cross island ymca 2013 camp guide

CROSS ISLAND YMCASummer Camp 2013

2 | Cross Island YMCa WInter & sprIng 2013 lIke us! WWW.faCebook.CoM/CrossIs ndYMCa 2 | Cross Island YMCa suMMer CaMp 2013 lIke us! WWW.faCebook.CoM/CrossIslandYMCa

Is Your ChIld readY for a suMMer of groWth and adventure? YMCA SUMMER CAMP

The Cross Island YMCA is about to embark on yet another fun and exciting summer of camp. Welcome to all of our returning and new campers to our 2013 Day Camp Program. Y Summer Camp uses hands-on learning through indoor and outdoor educational activities. Thank you for choosing our summer day camp for your child. We look forward to getting to know your son or daughter!

Sincerely,tyronza MurraySenior Program Director

3 | Cross Island YMCa WInter & sprIng 2013 lIke us! WWW.faCebook.CoM/CrossIsland-YMCa vIsIt us at WWW.YMCanYC.org/CrossIsland Cross Island YMCa suMMer CaMp 2013 | 3

WelCoMe to YMCa suMMer CaMpThrough programs like YMCA Day and Sleepaway Camp, we nurture your child’s sense of self-confidence and introduce them to positive, fun experiences that build leadership and social skills. Well-trained, qualified staff serve as positive role models for campers. Y Day Camp enhances camper’s self-confidence, self-esteem and leadership skills through structured (and fun!) activities. Campers develop a true understanding of diversity in an atmosphere of acceptance and approval of the uniqueness of others. Campers are encouraged to be creative, expressive and learn new skills. Summer learning activities offer fun way for campers to read and learn over the summer months. All YMCA Day Camps are licensed by the NYC Department of Health and Accredited by the American Camping Association (ACA).

YMCA Summer Camp helps campers ages 2-12 years old and teens ages 13-17 years old grow mentally and physically by participating in challenging activities in both small and large group settings under the supervision of a caring and well trained staff.

SUMMER LEARNINGTo succeed in school and life, children and young adults need ongoing opportunities to learn and practice essential skills. This is especially true during the summer months when children lose much of what they learn during the school year.

YMCA of Greater New York Day Camps provide high-quality summer learning initiatives that give children a variety of ways to improve reading and math skills and explore music, drama, art and sports. Through fun, themed curriculum that incorporates key academic components, children will practice and further their academic skills, learn to plan and create projects, learn teamwork and develop new skills. To inspire reading, our program will provide books recommended by the Department of Education for summer reading.

OUR CAMP LOCATIONSThe Cross Island YMCA Summer Day Camp operates out of Cross Island YMCA and PS 33. We also use offsite facilities such as local parks to conduct Day Camp.

CONTACT USFor more information or have questions, please contact: Dana Feinberg, Executive Director 718-551-9306; [email protected] Murray, Sr. Program Director 718-551-9320; [email protected] Turenne, Camp Director 718-551-9336; [email protected] Batson, Program Associate 718-551-9309, [email protected] Mandy Dihal, Program Coordinator 718-551-9334; [email protected]é Vielot, Sports Coordinator 718-551-9337; [email protected] Batra, Kinder Camp Director 718-551-9313; [email protected] [email protected] or visit www.ymcanyc.org/careers


KINDER CAMP(Ages 2 – 5.8) • session i - iV RATES: SEE PAGE 10our primary goal is for each child to develop a positive self-image. The staff is made up of carefully selected teachers and assistant teachers. They provide guidance and supervision so that each child can achieve self-confidence and awareness.

our camp offers air-conditioned classrooms, outdoor playground, picnic area, indoor pool and gym. Children participate in a wide variety of activities, including arts & crafts, swim (3 years & up), gym, music, and organized games. Each week will feature a special theme, and each session will have a trip to the zoo, children’s museum or park. All activities are geared to meet individual needs, abilities, and interests.

KinDer CAmp ConTACT inFormATionSunita Batra at 718-551-9313; [email protected]

YOUTh CAMP (Ages 5.9 – 12) • session i - iV member rATes: $400 per session

progrAm member rATes: $410 per sessionCampers participate in a wide range of sports, instructional swimming, mini trips, arts and crafts, weekly themed days, environmental science and more. To facilitate academic success our recreational reading component is designed to help kids sharpen their reading skills throughout the summer months. Campers are paired with others within 2 years of their age range.

