-1

5

13

2015 sUmmer CAmp registrAtion form - teen/tWeen trAvel CAmpone form for eACh Child - pleAse print

Camper’s First Name____________________________________________________ Last Name __________________________________________ Gender (Circle) M/FAddress __________________________________________________________________________________________________ Date of Birth _________________________________City ___________________________________________________________ State _______________ Zip ________________ Grade (9/1/15) ____________Mother (Guardian) Name ____________________________________________________________________________ Date of Birth __________________________E-mail _____________________________________________________________ Home#___________________________ Work#_________________Cell#____________________Father (Guardian) Name _____________________________________________________________________________ Date of Birth___________________________E-mail _____________________________________________________________ Home#___________________________ Work#_________________Cell#____________________Parents’ Authorization and Registration agreement - In order to meet all legal requirements, I hereby authorize representatives of the Meadowlands Area YMCA to give consent for any and all emergency medical care for my child while the said child attends programs sponsored by the Meadowlands Area YMCA. I acknowledge that I must complete all required forms prior to my child starting a program sponsored by the Meadowlands Area YMCA. I give permission for my child to be transported by bus to and from special activities.

X__________________________________________________________________________________________________________________________________ Signature (Adult/Parent/Guardian) Date

RutherfordUnion RCCWeek 1 2 3 4 5 6 7 8 9 10 11

teen

/tw

een

trav

el C

amp

6/2

2-6

/26

6/3

0-7

/2

7/7

-7/9

7/1

4-7

/16

7/2

1-7

/23

7/2

8-7

/30

8/4

-8/6

8/1

1-8

/13

8/1

8-8

/20

8/2

5-8

/27

9/1

-9/3

Not

Ava

ilabl

e

☐ $225 ☐ $225 ☐ $225 ☐ $225 ☐ $225 ☐ $225 ☐ $225 ☐ $225 ☐ $225 ☐ $225

teen

le

ader

ship

6/2

9, 7

/3

7/6

, 7/1

0

7/1

3, 7

/17

7/2

0, 7

/24

7/2

7, 7

/31

8/3

, 8/7

8/1

0, 8

/14

8/1

7, 8

/21

8/2

4, 8

/28

8/3

1, 9

/4

☐ $64.50 ☐ $129 ☐ $129 ☐ $129 ☐ $129 ☐ $129 ☐ $129 ☐ $129 ☐ $129 ☐ $129

t-shirt (Check size)☐ Adult Small ☐ Adult Medium ☐ Adult Large

☐ Adult X-Large ☐ Adult XX-Large

AdditionalT-ShirtsQuantity ________ X $13.00 = $____________ Note: If T-shirt is ordered after June 1st, size is not guaranteed. Ordersupplieswhiletheylast.

A. Teen/Tween Camp Total $


C. Processing Fee ($25 Non-Refundable) Includes T-shirt $ 25.00

D. Membership Fee ($20 if not current member) $

E. Additional T-shirts @ $13.00 each $

F. TOTAL ENCLOSED AT REGISTRATION (B+C+D+E) $

G. BALANCE DUE - June 1 (Unless Using Easy Payment Plan 2) $


Credit Card Number

Expiration Date

Signature ___________________________________________________________________________________________________________


Signature___________________________________________ Date______/______/_____



Bank Name:

Account #

Routing #

mail to: meadowlands Area YmCA: p.o. Box 252 rutherford nJ 07070or fax registrations accepted with credit card payment to 201.955.2055.

speC

iAlt

Y h

Alf

-dA

Y C

Am

ps2015 sUmmer CAmp registrAtion form - speCiAltY dAY CAmpsone form for eACh Child - pleAse print

Camper’s First Name____________________________________________________ Last Name __________________________________________ Gender (Circle) M/FAddress __________________________________________________________________________________________________ Date of Birth ________________________________City ___________________________________________________________ State _______________ Zip ________________ Grade (9/1/15) ____________Mother (Guardian) Name ____________________________________________________________________________ Date of Birth _________________________E-mail _____________________________________________________________ Home#___________________________ Work#_________________Cell#___________________Father (Guardian) Name _____________________________________________________________________________ Date of Birth__________________________E-mail _____________________________________________________________ Home#___________________________ Work#_________________Cell#___________________

please check the Camp sessions your child would like to attend. Use a separate sheet for each camper.

Are YoU A CUrrent memBer? YES / NO Expiration DATE: ……………….. ARE YOU RENEWING? YES / NOYMCA Membership (Check Type) $................... ☐ Youth ($20) ☐ Adult ($25) ☐ Senior ($22) ☐ Family of 3 ($45) ☐ Additional Family Members ($5)

mUsiCAl theAtre CAmp

Session I: 6/29 - 7/10The Variety Show

Session II: 7/13 - 7/31Through The Looking Glass

Session I & II Total

YMCA Member: $ 271 ☐ YMCA Member: $ 394 ☐ YMCA Member: $599 ☐$

YMCA Non-Member: $284 ☐ YMCA Non-Member: $408 ☐ YMCA Non-Member: $623 ☐DVD of Final Performance: ☐ $10 per copy x Session I ☐ ________ Session II ☐ ________ $

Extra Camp shirt ☐$10 x ___________ (circle size below)

$Camper’s Performance T-shirt is INCLUDED in camp price.

musical theatre Camp t-shirts (Circle size)Youth Small Youth Medium Youth LargeAdult Small Adult Medium Adult LargeAdult X-Large Adult XX-LargeNote: T-shirts ordered after June 20th are not guaranteed.

