dodge 2012 summer day camp program guide

A SUMMER TO DISCOVER DODGE YMCA Summer Day Camp 2012

Is your child ready for a summer of adventure?

The Dodge YMCA is about to embark on yet another fun and exciting summer of

Day Camp. Welcome to all of our returning and new campers to our 2012 Day Camp

Program. Y Day Camp uses hands-on learning through indoor and outdoor educa-

tional activities. Thank you for choosing our Summer Day Camp and we look

forward to getting to know your child.

Sincerely,

Ruth Chan & Nayira Polanco

The Youth & Family Department YMCA Day Camp Through programs like Day 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 a fun way for camp-

ers 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 Asso-

ciation (ACA).

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WHAT YOU NEED TO KNOW

OUR YMCA MISSION The YMCA of Greater New York is a community-based service organization which promotes positive values through programs that build spirit, mind, and body, welcoming all people with a focus on youth.

OUR VALUES Caring, honesty, respect and responsibility.

YMCA DAY CAMP OBJECTIVES YMCA Summer Day Camp helps campers ages 4 1/2 – 12 years old grow mentally and physi-cally by participating in challenging activities in both small and large group settings under the supervision of a caring and well trained staff.

SUMMER LEARNING To 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.

CAMP LOCATION The Dodge YMCA Summer Day Camp operates out of 225 Atlantic Ave Brooklyn, NY 11201. We also use offsite facilities such as local parks and schools to conduct Day Camp.

DATES & HOURS OF OPERATION The Dodge YMCA Summer Day Camp is an eight-week program that runs from July 2nd, 2012 - August 24th, 2012 , 8:00am- 4:00pm. Extended day option of 4:00pm-6:00pm is also available for an additional fee.

OPEN HOUSES Saturday, March 3, 2012 11am – 3 pm Saturday, April 28, 2012 11am – 3 pm Saturday, May 19, 2012 11am – 3 pm

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REGISTRATION MADE EASY • Registration begins January 15, 2012.

• Fill out all registration packet forms, following all instructions and making sure they are complete and signed.

• Bring everything to the Membership Desk with payment for your child’s first session with additional deposits of $75 for each additional week. This will hold your child’s spot for the designated weeks of camp.

• Take advantage of the 10% Early Bird discount by paying off your entire balance by Saturday, May 19, 2012.

• Submit your child’s medical form, com-plete with parent information and signa-ture as well as the doctor’s information, signature and stamp as soon as possi-ble. It’s a good idea to keep extra copies of the medical form for your records.

• Please note that registration is not com-plete until a valid medical form is on file.

The YMCA accepts all major credit cards or you may sign up for automatic billing to ensure pay-ments are made on time with no late fees in-curred.

PARENT ORIENTATION Parent Orientation is mandatory. Parent or guardian must attend one mandatory meeting on : June 6th 6:00pm-7:00pm or June 9th 10:00am-11:00am

FINANCIAL ASSISTANCE The YMCA of Greater New York awards scholarships to campers based on a parent or a family’s annual income. The scholarship applications will be available by January 15th and must be submitted by March 31, 2012. Acceptance letters will be mailed out by May 5th 2012.

GOVERNMENT & UNION VOUCHERS We accept ACD, HRA, TWU Local 100, and 1199 SEIU vouchers. You must have your confirmation letter with you at the time of registra-tion.

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. There are no credits or refunds for camp fees due to illness, absences or missed days, or any other circumstances. Deposits are non-transferable and non-refundable. Any refund requests will be submitted to the Camp Director and will be granted under the dis-cretion of the Sr. Director of Youth & Family. All requests should be made prior to the start of the session.

PROMOTIONAL OFFERS Early Bird Discounts 10% discount for participants who are registered by May 19 and have paid in full.

Siblings Discounts 10% off each additional sibling. Discounts cannot be combined.

CAMP GEAR Each child will receive two t-shirts and a camp bag. Swim caps will be given during the camper’s first day of swimming. Additional shirts may be purchased at the membership desk for $ 8 each or 3 for $20. Swim gear must consist of a towel, swimsuit, swim cap, a change of clothing, and a plastic bag (or other recep-tacle for wet swim gear). Camp gear is distributed on the camper’s first day of camp.