TEAM SPORTS CAMP (Ages 5.9 – 12) • session i - iVmember rATes: $450 per session

progrAm member rATes: $460 per sessionBaseball, Basketball, Soccer and Flag Football. Campers will learn basic fundamentals and rules for each of the sports. Each day of the week our staff will focus on one of the four sports. our goal is to expose the children to a variety of sports. Camper should bring proper equipment for each sport.

BASKETBALL CAMP(Ages 5.9 – 12) • session i - iVmember rATes: $450 per session

progrAm member rATes: $460 per sessionClasses are based on appropriate age and level of play. All ability levels are welcomed. offensive and defensive skills and team concepts develop the most complete basketball player possible.

GYMNASTICS CAMP(Ages 5.9 – 12) • session i - iVmember rATes: $450 per session

progrAm member rATes: $460 per sessionDrills and skills in all olympic events, following a progressive program. Dance, conditioning, stretching and performance tips will focus on fun for gymnasts of every level. The last day exhibition will give gymnasts an opportunity to show their new skills.

TENNIS CAMP(Ages 5.9 – 12) • session i - iVmember rATes: $450 per session

progrAm member rATes: $460 per sessionThe Tennis Camp offers drills and activities carefully designed for different developmental levels so each camper will have a successful learning experience. The camp will focus on positioning, court layout and rules and regulations. The campers will also learn about the basic fore-hand and back hand strokes and compete in both singles and doubles activities. Campers must bring a racket and a sun visor or hat.

PERFORMANCE ARTS OR MUSIC CAMP(Ages 5.9 – 12) • session i - iVmember rATes: $450 per session

progrAm member rATes: $460 per sessionPerformance Arts Camp participants experience a wonderful summer of dance, drama, music & art. Campers will learn the basics of choreography from lyrical to hip-hop. In addition, campers will learn the fundamentals of acting, character study, improvisation exercises, and even try script writing. Create, Play, have Fun! Music Camp will start or continue a love for musical instruments. Your child will be in a rock band, write a song, and perform. Each camp showcases their new skills and performs for their families at the end of the session.

CRAFTS CAMP (Ages 5.9 – 12) • session i - iVmember rATes: $450 per session

progrAm member rATes: $460 per sessionCrafts campers experience a vast array of creative arts, including sculpture, painting, collaging, scrapbooking, drawing, and more. This project based camp will give young artists hands on experience trying new mediums. Campers will make different art projects weekly, learn new skills, and develop lasting friendships in Crafts Camp!

daY CaMp All Day Camps include swimming lessons, field trips to various museums and events, and projects that explore our weekly themes.



TEEN CAMP (Ages 13 – 15) • session i - iV member rATes: $400 per session

progrAm member rATes: $410 per sessionTeen Camp balances scheduled and optional activities for older boys and girls. Campers participate in a wide range of sports, instructional swimming, mini trips, arts and crafts, weekly themed days, environmental science and more. Teen Camp will have three major components: sports and recreation, visual and performing arts, and leadership training. All activities, trips, and additional programming will be an outgrowth of these three components.

TEEN SPORTS CAMP (Ages 13 – 15) • session i - iiimember rATes: $450 per session

progrAm member rATes: $460 per sessionour progressive curriculum enhances various sports skills and fundamentals. Campers will learn the different rules of each game while practicing their techniques in mini games. In addition, they will learn about team work, sportsmanship, and motivating each other to succeed. The camp will also focus on teaching fitness and healthy lifestyles.

COUNSELOR–IN–TRAINING(Ages 16-17) • session i - iiimember rATes: $250 per session

progrAm member rATes: $260 per sessionour Counselor in Training (CiT) program is for tomorrow’s leaders. Teens who are involved in this amazing program gain job readiness skills and work experience during the summer working along with experienced staff. CITs l receive training in program safety and a Community Service Award. The program will provide hands-on learning allowing teens to slowly work into responsible roles leading children. Staff will assist teens in developing their communication and organization skills. CIT candidates will be interviewed by our Camp Director.