Sub-Total: $YMCA Membership Total: $

grAnd totAl: $

sCienCe disCoverY CAmp

Session IJune 29 - July 10

Session IIJuly 13 - July 31

Session I & II Total

YMCA Member: $271 ☐ YMCA Member: $394 ☐ YMCA Member: $599 ☐$

YMCA Non-Member: $284 ☐ YMCA Non-Member: $408 ☐ YMCA Non-Member: $623 ☐Sub-Total: $

YMCA Membership Total: $grAnd totAl: $

…………………………………………………………………………………………………………………………………………………………I hereby release, indemnify, keep, and hold harmless, for myself and on behalf of my child/children, my family, heirs, executors, administrators and assignees, the YMCA and its officers, members, employees, agents, and successors of any aforementioned, against and from any and all liability with regard to any injury, loss, claim, and /or damage to myself or my child/children and from any loss, damage, claims, cause of action, liabilities, obligations, demands, or expenses asserted against the YMCA or its officers, members, employees, agents, and successors, by any person, persons, or entity, as well as from and against all costs, counsel fees expenses and liabilities incurred in the event or activity identified above. This release waives all claims, including those of which I am not aware and those not mentioned in this release. I understand that the YMCA may photograph or film any participation and use said pictures for any form of advertising or promotion as deemed appropriate.

X___________________________________________________________________________________________________________________________________________________ Signature (Adult/Parent/Guardian) Date

Mail To: Meadowlands Area YMCA

P.O. Box 252Rutherford NJ 07070

or Fax registrations accepted with credit card payments to

201.955.2055.

PAYMENT METHOD Amount: $________________________

□ Visa □ MasterCard □ American Express □ Check #___________ □ Cash

Credit Card Number Expiration Date

Signature ___________________________________________________________________________________________________________

Please Print Name As It Appears On Credit Card ________________________________________________________________________________

speCiAltY

hA

lf-dA

Y CA

mps

15

sCienCe disCoverY CAmp5-10 YeArs mondAY-fridAY 12:30pm-3:30pm

If you like to figure out how things work and try new experiments, then you’ll love our Science discovery Camp. We’ll explore all sorts of topics, from water and air pressure to ooey-gooey concoctions. You’ll make a simple robot, and learn new uses for household items, while having lots of fun with these experiments. volcanoes, tornadoes, potatoes and more are featured in this fun camp. Campers will receive instruction in age-appropriate activities.

loCAtion: pierrepont sChool, rUtherford

session i: June 29 - July10

no Camp 7/3YmCA member-$271

non-YmCA member-$284

session ii: July 13 - July 31

YmCA member-$394non-YmCA member-$408

session i & ii: YmCA member- $599

non-YmCA member- $623

other sports & speCiAltY CAmpsfor more information about any of these camps, please visit see our 2015 summer program guide or check our website: www.YmCAinfo.org.

•metropolitAn soCCer•tgA premier JUnior golf•CAmp potpoUrri•mAd sCienCe

•hoBBY QUest•tgA JUnior tennis•AdventUres in leArning

mUsCiAl theAtre CAmpBoth sessions are held at WrCC – Wood-ridge CiviC Center: 495 highland Avenue, Wood-ridge (Corner of hackensack street and highland Avenue) with the last 2 days of camp at felician College, lodi Campus

SESSIONI:the vArietY shoWJUne 29 – JUlY 10no Camp 7/3 SESSIONII:gollY gee WhizJUlY 13 – JUlY 31WINNER OF THE NATIONAL YOUTH THEATRE AWARD FOR OUTSTANDING NEW MUSICAL

ALLSESSIONS:Ages 5–7: mondAY–fridAY; 1pm-4pm

Ages 8–11: mondAY–fridAY; 1pm-4pm

Ages 12–14: mondAY–fridAY; 1pm-4pm

SessionI: YMCAMembers:$271 Non-YMCAMembers:$284SessionII: YMCAMembers:$394 Non-YMCAMembers:$408SessionI&II: YMCAMembers:$599 Non-YMCAMembers:$623

funding has been made possible in part by a grant administered by the Bergen County department of parks, division of Cultural and historic Affairs from funds granted by the new Jersey state Council on the Arts.

meAdoWlAnds AreA YmCAp.o. Box 252rutherford nJ 07070

855.788.YmCAWWW.YmCAinfo.org

neW CAmp open hoUses

WaiveRegistrationFeeSeecampfacilityMeetthestaff

Freeactivities(CATCH)EasyPayments

CliffsidePark&WRCivicCenter:

April23rd6:30pm-8:30pm

RutherfordUnion&EastRutherford:

April24th

6:30pm-8:30pm

speCiAl registrAtion offers inside!

SeePage6.

Meadowlands Area YMCA PO Box 252, Rutherford, NJ 07070 Phone: (201) 955-5300, (855) 788-YMCA (9622) Fax: (201) 955-2055 www.YMCAinfo.org

SUMMER SCHOOL AGE CHILD CARE APPLICATION PACKAGE 2015

APPLICATION PACKAGE 2015

1. ________Fill out Registration Form (if one has not already been submitted for the current year’s camp) 2. ________Fill out Child Information Form 3. ________List Approved Individuals for Pick Up and Additional Emergency Contacts 4. ________Sign Registration Agreement and Permission for Emergency Medical Care 5. ________Fill out and sign Medical Report Form 6. ________Attach a copy of Immunization Records from Doctor/Pediatrician’s Office 7. ________Sign Information to Parent Statement, Walking and Bus Permission Form 8. ________Pull off Policies and Procedures and keep for further reference 9. ________Parent Pack must be mailed or dropped off at the YMCA office. – No Faxes or E-mails 10. ________Enclose payment for fees made out to: Meadowlands Area YMCA

ALL PARTICIPANTS MUST COMPLETE FORMS Regardless of Prior Participation.

Please DO NOT E-Mail or Fax Completed Forms.