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DAY CAMP (AGES 4.5 – 12) Day Camp at the Dodge YMCA is an all inclusive camp experience. Using a themed-based curriculum throughout the summer, we make learning engaging and fun. Campers also participate in swimming three times a week, arts and crafts, health and fitness, and group games. Campers also have the opportunity to participate in weekly excursions to museums, playgrounds and cultural events. As a part of Day Camp, campers learn how to develop long-lasting friendships and build solid social skills by learning about and utilizing our four core values. Children must have completed Kindergarten to Children must have completed Kindergarten to Children must have completed Kindergarten to Children must have completed Kindergarten to attend day camp. attend day camp. attend day camp. attend day camp.

SUMMER SPORTS COMPONENT During each 2-week session your child will also be engaged in a structured sport program with the opportunity to develop and learn about different sports. Our sports components include swimming three times a week through all four sessions, and specialized sports three times a week at various locations including the Dodge YMCA, Local schools, and community parks. The following is a brief de-scription of what campers will walk away with: Session I– July 2nd—July 13th [Soccer] Session II– July 16th—July 27th [Basketball] Session III– July 30th—August 10th [Baseball] Session IV– August 13th– August 24th [Tennis]

RULES & REGULATIONS The Dodge YMCA upholds its values of caring, hon-esty, responsibility and respect. Our goal is for all campers and staff to have safe and fulfilling sum-mer while exercising our four core values. Parents are also a crucial part of our YMCA community in modeling behavior consistent with our values.

SAFETY CONCERNS Health and safety are the highest priorities for summer camp activities. All staff persons are

trained in standard first aid and CPR. All pool staff are certified lifeguards. Safety procedures are part of on-going staff training and are reviewed throughout the summer. All staff undergo back-ground checks and drug testing. We are licensed by the New York City Department of Health and ac-credited by the American Camping Association.

MEDICAL INFORMATION If your child is injured, the Basic Life Support and First Aid Certified Director and camp staff will take whatever steps necessary to administer care and or / obtain emergency medical care. These steps include but not limited to: 1. Administering First Aid. 2. If necessary, an ambulance will be called and a

staff member will accompany the child to the emergency room of the nearest hospital (Long Island College Hospital) until the parent / guardian arrives.

3. Contact parent / guardian or emergency con-tact person.

CONTACT US For more information or have questions, please contact: Ruth Chan, Sr. Director, Youth & Family, [email protected], 718.625.3136

EXPLORE PLAY AND GROW Each week of camp provides your child hands-on activities including educational field trips and theme days.

A DAY AT CAMPA DAY AT CAMPA DAY AT CAMPA DAY AT CAMP

8:00-9:00 Arrival & Camp Cheers

9:00-10:00 Science Experiment 10:00-11:00 Swimming 11:00-12:00 Art Activity 12:00-1:00 Lunch 1:00-2:00 Sports 2:00-3:00 Vocabulary Relay (gym)

3:00-4:00 Snack and Journal

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A SUMMER OF FUN 2012 Summer Day Camp Sessions and Fees

CAMPS (AGES 4.5CAMPS (AGES 4.5CAMPS (AGES 4.5CAMPS (AGES 4.5----12)12)12)12)

SessionSessionSessionSession DatesDatesDatesDates Payment Due Date*Payment Due Date*Payment Due Date*Payment Due Date*

I July 2 – July 13 (closed July 4) June 1st

II July 16 – July 27 June 1st

III July 30– August 10 July 1st

IV August 13– August 24 July 1st

* Payment must be paid in full by due date before child can attend camp.

DAY CAMP FEESDAY CAMP FEESDAY CAMP FEESDAY CAMP FEES

SESSION I SESSION I SESSION I SESSION I (9 days /closed July 4)

Member FeeMember FeeMember FeeMember Fee $445 $445 $445 $445 (Week 1:$200 week 1, Week 2:$245)

NonNonNonNon----member fee $550 member fee $550 member fee $550 member fee $550 (Week 1:$250 week 1, Week 2:$300)

SESSION IISESSION IISESSION IISESSION II----IV IV IV IV (2 weeks per session)

Member FeeMember FeeMember FeeMember Fee $ 490 $ 490 $ 490 $ 490 ($245 per week )

NonNonNonNon----member fee $ 600 member fee $ 600 member fee $ 600 member fee $ 600 ($300 per week )

EXTENDED HOURS Extended hours are available to parents from 4:00pm-6:00pm at $50 per week. Extended hours are not prorated.