LISA BETh GERSTMAN CAMP FOR ChILDREN WITh PhYSICAL ChALLENGES(Ages 6 – 14) • session A - b rATes: $700 per 3 WeeK sessionThe Cross Island YMCA is extremely proud to offer The Lisa Beth Gerstman YMCA Summer Day Camp program serving children with physical and developmental challenges in an integrated setting. Every child deserves the opportunity to participate in a safe, caring, and fun learning environment. our goal is to develop each child’s spirit, mind, and body through quality driven programs. This special camp is made possible through the generous support of the Lisa Beth Gerstman Foundation. Its donation has offset the expenses of equipment, transportation and staffing required to serve youngsters with special needs. All children will receive wheelchair accessible transportation, one-on-one swimming instruction, adaptive physical activities and equipment. A nurse is also present both onsite and on field trips outside of the Y for children who require special care like catheterization and/or medication administration.

Lbg DAY CAmp session Monday - Friday 9:00am - 4:00pm Session A July 8 - July 26 Session B July 29 - August 16

Lbg ConTACT inFormATionJean Dattner at 718-551-9325, [email protected] DiPeri at 718-551-9319, [email protected]

INCLUSION CAMP (Ages 5.9 – 14) • session i - iV rATes: $700 per sessionA special summer experience awaits those enrolled in the inclusion explorer camp. This camp brings an inclusive recreational experience to children with disabilities. This unique camp gives children with special needs the same experience as other campers. Children with disabilities and their peers who are typically developing come together to participate in recreational activities such as swimming, arts and crafts, educational activities, reading, physical fitness and more. Camp counselors will serve as shadows—one counselor to every 2 campers.


SUMMER SLEEPAWAY CAMP (June 30TH – AugusT 23RD)Have an unforgettable summer at new York’s YmCA Camp! our camp is for boys and girls ages 6-16 from all over the world. There are two villages, mcAlister (Ages 6-12) and Talcott (12-15), that are located on our 1,150 acre property for Summer Sleepaway Camp. Just a sample of activities that we offer are swimming lessons, a wide variety of sports, arts and crafts, outdoor living skills, our new media program, canoeing, and our ropes courses. We also offer specialty programs that include water skiing, horseback riding, and rafting trips.We are 86 Miles outside of NYC and we are a safe, inclusive, and diverse camp community. We are a place where children can develop friendships, lifelong skills, and cherished memories.

sleepaWaY CaMpThe New York YMCA Camp is located 86 miles from NYC on a 1,150 acre property. Activities offered at New York YMCA Camp are Summer Sleepaway Camp, Specialized Summer Sports Camps (Gymnastics, Volleyball and Judo), Day Camp for Hudson Valley residents, Greenkill Outdoor Education Center, and customizable Retreat Groups or Special Retreat Weekends (Women’s Wellness Weekend, Men’s Adventure Weekend, Family Camp).

SPORTS CAMPSGYMNASTICS (June 23RD – JuLY 5TH)We offer world class training for dedicated and determined gymnasts from around the world. our focus is to support each gymnast while learning new skills and improving existing ones. Every gymnast has the opportunity to train closely with our world-class coaches. our facilities include 16,000 sq feet of training space, 6 vault stations, 12 beam stations, 4 sets of competition bars, 2 full floor exercises, and more.

VOllEYbAll (JuLY 14TH – AugusT 9TH)We offer progressive training techniques for all skill levels, position specific training, and video training with personal feedback. We also offer plyometric and weight training opportunities for qualified campers. our facilities include 6 indoor courts with all new sport court, 5 outdoor grass courts, a training room, certified athletic trainers, and medical attention available 24/7.

JuDO (AugusT 11TH – AugusT 17TH)We offer world class training for athletes from around the world. During daily practice and evening Randori, our coaches evaluate skills to develop an individualized, appropriate training program for every camper. our focus is to support each child and adult to learn new skills and to perfect their existing ones.



DAY CAMP - (hudson Valley)(JuLY 1ST – AugusT 23RD)All camp activities are progressive and designed to allow each child to see the growth of skills they learn in a fun and safe environment. Younger campers are lead through adventurous and fun activities, while older campers have a choice in the activities they participate in throughout the day.