Camp Rock - McKenzie School, East Rutherford, NJ

Camp Roll - McKenzie School, East Rutherford, NJ

Camp Believe - Wood-Ridge Civic Center, Wood-Ridge, NJ (Drop Off/Pick Up Location Only)

Camp Stars - Union School, Rutherford, NJ

Camp Twizzler – Cliffside Park, Bergen Head Start Bldg. 263 Lafayette Avenue

Camp Spirit - Lakeland High School, Wanaque, NJ

Camp Voyagers - Teen Camp – Union School, Rutherford, NJ

Camp RCC – Rutherford Congregational Church, Rutherford, NJ

Registration is U Not Finalized until you have completed this

Parent Pack. It must be received in the YMCA Office

no later than Friday, June 5, 2015

Child’s Name: _________________________________________________ Camp Location: ___________________________________

2

Meadowlands Area YMCA PO Box 252, Rutherford, NJ 07070

Phone: (201) 955-5300, (855) 788-YMCA (9622), Fax: (201) 955-2055 www.YMCAinfo.org

(Return this Page) CHILD INFORMATION FORM SUMMER SACC 2015U

CHILD’S NAME NICKNAME

ADDRESS HOME TELEPHONE ___________

CITY ____________ ZIP __________

BIRTHDATE / / ________ AGE SEX

MOTHER/GUARDIAN’S NAME _____________________________ ____________________

EMPLOYER_______________________________________________________________OCCUPATION ____________

WORK ADDRESS *

E-MAIL___________________________________________________________________ BIRTHDATE / /

HOME ADDRESS

TELPHONE (HOME) (BUSINESS) (CELL)

FATHER/GUARDIAN’S NAME _____________________

EMPLOYER________________________________________________________________OCCUPATION ____________

WORK ADDRESS *

E-MAIL___________________________________________________________________ BIRTHDATE / /

HOME ADDRESS

TELPHONE (HOME) (BUSINESS) (CELL)

I am providing the Meadowlands Area YMCA with a current photograph of my child for his/her file. I understand that this is for

Identification purposes only and will not be returned at the end of the camp.

Parent Signature ______________________________________________ Date ________________________________________

***Please staple picture to the bottom of this form. ***

*Please be sure to include your employer's information. The School Age Child Care Program is partially funded through corporate and individual

contributions. This information could be helpful in securing these contributions and grants. **It is your responsibility to inform the YMCA in

writing (providing legal documentation) of any custody limitations for either parent. It is sometimes necessary to communicate

with a parent or guardian during the day because of accident, illness or absenteeism. WE WILL TRY THE ABOVE LISTED NUMBERS FIRST. If we are unable to contact

you, please list those additional people that we may contact in an emergency under Emergency Contacts/Pick up Plan.

(Return this Page)

Staple

Child’s

Picture Here


3



2015 SUMMER SACC APPROVED INDIVIDUALS FOR CHILD PICK-UP

LIST ALL PERSONS APPROVED TO PICK UP THE CHILD, INCLUDING PARENT/GUARDIANS. THE CHILD WILL NOT BE RELEASED TO ANYONE ELSE WITHOUT WRITTEN PERMISSION FROM PARENTS/GUARDIANS. PLEASE NOTE THAT THESE INDIVIDUALS MUST BE ABLE TO PROVIDE INDENTIFICATION TO YMCA STAFF.

NAME ______________________ Relationship

Telephone #s Home Work Cell _______________________________________

NAME ___ __________ Relationship ___________

Telephone #s Home Work Cell ________________________________________

NAME ___ _____ Relationship


NAME ____ _____ Relationship


EMERGENCY CONTACTS/PICK UP PLAN

You are required to have an Emergency Pick up Plan for your child. In the event that the school building is closed unexpectedly, due to inclement weather, loss of electricity, etc. the Summer School Age Child Care program may be cancelled. If such a situation should arise, we need to know whom to call if we are unable to contact you. Please make advanced arrangements with three adults upon whom we may call to quickly pick up your child. Please list them below with all the required information. We recommend that you choose adults who reside or work close to camp. It is sometimes necessary to contact a parent or guardian during the day because of accident, illness or absenteeism. We will try to contact parent/guardians first. However, if we are unable to contact you, we will call your Emergency Contacts. Name__________________________________________________________________________________________ Relationship ____________________________

Address_______________________________________________________________________________________________________________________________________________________ Street Town/City State Zip Phone (Home) ___________________________________________ Business___________________________________________________Cell ____________________________________________

Name__________________________________________________________________________________________ Relationship ____________________________

Address_______________________________________________________________________________________________________________________________________________________ Street Town/City State Zip Phone (Home) ___________________________________________ Business ___________________________________________________Cell ____________________________________________

Name__________________________________________________________________________________________ Relationship ____________________________

Address_______________________________________________________________________________________________________________________________________________________ Street Town/City State Zip Phone (Home) ___________________________________________ Business ___________________________________________________Cell ____________________________________________

It is your responsibility to inform the YMCA in writing (Providing legal documentation) of any custody limitations for any person.

(Return this Page)


4



REGISTRATION AGREEMENT

1) I am enrolling my child for the Summer Child Care. A $25.00 processing fee (includes required T-shirt). However, T-shirt

sizes ordered after 6/20 will not be guaranteed.

2) I understand that my deposit made at time of registration is non-refundable and that the balance is due June 1st unless I have signed up for the Payment Plan Option #2. All field trip fees must be paid at time of registration and there are no refunds for Field Trips.

3) I acknowledge that I have received, understand and agree to follow the Summer School Age Child Care Program’s Policies

and Procedures including the outlined Discipline Policy.

4) By signing this agreement I understand and agree that, in the event I should fail to pay any balance due, then I shall be responsible to pay interest at 1.5% per month until the amount due is paid, plus reasonable attorney’s fee in an amount not to exceed one third of the amount due.

5) I give permission for the YMCA to photograph or film my child and use said pictures for any form of advertising or

promotion as deemed appropriate.