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THE NEXT ADVENTURE New York YMCA Sleepaway Camp

Boys and Girls (Ages 6 – 16)

Located 86 miles northwest of Manhattan, the New York YMCA Camp is a globally diverse community built upon the YMCA core values of caring, honesty, respect and responsibility. Here each child enjoys adventures, new friendships and joyful experiences. Campers are secure in our bully-free camp from day one. Children are always supervised by highly trained counselors. Friend-ships are immediately fostered through teambuilding and cabin activities. By supporting each camper and cabin group, our counselors help campers form the life-long relationships for which our camp is known.

• Sports • Horseback Riding • Performing Arts

• Outdoor Life Skills • Swimming • Boating

• Waterskiing • Tubing • Arts

Call us toll free at 877-30-YCAMP or visit us online www.newyorkymcacamp.org to learn more.

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PARTICIPANT INFOPARTICIPANT INFOPARTICIPANT INFOPARTICIPANT INFO

Child Name _____________________________________________________________ Age ______________ D.O.B _____________________ M □ F □

Address _________________________________________________________________________________________________ Apt # _______________________

City _______________________________________________________________ State ___________________________ Zip ____________________________

School Name _______________________________________________________________ Grade starting in Sept 2012 ______________________

Y Member? Y □ N □ T-Shirt Size Child: S □ M □ L □ Adult: S □ M □ L □ XL □

PARENT/GUARDIAN INFOPARENT/GUARDIAN INFOPARENT/GUARDIAN INFOPARENT/GUARDIAN INFO

Guardian1 Name _____________________________________________ Guardian 2 Name _______________________________________________

Relation _______________________________________________________ Relation __________________________________________________________

Work Tel # _____________________________________________________ Work Tel # _______________________________________________________

Mobile Tel # ___________________________________________________ Mobile Tel # ______________________________________________________

Home Tel # _____________________________________________________ Home Tel # ________________________________________________________

Email ____________________________________________________________ Email _______________________________________________________________

AUTHORIZED PICK UP AND EMERGENCY CONTACT INFOAUTHORIZED PICK UP AND EMERGENCY CONTACT INFOAUTHORIZED PICK UP AND EMERGENCY CONTACT INFOAUTHORIZED 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 1: Yes □ No □

2. Parent 2: Yes □ No □

3. Name _______________________________________________ Relation ______________________________ Tel _________________________________



DISMISSAL OPTIONS (Choose One)DISMISSAL OPTIONS (Choose One)DISMISSAL OPTIONS (Choose One)DISMISSAL OPTIONS (Choose One)

□ I, _________________ will be picking up my child from Dodge Y between 3:30pm and 4:00pm (initial)

□ I, _________________ will be picking up my child from Dodge Y between 5:30pm and 6:00pm (extended day) (initial)

□ I, _________________ give my permission for my child (10+yrs) to walk home from the program unattended at (initial)

□ 3:30pm □ 5:30pm (extended day fee applies)

DODGE SUMMER CAMP REGISTRATION FORM DODGE SUMMER CAMP REGISTRATION FORM DODGE SUMMER CAMP REGISTRATION FORM DODGE SUMMER CAMP REGISTRATION FORM

PAYMENT INFORMATIONPAYMENT INFORMATIONPAYMENT INFORMATIONPAYMENT INFORMATION Fees & DiscountsFees & DiscountsFees & DiscountsFees & Discounts • For fees, please see page 5. For discounts, please see page 3 • Child membership fee: 5-11yrs: $128/yr; 12-17yrs: $158/yr • Financial Assistance deadline: March 31, 2012

Payment DeadlinesPayment DeadlinesPayment DeadlinesPayment Deadlines Sessions I & II: Friday, June 1, 2012 Sessions III & IV: Sunday, July 1, 2012