OuTDOOR ADVENTuRE (June 30TH – AugusT 23RD)

Safe, sensational travel adventures for ages 10 to 15. Experience outdoor adventure activities during one and two week camping trips in the NE and SE regions.

YEAR-ROUND PROGRAMSOUTDOOR EDUCATION (sepTember – June)The greenkill outdoor education Center provides safe and educational programs for students through a holistic approach that tailors each trip to a school’s specific needs. our professional staff focuses on the needs of students and encourages learning in the natural environment.

WINTER FAMILY CAMP AND SUMMER FAMILY CAMP(WinTer - Feb. 15TH – 18TH summer - Aug 30TH – sepT 2ND)Enjoy a wonderful themed weekend during the winter, the summer, or both filled with family fun.

sleepaWaY CaMp open houses at neW York YMCa CaMp • March 24 • April 14 • May 5 • June 2

1:00 -4:00pm

Transportation is available from NYC

For more information on any of these activities please call 877-30-CAMPS or visit our website at www.nyycamp.org


eXplore, plaY and groW

safe adventuresneW frIendshIpsa healthY suMMer



PARENT/GUARDIAN INFO

PARTICIPANT INFO Child’s Name ___________________________________________________ Age ______________ D.O.B ___________________ M □ F □ Address _____________________________________________________________________________________ Apt # _____________________ City _______________________________________________________________ State ___________________________ Zip _______________ School Name _______________________________________________________ Grade starting in Sept 2013 ___________________ Y Member? Y □ N □ T-Shirt Size Child: XS □ S □ M □ L □ XL □ Adult: S □ M □ L □ XL □ 2XL □

Cross Island YMCA Summer Camp Registration Form

Guardian 1 Name ________________________________________ Relation __________________________________________________ Work Tel # ________________________________________________ Mobile Tel # _______________________________________________ Home Tel # ________________________________________________ Email _______________________________________________________

PARENT/GUARDIAN AGREEMENT I, the undersigned, give permission for my child to participate in all summer camp activities for the days he/she attends. I

understand that no refunds or credits will be given for missed days under any circumstances. I understand that a completed

medical form signed by the physician is required before my child may begin camp. In addition I am fully aware that all bal-

ances are due by the due date listed above before my child may begin camp. I also hereby give authority to YMCA staff to

obtain necessary emergency medical treatment for my child with the understanding that the family will be notified as soon

as possible. In addition, in consideration of the good will, public service, and community aid provided by the YMCA of

Greater New York, I hereby grant permission to the YMCA to use my child’s name, to take and publish photographs, video of

him/her which include his/her voice and image, in any media for YMCA purposes. I release all rights to such photographs and

video. I acknowledge that the YMCA will be the sole owner of all rights arising out of their use for all purposes. I understand

that I shall receive no compensation from their use from any source whatsoever.

Parent/Guardian Signature _____________________________________________________ Date ____________________________

Guardian 2 Name ________________________________________ Relation __________________________________________________ Work Tel # ________________________________________________ Mobile Tel # _______________________________________________ Home Tel # ________________________________________________ Email _______________________________________________________

AUTHORIZED PICK UP AND EMERGENCY CONTACT INFO At dismissal and/or in case of an emergency, the following people are authorized to pick up my child: 1. Parent/Guardian 1: Yes □ No □ 2. Parent/Guardian 2: Yes □ No □ 3. Name ____________________________________________ Relation __________________________ Tel ____________________________ 4. Name ____________________________________________ Relation __________________________ Tel ____________________________ 5. Name ____________________________________________ Relation __________________________ Tel ____________________________

2013 SUMMER DAY CAMP REGISTRATIONCross isLAnD Y CAmp regisTrATion Form (all ages)

"


2013 SUMMER DAY CAMP SESSIONS AND FEESCross isLAnD Y YouTH & Teen CAmp oFFerings (ages 5.9-17)

2013 Summer Day Camp Sessions and Fees Youth & Teen Registration Form

A “Program” Member is an individual who participates only in specific programs and registers at Program Member rates with no further facility or membership privileges.