Parent Signature: _____________ Date:

PERMISSION FOR EMERGENCY MEDICAL CARE

In order to meet all legal requirements, I hereby authorize representatives of the Meadowlands Area YMCA to give consent for any and all emergency medical care for my child while he/she attends programs sponsored by the Meadowlands Area YMCA.

Parent/Guardian Signature: ______________________________________________________________________________ Date: __________________________

WALKING TRIPS PERMISSION

I give permission for my child to participate in any walking trips outside the building with the YMCA staff and participants. Parent/Guardian Signature: _______________________________________________________________________________ Date: __________________________

BUS TRIP PERMISSION

I give permission for my child to participate in any bus trip arranged by the Meadowlands Area YMCA.

Parent/Guardian Signature: __________________________________________________________________________________ Date: __________________________

(Return this Page)


5



U SCHOOL AGE CHILD CARE MEDICAL REPORT FORM 2015

***Copy of Immunizations Record from Pediatrician/Doctor MUST be included*** NAME U _______________________ ________________________ ADDRESS PHONE BIRTH DATE PARENT’S NAME

DATE OF IMMUNIZATION (Most recent only): EXAMINATION-Check () if normal, if not, TETANUS (x) and give details on back: DIPTHERIA GENERAL CONDITION WHOOPING COUGH U _____________ SMALL POX HEIGHT POLIO WEIGHT OTHER: EARS HEARING ALLERGIES DISEASE HISTORY – Give age child had Any of the following: WHOOPING COUGH POST NASAL CONDITION MUMPS EYES CHICKEN POX LUNGS ASTHMA HEART SCARLET FEVER HERNIA EPILEPSY SKIN MEASLES ORTHOPAEDIC-FEET GERMAN MEASLES OTHER OTHER

Has child had any serious accident(s)? ___________ At what age? Please describe. _____________ Has child ever been hospitalized? Under what circumstances? ____________ Does the child have frequent sore throats? ____________ Gifted? Physically Handicapped? _____________ Neurologically Impaired? Emotional or behavioral problems? Does the child have any special needs of which we should be aware? ________________________ Is the child on any special medication? If so, please explain. ____________ Is the child subject to frequent colds? __________________________ Habits? ____________ Does the child understand and speak English? Other Languages ________________________ Physician's Name____________ __________Phone____________________ Address______________________ ________________________________

MY CHILD, ___ , IS IN CONDITION AND MAY SAFELY ENGAGE IN ALL USUAL ACTIVITIES EXCEPT AS NOTED ABOVE. Parent/Guardian Signature________________________________________ Date____/____/____

(Return this Page)

The parent must fill out this page.

Doctor’s signature is not necessary.


6



INFORMATION TO PARENTS STATEMENT I have read and received a copy of the Information to Parents Statement prepared by the Office of Licensing, Child Care & Youth Residential Licensing in the Department of Children and Families (page 14). Print name of Child ___________________________________________________________________________________________________________ Printed Name of Parent/Guardian ____________________________ Signature ____________________________ Date

Drop Off, Pick Up and Optional Walk Home Policy

For Teen Camp Only

All campers must be signed in every day by an adult.

Teen Travel Campers have the option to sign themselves out of camp and walk home after we return from our trip or at the end of our camp activities provided a parent/guardian signs the permission slip below. No Teen Travel Camper will be allowed to sign out of camp before 5:00PM. Teen Travel Camper must get a Camp Director or Counselor to initial that he /she is signed out of camp.

Once signed out of camp, Teen Travel Camper must leave the camp.

All Campers must be signed in and out of camp each day.

Walk Home Permission Slip

Teen Travel Camp ONLY

(Optional Form)

I give permission for my child_______________________ to sign out of camp and walk home. I understand that no camper will be allowed to sign out from camp before 5:00 PM. My child and I agree to follow the above policy regarding signing out of camp.

I acknowledge that once my child signs out of camp, the Meadowlands Area YMCA is no longer responsible for him/her. I further acknowledge that I will not hold the Meadowlands Area YMCA liable for anything that may happen to my child on the

way home.

Parent Name________________________________________________________________________________________________________________ Parent’s Signature____________________________________________________________________ Date_______________________________

(Return this Page)


7



MEMBER/CHILDREN

RELEASE and WAIVER of LIABILITY and INDEMNITY AGREEMENT IN CONSIDERATION of being permitted to utilize the facilities, services and programs of the YMCA (or for my children to so participate) for any purpose, including, but not limited to observation or use of facilities or equipment, or participation in any off-site program affiliated with the YMCA, the undersigned, for himself or herself and such participating children and any personal representatives, heirs, and next of kin, hereby acknowledges, agrees and represents that he or she has, or immediately upon entering or participating will, inspect and carefully consider such premises and facilities or the affiliated program. It is further warranted that such entry into the YMCA for observation or use of any facilities or equipment or participation in such affiliated program constitutes an acknowledgement that such premises and all facilities and equipment thereon and such affiliated program have been inspected and carefully considered and that the undersigned finds and accepts same as being safe and reasonably suited for the purpose of such observation, use or participation by the undersigned and such children. IN FURTHER CONSIDERATION OF BEING PERMITTED TO ENTER THE YMCA FOR ANY PURPOSE INCLUDING, BUT NOT LIMITED TO OBSERVATION OR USE OF FACILITIES OR EQUIPMENT, OR PARTICIPATION IN ANY OFF-SITE PROGRAM AFFILIATED WITH THE YMCA, THE UNDERSIGNED HEREBY AGREES TO THE FOLLOWING: 1. THE UNDERSIGNED ON HIS OR HER BEHALF AND BEHALF OF SUCH CHILDREN, HEREBY RELEASES, WAIVES, DISCHARGES AND

CONVENANTS NOT TO SUE the YMCA and all branches thereof, its directors, officers, employees, and agents (hereinafter referred to as "releasees") from all liability to the undersigned or such children and all his personal representatives, assigns, heirs, and next of kin for any loss or damage, and any claim or demands therefore on account of injury to the person or property or resulting in death of the undersigned or such children whether caused bv the negligence of the releasees or otherwise while the undersigned or such children is in, upon, or about the premises or any facilities or equipment therein or participating in any program affiliated with the YMCA.

2. THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the releasees and each of them from any, loss, liability, damage or cost they may, incur due to the presence of the undersigned or such children in, upon or about the YMCA premises or in any way observing or using any facilities or equipment of the YMCA or participating in any program affiliated with the YMCA whether caused by the negligence of the releasees or otherwise.

3. 'I'HE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE to the undersigned or such children due to negligence of releasees or otherwise while in, about or upon the premises of the YMCA and/or while using the premises or any facilities or equipment thereon or participating in any program affiliated with the YMCA.

THE UNDERSIGNED further expressly agrees that the foregoing RELEASE WAIVER AND INDEMNITY AGREEMENT is intended to be as broad and inclusive as is permitted by the law of the State of New Jersey and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. 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. I HAVE READ AND UNDERSTAND THIS DOCUMENT AND RELEASE _______________________________ ____________________________________________________________ Date Parent/Guardian Signature

(Return this Page)


8



From this point

forward,

keep for your records.


9



INFORMATION TO PARENT

Dear Parent: In keeping with New Jersey’s child care center licensing requirements, we are obligated to provide you, as the parent of a child enrolled at our center, with this informational statement. The statement highlights, among other things: your rights to visit and observe our center at any time without having to secure prior permission; the center’s obligation to be licensed and to comply with licensing standards; and the obligation of all citizens to report suspected child abuse/neglect/exploitation to the State Child Abuse Hotline 1 (877) NJ ABUSE. Updated 4/17/08 Please read this statement carefully and if you have any questions feel free to contact me at (201) 955-5300. Sincerely,

Jane A. Egan Jane A. Egan CEO

(Keep This Page for Your Records)


10



EXPULSION POLICY

Unfortunately, there are reasons we have to expel a child from our program either on a short tern or permanent basis. We wan t you to know we will do everything possible to work with the family of the child in order to prevent this policy from being enforced. The following are reasons we may have to terminate or suspend a child from this program. PARENTAL ACTIONS FOR CHILD'S EXPULSION

Failure to pay/habitual lateness in payments

Failure to complete required forms including the child's immunization records.

Habitual tardiness when picking up your child

Physical or verbal abuse to staff or other children in the program.

Other (Explain) _________________________________________________________ CHILD'S ACTIONS FOR EXPULSION

Failure of child to adjust after a reasonable amount of time

Uncontrollable tantrums/angry outbursts.

Outgoing physical or verbal abuse to staff or other children

Biting is not permitted.

Other (Explain)__________________________________________________________ PROACTIVE ACTIONS THAT WILL BE TAKEN IN ORDER TO PREVENT EXPULSIONS

Staff will try to redirect child from negative behavior.

Staff will reassess classroom environment, appropriate of activities, supervision.

Staff will always use positive methods and language while disciplining children.

Staff will praise appropriate behaviors

Staff will consistently apply consequences for rules.

Child will be given verbal warnings.

A brief time-out will be given so child can regain control.

Child may lose certain privileges (Explain).

The director, classroom staff and parent/guardian will have a conference(s) to discuss how to promote positive behaviors.

Child's disruptive behavior will be documented and maintained in confidentiality.

Parent/Guardian will be notified verbally.

Parent/Guardian will be given written copies of the disruptive behaviors that might lead to expulsion.

The parent will be given literature or other resources regarding methods of improving behavior.

Recommendation of evaluation by professional consultation on premises

Recommendation of evaluation by local school district child study team. SCHEDULE OF EXPULSIONS

If after the remedial actions above have not worked, the child's parent/guardian will be advised verbally and in writing about the child's or parent's behavior warranting an expulsion. An expulsion action is meant to be a period of time so that the parent/guardian may work o n the child's behavior or come to an agreement with the center.

o The parent/guardian will be informed regarding the length of the expulsion period . o The parent/guardian will be informed about the expected behavioral changes required in order for the child or parent to retur n to

the center. o The parent/guardian will be given a specific expulsion date that allows the parent an adequate amount of time to seek alterna te

child care (approximately one to two weeks notice depending on risk to other children's welfare or safety). o Failure of the child/parent to satisfy the terms of the plan may result in permanent expulsion from the center.

A CHILD WILL NOT BE EXPELLED If a child's parent(s):

o Made a complaint to the Office of Licensing regarding a center's alleged violations of the licensing requirements (1-877-667-9845)

o Reported abuse or neglect occurring at the center. (1-877-NJ ABUSE) (1-877-652-2873) o Questioned the center regarding policies and procedures. o Without giving the parent an adequate amount of time to make other child care arrangements.



11



POLICIES AND PROCEDURES SUMMER 2015 REGISTRATION

Payments may be paid by Visa/MasterCard/American Express, cash, check, or money order. Credit card payments will only be accepted via Fax, Mail or walk-in. Checks should be made out to the Meadowlands Area YMCA. Prior to June 1st, $50.00 deposit per registered week of camp + 25.00 processing fee (which includes required T-shirt) + additional field trip fees. Balance is due June 1st unless you have chosen Payment Plan Option #2. Late payment fee of $20.00 will be assessed to all balances not paid by June 1st. Full payment is due at time of registration, if after June 1st unless you are using payment Plan Option #2. All payments should either be mailed directly to the YMCA office (P.O. Box 252 Rutherford, NJ 07070) or brought to the YMCA Office (436 Ridge Road, North Arlington, NJ). Payments must not be sent with the child to the Program.

All children must be current YMCA members. The annual fee is $20 per child or $45 per family of three ($5.00 each additional family member.)