Credit Card Information Credit Card Information Credit Card Information Credit Card Information

□ I will be paying manually for camp fees at the Dodge Membership Desk

□ I authorize Dodge YMCA to charge my credit card on Fri June 1 Fri June 1 Fri June 1 Fri June 1 for the full amount due for Sessions 1&2Sessions 1&2Sessions 1&2Sessions 1&2

□ I authorize Dodge YMCA to charge my credit card on Sun July 1 Sun July 1 Sun July 1 Sun July 1 for the full amount due for Sessions 3&4Sessions 3&4Sessions 3&4Sessions 3&4

Visa □ Mastercard □ Amex □ Authorized Signature ______________________________________________________________

CC# ______________________________________________________________________ Expiration _______/________ Security Code: ____________

Summer CampSummer CampSummer CampSummer Camp Extended DayExtended DayExtended DayExtended Day

Week 1*Week 1*Week 1*Week 1* 7/2-7/6 □ □ Week 2Week 2Week 2Week 2 7/9-7/13 □ □


Week 3Week 3Week 3Week 3 7/16-7/20 □ □ Week 4Week 4Week 4Week 4 7/23-7/27 □ □





SESSION IIISESSION IIISESSION IIISESSION III SESSION IVSESSION IVSESSION IVSESSION IV

SESSION IISESSION IISESSION IISESSION II SESSION I SESSION I SESSION I SESSION I

* No Summer Camp on 7/4

PARENT/GUARDIAN AGREEMENTPARENT/GUARDIAN AGREEMENTPARENT/GUARDIAN AGREEMENTPARENT/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 un-derstand 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 balances 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 __________________________________

CAMP PROGRAM SCHEDULE CAMP PROGRAM SCHEDULE CAMP PROGRAM SCHEDULE CAMP PROGRAM SCHEDULE Select weeks. Select extended day if desired (optional).Select weeks. Select extended day if desired (optional).Select weeks. Select extended day if desired (optional).Select weeks. Select extended day if desired (optional). Summer Camp Regular Hours- 8:00am-4:00pm, Extended Hours– 4:00pm-6:00pm

PARTICIPANT INFOPARTICIPANT INFOPARTICIPANT INFOPARTICIPANT INFO

Child’s Name ____________________________________________________________ Age _________________ D.O.B _____________________________

Address _________________________________________________________________________________________________ Phone _______________________

Guardian Name _____________________________________________ Phone: _______________________________________________

Place of Employment (Mother) ______________________________________________________ Phone _____________________________________

(Father) _______________________________________________________ Phone _____________________________________

In Case of Emergency, notify: _________________________________________________________ Phone _____________________________________

If Parent or Guardian is not available in an emergency, notify:

1. Name _______________________________________________ Relation _______________________________ Tel __________________________________

2. Name _______________________________________________ Relation _______________________________ Tel __________________________________

* Has this camper ever been exposed to any communicable disease during the three weeks prior to camp

attendance? Yes □ No □ (If yes, state type of exposure: ______________________________________________________________)

HEALTH HISTORY HEALTH HISTORY HEALTH HISTORY HEALTH HISTORY (Check, giving approximate dates)(Check, giving approximate dates)(Check, giving approximate dates)(Check, giving approximate dates)

ILLNESSESILLNESSESILLNESSESILLNESSES ALLERGIESALLERGIESALLERGIESALLERGIES

□ Rheumatic Fever __________________________ □ Hay Fever □ Seizures __________________________ □ Poison Ivy □ Diabetes __________________________ □ Insect Stings □ Asthma __________________________ □ Penicillin □ Chicken Pox __________________________ □ Other Drugs ____________________________________________________ □ Ear Infections __________________________ □ Food _______________________________________________________________ Other Past Illnesses _________________________________________________________________________________________

Operations or Serious Injuries (& dates) _________________________________________________________________________________________

Hospitalizations (& dates) _________________________________________________________________________________________

Chronic and Recurring Illnesses _________________________________________________________________________________________

Any specific activities to be encouraged? _________________________________________________________________________________________