Payment is due 30 days before participant attends camp. No camp will be held on July 4th. Session I/Week I rates are prorated. Sessions may be split. A non-refundable deposit of $100 per session is required at the time of registration. Accepted forms of payment are cash or credit card. Financial Aid is available to those that qualify. Forms are available at the Members Services Desk or online at ymcanyc.org.

CHECK ALL SESSIONS AND CIRCLE ALL PRICES THAT APPLY TO YOU

Youth & Teen Camp Member Program

□ Session I 7/01 - 7/12 $360 $370 □ Session II 7/15 - 7/26 $400 $410 □ Session III 7/29 - 8/9 $400 $410 □ Session IV 8/12 - 8/23 $400 $410

Ages 5.9-8, 9-12 &13-15

Fees

(9 Days) Session I $______________________

Session II $______________________

Session III $______________________

Session IV $______________________

— Discounts $______________________

Extended Hours (Rate multiplied by # of sessions) $______________________

Transportation (Rate multiplied by # of sessions) $______________________

Grand Total $______________________

Extended Hours AM only PM only Both

Sessions I, II, III, IV $100 $100 $200

Transportation (ages 6+ only) AM only PM only Both

Sessions I, II, III, IV $140 $140 $280

Additional Services

Specialty Camps Member Program Member Program

Basketball Camp Ages 5.9-8 & 9-12 Crafts Camp Ages 5.9-8 & 9-12 □ Session I 7/01 - 7/12 $405 $415 □ Session I 7/01 - 7/12 $405 $415 □ Session II 7/15 - 7/26 $450 $460 □ Session II 7/15 - 7/26 $450 $460 □ Session III 7/29 - 8/9 $450 $460 □ Session III 7/29 - 8/9 $450 $460 □ Session IV 8/12 - 8/23 $450 $460 □ Session IV 8/12 - 8/23 $450 $460 Team Sports Camp Ages 5.9-8 & 9-12 Performing Arts Camp Ages 5.9-8 &9-12 □ Session I 7/01 - 7/12 $405 $415 □ Session I 7/01 - 7/12 $405 $415 □ Session II 7/15 - 7/26 $450 $460 □ Session II 7/15 - 7/26 $450 $460 □ Session III 7/29 - 8/9 $450 $460 □ Session III 7/29 - 8/9 $450 $460 □ Session IV 8/12 - 8/23 $450 $460 □ Session IV 8/12 - 8/23 $450 $460 Gymnastics Camp Ages 5.9-8 & 9-12 Music Camp Ages 5.9-8 &9-12 □ Session I 7/01 - 7/12 $405 $415 □ Session I 7/01 - 7/12 $405 $415 □ Session II 7/15 - 7/26 $450 $460 □ Session II 7/15 - 7/26 $450 $460 □ Session III 7/29 - 8/9 $450 $460 □ Session III 7/29 - 8/9 $450 $460 □ Session IV 8/12 - 8/23 $450 $460 □ Session IV 8/12 - 8/23 $450 $460

Teen Sports Camp Ages 13 - 15 □ Session I □ Session I 7/01 - 7/12 $405 $415 □ Session II 7/15 - 7/26 $450 $460 □ Session II 7/15 - 7/26 $450 $460 □ Session III 7/29 - 8/9 $450 $460 □ Session III 7/29 - 8/9 $450 $460 □ Session IV 8/12 - 8/23 $450 $460 Counselors In Training Ages 16 - 17 □ Session I 7/01 - 7/12 $225 $235 Inclusion Camp Ages 5.9-8, 9-12 &13-14 □ Session II 7/15 - 7/26 $250 $260 □ Session I 7/01 - 7/12 $630 $630 □ Session III 7/29 - 8/9 $250 $260 □ Session II 7/15 - 7/26 $700 $700 □ Session III 7/29 - 8/9 $700 $700 Lisa Beth Gerstman Camp Ages 6 -14 □ Session IV 8/12 - 8/23 $700 $700 □ Session A 7/8 - 7/26 $700 $700 □ Session B 7/29 - 8/16 $700 $700

Tennis Camp Ages 5.9-8 & 9-12 7/01 - 7/12 $405 $415

PARTICIPANT INFO Child’s Name ______________________________________________________________________________________________________________________ Age _____________________________________ Date of Birth _____________________________________________________ Male □ Female □ Address ____________________________________________________________________________________ Apt # ______________________________ City __________________________________________________________________ State ___________________________ Zip ____________________ Home Phone ___________________________________________________ Cell Phone ____________________________________________________