A CHILD MAY NOT ATTEND WITHOUT THE PROPER FEES BEING CURRENT. There are no CREDITS OR REFUNDS for days missed. Personal illness and activities do not reduce weekly fees. Your fee pays for direct operating costs, such as staff, snack and materials. All of these must be available for your child. When you enroll, you are reserving the time, space, staffing and provisions for your child whether the child attends or not.

If a check is returned by the bank for any reason, there will be a $25.00 penalty fee. All subsequent payments must be made with cash or money order.

In the event that any balance due is not paid, the YMCA may charge interest at 1.5% per month until the amount due is paid, plus reasonable attorney's fees in an amount not to exceed one third of the amount due.

HEALTH

If your child will be absent from the summer program, as a courtesy please call the YMCA camp director on the camp phone.

Each child must have a medical form and immunization records filled out by a parent prior to admission.

DO NOT send your child to the program if he/she has any of the following symptoms: fever or headaches, rashes or inflamed skin, nausea or vomiting, abdominal pains or diarrhea, sore throats, ear ache, inflammation of the eyes, enlarged glands, persistent coughing.

The YMCA should be informed about the nature of any illness. If your child has a communicable disease, tell us when it first appeared.

No medicine can be administered by staff; but medication can be overseen by staff with doctor’s authorization and note from parent/guardian. Please contact the Child Care Director for specific procedures and guidelines.

If a child develops any of the above symptoms while in the YMCA's care, the parents will be notified to have the child picked up by an authorized adult. Doctor's permission may be required for that child to return to the program in some cases.

Children may not make up an absence on another day. YMCA Camp T-Shirts - A YMCA T-shirt must be worn on a daily basis for safety and accountability. Children are required to wear their camp T-shirt while swimming. SWIMMING - Children should wear their bathing suits to camp on swim days along with the camp T-shirt. The child’s family should provide towels and sunscreen. Only Coast Guard approved flotation devices are permitted. Water shoes are optional. A child may not enter the deep end unless they have passed a swimming test without the use of any flotation aid. SNACKS

The YMCA attempts to make the food breaks healthful. We try to involve children in the preparation and in nutrition education. If your child has dietary restrictions, be sure to indicate them on the health form.



12



Children should bring a bagged lunch to the program each day (Lunch is provided by the YMCA on certain outings, parents will be notified). Please check your campsite’s schedule. In the meantime, assume that on all other days you should bring your child's lunch unless otherwise notified by the staff. Be sure to put your child’s name on the bag. It is best to send non-perishable items. (NO GLASS BOTTLES PLEASE)

VALUABLES

The YMCA Day Camp program is not responsible for articles that may be lost or damaged. Children are asked to keep valuables at home. Should you permit your child to bring these items, the YMCA is not responsible for any loss or damage to them.

When giving spending money, please place money in a sealed envelope with your child's name, campsite and the amount written on the front. Please hand envelope to the Director/Leader to hold until needed. This format must be followed; however the YMCA is not responsible for any monies that are lost or stolen.

DROPPING OFF AND PICKING UP CHILDREN

The YMCA is responsible for the children once they are signed into the program.

When dropping off a child, NEVER leave him/her unattended. Escort him/her to the staff person on duty and SIGN THE CHILD IN ON A DAILY BASIS. Only authorized persons listed on the information package may pick up the child. THEY MUST SIGN THE CHILD OUT EACH DAY. ID must be presented when picking up a child from the Summer Day Camp Program.

Written notices must be given if a child is to leave with someone other than the authorized people on the information package. ID must be presented when picking up a child from the Summer Day Camp Program. Please check for information from the staff each day when you sign your child out.

Children may not be picked up from a Special Event Site under any circumstances. Pick-up or drop off is only scheduled at the Camp Site. Again each child must be signed In and Out at the campsite. This rule is stipulated for the accountability and safety of all children. Children must not be dropped off before their scheduled drop off time. A child who is dropped off early will be accessed an Early Drop off Fee of $18 per half hour (or part thereof). The children must be picked up promptly at registered pick up time or there will be a late pick up charge of $18.00 per half-hour (or part of). After the first half-hour, an authorized adult on the emergency form will be contacted to pick up the child. If an authorized adult cannot be reached one hour after pick up time, the Site Director or Acting Site Director will make arrangements with the Division of Youth and Family Services to care for the child until an authorized adult can pick up the child. There is a limit of 3 late pick-ups. Any child who is chronically picked up late will not be allowed to remain in the program.

Please LABEL all of your child's belongings with a permanent black marker, as the YMCA is not responsible for lost or stolen items. We are not opposed to electronic games or equipment (i.e.: game boys) however the YMCA is not liable for any loss or damage to any items brought to camp.

The YMCA will provide two snacks per day (one snack for morning and one snack for afternoon). Please provide your child with additional water/drink bottle.

It is imperative that your child is signed In and Out each day they attend camp. Please always have your Picture ID available as you may be asked to present it when picking up your child.

Cell Phones are not permitted at any time. If any child brings a cell phone to the campsite, it will be retrieved and returned to the parent when he/she picks up the child.

Items your child must bring on a daily basis in his/her backpack. Lunch – except when notified Suntan Lotion Water Bottle Additional T-shirt Bathing Suit Towel


13



Your Camp Director will inform you of the bus departure and arrival time for any scheduled events. Please drop your child off at the campsite at least 15 minutes prior to the departure time. The bus cannot be held for any reason.

On swim days, please make sure that your child is wearing their bathing suit under their clothing, as there are no changing rooms at the sites. Please apply sunscreen before you leave your home.

Every Friday, the following week’s camp schedule will be available. Make sure to take a copy. You can also contact the YMCA office at 201-955-5300 if you did not get a copy. We will also be trying to post the weekly schedule on our website but this is not a guarantee. This will be updated every Friday after 5PM. The website is www.YMCAinfo.org.

Important Note: Trips are subject to change as well as departure and arrival times.