"



2013 SUMMER DAY CAMP SESSIONS AND FEESCross isLAnD Y KinDer CAmp oFFerings (ages 2-5.8)

CHECK ALL SESSIONS AND CIRCLE ALL PRICES THAT APPLY TO YOU

Early Childhood 2013 Summer Program Sessions and Fees 2 to 5.8 years Registration Form

Toddler 2 to 3.4 years Half Day Full Day 5 Days (Monday—Friday) Member Program Member Program

□ Session I 7/01 - 7/12 $245 $255 $460 $470 □ Session II 7/15 - 7/26 $270 $280 $510 $520

□ Session III 7/29 - 8/9 $270 $280 $510 $520

□ Session IV 8/12 - 8/23 $270 $280 $510 $520

Fees

Session I $______________

Session II $______________

Session III $______________

Session IV $______________

— Discounts $______________ Extended Hours

(Rate multiplied by # of sessions) $______________

Total Session Fee $______________

Grand Total $______________

Additional Services Extended Hours Sessions I, II, III, IV AM only PM only Both

5 Days (Monday—Friday) $100 $100 $200

2 Days (Tuesday-Thursday) $50 $50 $100 3 Days (Mon, Wed, Fri) $70 $70 $140

5 Days (Monday—Friday) Member □ Session I 7/01 - 7/12 $445 □ Session II 7/15 - 7/26 $495 □ Session III 7/29 - 8/9 $495 □ Session IV 8/12 - 8/23 $495

Early Childhood 4.5 to 5.8 years Full Day Program

$455 $505 $505 $505

A “Program” Member is an individual who participates only in specific programs and registers at Program Mem-ber rates with no further facility or membership privi-leges.

Payment is due 30 days before participant attends camp. No camp will be held on July 4th. Sessions may be split. A non-refundable deposit of $100 per session is required

at the time of registration. Accepted forms of payment are cash or credit card. Financial Aid is available to those that qualify. Forms are

available at the Members Services Desk or online at ymcanyc.org.

PreSchool 3 to 4.5 years Half Day Full Day 5 Days (Monday—Friday) Member Program Member Program


□ Session III 7/29 - 8/9 $260 $270 $495 $505

□ Session IV 8/12 - 8/23 $260 $270 $495 $505

Half Day Full Day 3 Days (Mon, Wed, Fri) Member Program Member Program


□ Session III 7/29 - 8/9 $200 $210 $375 $385

□ Session IV 8/12 - 8/23 $200 $210 $375 $385

Toddler 2 to 3.4 years PreSchool 3 to 4.5 years Half Day Full Day 3 Days (Mon, Wed, Fri) Member Program Member Program


□ Session III 7/29 - 8/9 $190 $200 $355 $365

□ Session IV 8/12 - 8/23 $190 $200 $355 $365

Toddler 2 to 3.4 years Half Day Full Day Member Program Member Program


□ Session III 7/29 - 8/9 $160 $170 $300 $310

□ Session IV 8/12 - 8/23 $160 $170 $300 $310

2 Days (Tuesday, Thursday) PreSchool 3 to 4.5 years Half Day Full Day 2 Days (Tuesday, Thursday) Member Program Member Program


□ Session III 7/29 - 8/9 $150 $160 $275 $285

□ Session IV 8/12 - 8/23 $150 $160 $275 $285

PARTICIPANT INFO Child’s Name __________________________________________________________________________________________________________ Age _____________________________________ Date of Birth _________________________________________ Male □ Female □ Address _________________________________________________________________________ Apt # ______________________________ City ______________________________________________________ State ___________________________ Zip ____________________ Home Phone _______________________________________________ Cell Phone ____________________________________________

"


"

2013 SUMMER DAY CAMP MEDICALCross isLAnD Y KinDer CAmp HeALTH exAm Form (ages 2-5.8)



2013 SUMMER DAY CAMP MEDICAL PART 1Cross isLAnD Y YouTH & Teen HeALTH exAm Form (ages 5.9-17)

HEALTH RECORD FOR CHILDREN IN DAY CAMPS & AFTERSCHOOL & YOUTH CENTERS(This side to be filled in by parent before presentation to physician)

NAME OF PROGRAM

/ / M ❑ F ❑CHILD'S LAST NAME FIRST NAME BIRTHDATE SEX

Home Address: Phone:

Parent or Guardian: Phone:

Place of Employment: Father (Guardian) Phone:

Mother (Guardian) Phone:

In case of emergency, notify: Phone:

If Parent, Guardian are not available in an emergency, notify:

1. Phone:

or 2. Phone:

Important: Has this camper been exposed to any communicable disease during the three weeks prior to camp attendance: Yes ❑ No ❑ (If yes, state type of exposure: )

HEALTH HISTORY: (Check box if child has had afflictions, give appropriate dates)Allergies

❑ Rheumatic Fever ❑ Hay Fever

❑ Seizures ❑ Poison Ivy, etc.

❑ Diabetes ❑ Insect Stings

❑ Asthma ❑ Penicillin

❑ Chicken Pox ❑ Other Drugs

❑ Food

CONSENT FOR EMERGENCY MEDICAL TREATMENTI do hereby give authority to the Day Camp and Year Round Afterschool and Youth Center Program staff to obtain necessary

emergency medical treatment for my child with the understanding that the family will be notified as soon as possible.

Relationship Signature Date Tel.#

Department of Health and Mental Hygiene — The City of New York — Bureau of Food Safety and Community Sanitation

Other Past Illnesses

Operations or Serious Injuries (Dates)

Hospitalization (Dates)

Chronic or Recurring Illness

Any specific activities to be encouraged?

Conditions that require activity to be restricted?

Permission for all program activities unless otherwise noted by Dr.

Appliance worn (glasses, contacts, etc.)

Medication taken

Suggestion from Parent/Guardian

DCR 7 (Rev. 2/04)

"


2013 SUMMER DAY CAMP MEDICAL PART 2Cross isLAnD Y YouTH & Teen pHYsiCAL exAminATion (ages 5.9-17)

PHYSICAL EXAMINATION(To be filled out by Physician – please note information on reverse side)

The purpose of this health record is to provide the staff with pertinent information which will help to serve the needsof this child in Day Camps and Afterschool and Youth Center programs.

IMMUNIZATION HISTORY – This is a record of dates of basic immunization and most recent booster doses.DTaP, DTP, DT, Td Date __________ Date __________ Date __________ Date __________ Date __________ Polio Date __________ Date __________ Date __________ Date __________ Date __________ MMR Date __________ Date __________ Date __________Hemophilus Influenzae type b (Hib) Date __________ Date __________ Date __________ Date __________Hepatitis B Date __________ Date __________ Date __________ Date __________Varicella Date __________ Date __________Pneumococcal Conjugate (PCV) Date __________ Date __________ Date __________ Date __________ Date __________Other _____________ Date __________ Other _________ Date __________ Other _________ Date __________

MEDICAL EXAMINATION – To be filled out by licensed physician.

Examination is acceptable when performed no more than 12 months prior to arrival at camp.

Code: S = SatisfactoryX = Not Satisfactory (Explain)0 = Not Examined

General AppearanceGenitaliaHeight Weight Blood Pressure Posture & Spine Throat - Tonsils Nose Teeth Abdomen Hernia Feet Lungs SkinHgb. Test (Date) Urinalysis (Date) Eyes Vision w/Glasses Extremities HeartEars Hearing Neurological FindingsDescribe Abnormal Findings and/or Handicapping Conditions

I have examined the person herein described, reviewed his/her health history and it is my opinion that he/she is physically able toengage in Day Camp/Year Round Afterschool and Youth Center activities, except as noted above.