PARENT INVOLVEMENT Involvement of parents in the program is essential.

Cooperation with all policies and procedures is necessary.

Take every opportunity to talk with YMCA staff about your child.

Ask your child about the program every day.

SUMMER CAMP LOCATIONS

Camp Rock - McKenzie School, 125 Carlton Avenue, East Rutherford, NJ

Camp Starts: 6/22/15 Camp Ends: 8/21/15

Camp Roll - McKenzie School, 125 Carlton Avenue, East Rutherford, NJ


Camp Believe - Wood-Ridge Civic Center, Wood-Ridge, NJ (Drop Off/Pick Up Location Only)


Camp Stars - Union School, 359 Union Avenue, Rutherford, NJ


Camp Twizzler - Bergen Head Start Bldg. 263 Lafayette Avenue, Cliffside Park, NJ


Camp Spirit - Lakeland High School, 205 Conklintown Road, Wanaque, NJ

Camp Starts: 6/25/15 Camp Ends: 8/21/15 Moves to: Ringwood Firehouse, 67 Edgewood Road, Ringwood, NJ Camp Starts: 8/24/15 Camp Ends: 9/4/15

Camp Voyagers - Teen Camp – Union School, 359 Union Avenue, Rutherford, NJ


Camp RCC – Rutherford Congregational Church, 251 Union Ave, Rutherford, NJ


There are NO camps open on Friday July 3, 2015


http://www.ymcainfo.org/

Meadowlands Area YMCA PO Box 252, Rutherford, NJ 07070 Phone: (201) 955-5300, (855) 788-YMCA (9622) Fax: (201) 955-2055 www.YMCAinfo.org

INFORMATION TO PARENTS

Under provisions of the Manual of Requirements for Child Care Centers (N.J.A.C. 10:122), every licensed child care center in New Jersey must provide to

parents of enrolled children written information on parent visitation rights, State licensing requirements, child abuse/neglect reporting requirements and other child care matters. The center must comply with this requirement by reproducing and distributing to parents this written statement, prepared by the Office of Licensing, Child Care & Youth Residential Licensing, in the Department of Children and Families (DCF). In keeping with this requirement, the center must secure every parent’s signature attesting to his/her receipt of the information.

Our center is required by the State Child Care Center Licensing Law to be licensed by the Office of Licensing, Child Care & Youth Residential Licensing, in the Department of Children and Families (DCF). A copy of our current license must be posted in a prominent location at our center. Look for it when you’re in the center.

To be licensed, our center must comply with the Manual of Requirements for Child Care Centers (the official licensing regulations). The regulations cover such areas as: physical environment/life-safety; staff qualifications; supervision, and staff/child ratios; program activities and equipment; health, food and nutrition; rest and sleep requirements; parent/community participation; administrative and recordkeeping requirements; and others.

Our center must have on the premises a copy of the Manual of Requirements for Child Care Centers and make it available to interested parents for review. If you would like to review our copy, just ask any staff member. Parents may secure a copy of the Manual of Requirements by sending a check or money order for $5 made payable to the “Treasurer, State of New Jersey” and mailing it to: NJ Department of Children and Families, Office of Licensing, Publication Fees, PO Box 657, Trenton, New Jersey 08646-0657.

We encourage parents to discuss with us any questions or concerns about the policies and program of the center or the meaning, application or alleged violations of the Manual of Requirements for Child Care Centers. We will be happy to arrange a convenient opportunity for you to review and discuss these matters with us. If you suspect our center may be in violation of licensing requirements, you are entitled to report them to the Office of Licensing toll free at 1 (877) 667-9845. Of course, we would appreciate your bringing these concerns to our attention, too.

Our center must have a policy concerning the release of children to parents or people authorized by parents to be responsible for the child. Please discuss with us your plans for your child’s departure from the center.

Our center must have a policy about administering medicine and health care procedures and the management of communicable diseases. Please talk to us about these policies so we can work together to keep our children healthy.

Our center must have a policy concerning the expulsion of children from enrollment at the center. Please review this policy so we can work together to keep your child in our center.

Parents are entitled to review the center’s copy of the Office of Licensing’s Inspection/Violation Reports on the center, which are issued after every State licensing inspection of our center. If there is a licensing complaint investigation, you are also entitled to review the Office’s Complaint Investigation Summary Report, as well as any letters of enforcement or other actions taken against the center during the current licensing period. Let us know if you wish to review them and we will make them available for your review.

Our center must cooperate with all DCF inspections/investigations. DCF staff may interview both staff members and children. Our center must post its written statement of philosophy on children discipline in a prominent location and make a copy of it available to parents upon request. We encourage you to review it and to discuss with us any questions you may have about it.

Our center must post a listing or diagram of those rooms and areas approved by the Office for the children’s use. Please talk to us if you have any questions about the center’s space.

Our center must offer parents of enrolled children ample opportunity to assist the center in complying with licensing requirements; and to participate in and observe the activities of the center. Parents wishing to participate in the activities or operations of the center should discuss their interest with the center director who can advise them of what opportunities are available.

Parents of enrolled children may visit our center at any time without having to secure prior approval from the director or any staff member. Please feel free to do so when you can. We welcome visits from our parents.