M.D.EXAMINING PHYSICIAN (SIGNATURE)

PHYSICIAN'S NAME (PLEASE PRINT)

Telephone Address

Date of ExaminationZIP CODE

DCR 7 (Rev. 2/04)

Allergy: (Please specify)

Recommendations and restrictions while in camp:

Special DietSpecial Medicine (dose, route of administration, when should it be administered)Is parent/guardian sending special medicine?Activity RestrictionsSwimming Diving

General Appraisal:

"



DATES & hOURS OF OPERATIONCross Island YMCA Summer Day Camp is an eight-week program that runs Monday to Friday, 9am - 4pm with optional morning and evening extended hours. Session Datessession i July 1 - July 12 (no Camp July 4th)Session II July 15 - July 26Session III July 29 - Aug 9Session IV August 12 - Aug 23

DAY CAMP OPEN hOUSES• Saturday, March 2 10am-4pm• Saturday, April 27 10am-4pm• Saturday, May 18 10am-4pm

REGISTRATION MADE EASY• Registration begins on February 1, 2013.

Follow instructions and fill out all enclosed registration packet forms making sure they are completed and signed.

• Register in person.

• Select your camp

• submit payment for your child’s first session with additional deposits of $100 for each added session. This will hold your child’s spot for the designated weeks of camp.

• Take advantage of the 10% Early Bird discount by registering on or before May 18.

• Please note: A “Program” Member is an individual who participates only in specific programs and registers at Program Member rates with no further facility or membership privileges.

• There will be a $25 (per change) transaction fee for any changes made with regard to camp or transportation after registration is completed.

• Submit your child’s medical form completed with parent information and signature as well as the doctor’s information, signature and stamp as soon as possible. It’s a good idea to keep extra copies of the medical form for your records.

• Have 2 passport size photos of your child for submission

• The YMCA accepts all major credit cards or you may sign up for automatic billing to ensure payments are made on time with no late fees

incurred.

PARENT ORIENTATIONparent orientation is mandatory. parent or guardian must attend this mandatory meeting on one of the following

dates: • Friday, June 7 7pm—8pm • Saturday, June 15 5pm—6pm • Sunday, June 23 3pm—4pm • Wednesday, June 26 7pm—8pm

FINANCIAL ASSISTANCEThe YMCA of Greater New York awards scholarships to campers based on a parent or a family’s annual income. The scholarship applications must be

submitted by May 18, 2013.

GOVERNMENT & uNION VOuCHERSWe accept ACD, HrA, TWu Local 100, and 1199 seiu

vouchers. You must have your confirmation letter

with you at the time of registration.

REFUNDS AND CREDITS If your child cannot attend camp for a period of

time paid, you may submit a request for credit along

with documentation to the Camp Director. Credits

can be used for camp or other programs throughout

the year. Any refund requests will be submitted

to the Camp Director and will be granted under

the discretion of the Senior Program Director. All

requests should be made prior to the start of the

session.

CAMP GEAREach child will receive 2 shirts and a camp bag. Camp

t-shirts must be worn every day and are distributed

during the camper’s first day of camp. Additional shirts

may be purchased at $9 each.

swim caps will be given during the camper’s first day

of swimming. Swim gear consists of a towel, swimsuit,

swim cap, a change of clothing, water shoes and a

plastic bag (or other receptacle for wet swim gear).

Cro

ss Is

lan

d Y

MCa

YM

Ca o

f g

rea

ter

neW

Yo

rk

23

8-1

0 H

illsi

de A

ve.

Belle

rose

, NY

11

426

71

8-4

79

-05

05

ww

w.y

mca

nyc.

org/

cros

sisl

and

Face

book

.com

/Cro

ssIs

land

YMCA

ear

lY b

Ird

d

IsCo

un

ts

10%

disc

ount

for p

arti

cipa

nts

who

are

regi

ster

ed b

y

May

18

and

hav

e pa

id in

full.

sIbl

Ing

d

IsCo

un

ts

10%

off

each

add

itio

nal s

iblin

g.

Dis

coun

ts c

anno

t be

com

bine

d.

pro

Mo

tIo

na

l o

ffer

s

vIs

It Y

MCa

nYC

.or

g/C

aM

pto

lea

rn

Mo

re!

DO

ES N

OT

APP

LY T

O N

EW Y

OR

K YM

CA C

AM

P PR

OG

RA

MS

non

-pro

fit

org

aniz

atio

nu

.s. p

osta

gepa

IdJa

mai

ca, N

YPe

rmit

No.

67

1

cross island ymca 2013 camp guide

Documents

cross island ymca summer

y summer camp

exciting summer of camp

summer reading

day camp program

summer months

summer of growth

camp director