Our center must inform parents in advance of every field trip, outing, or special event away from the center and must obtain prior written consent from parents before taking a child on each such trip. Our center is required to comply with the New Jersey Law Against Discrimination (LAD), P.L. 1945, c. 169 (N.J.S.A. 10:5-1 et seq.), and the Americans with Disabilities Act (ADA), P.L. 101-336 (42 U.S.C. 12101 et seq.). Anyone who believes the center is not in compliance with these laws may contact the Division on Civil Rights in the New Jersey Department of Law and Public Safety for information about filing an LAD claim at (609) 292-4605 (TTY users may dial 711 to reach the New Jersey Relay Operator and ask for (609) 292-7701), or may contact the United States Department of Justice for information about filing an ADA claim at (800) 514-0301 (voice) or (800) 514-0383 (TTY). Our center is required to periodically review the Department of Law and Public Safety (DLPS), Division of Consumer Affairs (DCA), unsafe children’s product list, make the list accessible to staff and parents, and ensure that items on the list are not at the center. The list is available at www.state.NJ.US/lps/ca/recall/recalls.htm. Internet access may be available at your local library. For more information call the DLPS, DCA, toll free at 1 (800) 242-5846. Anyone who has reasonable cause to believe that an enrolled child has been or is being subjected to any form of hitting, corporal punishment, abusive language, ridicule, harsh, humiliating or frightening treatment, or any other kind of child abuse, neglect, or exploitation by any adult, whether working at the center or not, is required by State law to report the concern immediately to the State Child Abuse Hotline, Toll Free at 1 (877) NJ ABUSE. Such reports may be made anonymously. Parents may secure information about child abuse and neglect by contacting: DCF, Office of Communications and Legislation at (609) 292-0422 or go to www.NJ.gov/DCF and select Publications.

http://www.state.nj.us/lps/ca/recall/recalls.htm

http://www.nj.gov/DCF

15



Meadowlands YMCA’s Commitment to Safety - Information to Parents

The Meadowlands Area YMCA is dedicated to providing you and your family with a safe, welcoming atmosphere in all of our programs. Our staff is critical to this goal. The YMCA has in place a comprehensive pre-employment screening procedure to screen-out staff not suited for working with children. Additionally, our staff receives Child Abuse Prevention training and is required to adhere to a Code of Conduct, which prohibits staff in having planned contact with youth participants when they are off duty. Our Professional Directors welcome your suggestions, observations and/or comments.

Employee Code of Conduct 1. In order to protect YMCA staff, volunteers, and program participants, at no time during a YMCA program may a staff person be alone with a

single child where he or she cannot be observed by others. As staff supervise children, they should space themselves in such a way that other staff can see them.

2. Staff shall never leave a child unsupervised. 3. Restroom supervision: Staff will make sure the restroom is not occupied by suspicious or unknown individuals before allowing children to use

the facilities. Staff will stand in the doorway of the restroom while children are using the restroom. This policy allows privacy for the children and protection for the staff (not being alone with a child). If staff is assisting younger children, doors to the facility must remain open. No child, regardless of age, should ever enter a bathroom alone on a field trip. Always send children in pairs, and whenever possible, with staff.

4. Staff should conduct or supervise private activities in pairs - diapering, putting on bathing suits, taking showers, etc. When this is not feasible, staff should be positioned so that they are visible to others.

5. Staff shall not abuse children including: a. Physical abuse - to strike, spank, shake, slap; b. Verbal abuse - to humiliate, degrade, threaten; c. Sexual abuse - to inappropriately touch or speak; d. Mental abuse - to shame, withhold kindness, be cruel e. Neglect - to withhold food, water, basic care, etc.

No type of abuse will be tolerated and may be cause for immediate dismissal. 6. Staff must use positive techniques of guidance, including redirection, positive reinforcement, and encouragement rather than competition,

comparison and criticism. Staff will have age-appropriate expectations and set up guidelines and environments that minimize the need for discipline. Physical restraint is used only in pre-determined situations (necessary to protect the child or other children from harm), is only administered in a prescribed manner, and must be documented in writing.

7. Staff will conduct a health check of each child, each day, as they enter the program, noting any fever, bumps, bruises, burns, etc. Questions or comments will be addressed to the parent or child in a non-threatening way. Any questionable marks or responses will be documented.

8. Staff will respond to children with respect and consideration and treat all children equally regardless of sex, race, religion, or culture. 9. Staff will respect children's rights to not be touched in ways that make them feel uncomfortable, and their right to say no. Other than

diapering, children are not to be touched on areas of their bodies that would be covered by a bathing suit. 10. Staff will refrain from intimate displays of affection towards others in the presence of children, parents and staff. 11. While the YMCA does not discriminate against an individual's lifestyle, it does require that in the performance of their job, they will abide by

the standards of conduct set forth by the YMCA. 12. Staff must appear clean, neat and appropriately attired. 13. Using, possessing, or being under the influence of alcohol or illegal drugs during working hours is prohibited. 14. Smoking or use of tobacco in the presence of children or parents during working hours is prohibited. 15. Profanity, inappropriate jokes, sharing intimate details of one's personal life and any kind of harassment in the presence of children or parents

is prohibited. 16. Staff must be free of physical and psychological conditions that might adversely affect the children's physical or mental health. If in doubt, an

expert should be consulted. 17. Staff will portray a positive role model for youth by maintaining an attitude of respect, loyalty, patience, courtesy, tact and maturity. 18. Staff may not be alone with children they meet in YMCA programs outside of the YMCA. This includes babysitting, sleepovers, and inviting

children to your home. Any exceptions require a written explanation before the fact and are subject to administrator approval. 19. Staff members are not to transport children in their own vehicles. 20. Staff may not date program participants under the age of 18 years of age. 21. Under no circumstances should staff release children to anyone other than the authorized parent, guardian, or other adult authorized by the

parent or guardian (written parent authorization on file with the YMCA.) 22. Staff members are required to read and sign all policies related to identifying, documenting, and reporting child abuse and attend trainings on

the subject, as instructed by a supervisor. 23. Staff will act in a caring, honest, respectful and responsible manner.

meAdoWlAnds AreA YmCA UnplUg Camp/… · SUMMER CAMP A LICENSED CHILDCARE PROGRAM TRAINED &...

Documents

Transcript of meAdoWlAnds AreA YmCA UnplUg Camp/… · SUMMER CAMP A LICENSED CHILDCARE PROGRAM TRAINED &...