Conditions that require activity to be restricted? Conditions that require activity to be restricted? Conditions that require activity to be restricted? Conditions that require activity to be restricted? _______________________________________________________________________________

Permission for all program activities unless otherwise noted by Dr. _________________________________________________________

Appliance worn (glasses, contacts, etc.)Appliance worn (glasses, contacts, etc.)Appliance worn (glasses, contacts, etc.)Appliance worn (glasses, contacts, etc.) _________________________________________________________________________________________

Medication takenMedication takenMedication takenMedication taken _________________________________________________________________________________________

Additional Suggestion from Parent/Guardian _____________________________________________________________________________________

CONSENT FOR EMERGENCY MEDICAL TREATMENTCONSENT FOR EMERGENCY MEDICAL TREATMENTCONSENT FOR EMERGENCY MEDICAL TREATMENTCONSENT FOR EMERGENCY MEDICAL TREATMENT

I do hereby give authority to the Dodge YMCA Summer Day Camp to obtain necessary emergency medical treat-ment for my child with the understanding that the family will be notified as soon as possible. Signature ________________________________________________________ Relationship ______________________________________________________ Phone # _________________________________________________________ Date ________________________________________________________________ Department of Health and Mental Hygiene— The City of New York — Bureau of Food Safety and Community Sanitation

DODGE YMCA SUMMER CAMP MEDICAL FORMDODGE YMCA SUMMER CAMP MEDICAL FORMDODGE YMCA SUMMER CAMP MEDICAL FORMDODGE YMCA SUMMER CAMP MEDICAL FORM

The purpose of this health record is to provide the staff with pertinent information which will help to serve the needs of this child in Summer Day Camp and other Dodge programs.

IMMUNIZATION HISTORY IMMUNIZATION HISTORY IMMUNIZATION HISTORY IMMUNIZATION HISTORY Record of dates of basic immunization and most recent booster dosesRecord of dates of basic immunization and most recent booster dosesRecord of dates of basic immunization and most recent booster dosesRecord of dates of basic immunization and most recent booster doses

□ DTap, DTP, TD Date __________ Date __________ Date __________ Date __________ Date __________

□ Polio Date __________ Date __________ Date __________ Date __________ Date __________

□ MMR Date __________ Date __________ Date __________

□ Hem. Influenza type B Date __________ Date __________ Date __________ Date __________ □ Hepatitis B Date __________ Date __________ Date __________ □ Varicella Date __________ Date __________

□ Pneumococcal Conjugate (PCV) Date __________ Date __________ Date __________ Date __________ □ Other ________________________________ Date __________ Date __________ Date __________ Date __________

MEDICAL EXAMINATION MEDICAL EXAMINATION MEDICAL EXAMINATION MEDICAL EXAMINATION to be filled out by licensed physician. to be filled out by licensed physician. to be filled out by licensed physician. to be filled out by licensed physician.

Examination is acceptable when performed no more than 9 months prior to arrival at camp.Examination is acceptable when performed no more than 9 months prior to arrival at camp.Examination is acceptable when performed no more than 9 months prior to arrival at camp.Examination is acceptable when performed no more than 9 months prior to arrival at camp. Code: S = Satisfactory X = Non Satisfactory (explanation required) O = Not Examined

General Appearance ___________________________________________________________________________________________________________________

Height __________ Weight __________ Blood Pressure __________ Hgb Test (Date) __________ Urinalysis (Date) _________

Eyes __________ Vision __________ w/Glasses __________ Posture/Spine __________ Throat/Tonsils _________

Heart __________ Ears __________ Hearing __________ Extremities __________ Feet _________

Lungs __________ Skin __________ Nose __________ Teeth __________ Hernia _________

Abdomen __________ Genitalia __________

Neurological Findings _____________________________________________________________________________________________________________________________

Describe Abnominal Findings and/or Handicapping Conditions __________________________________________________________________________

_________________________________________________________________________________________________________________________________________________________

Allergy (please specify) __________________________________________________________________________________________________________________________

Recommendations and restrictions while in camp:

Special Diet _________________________________________________________________________________________________________________________________________

Special Medicine (name, dose, administration) _____________________________________________________________________________________________

Swimming _______________________________________________________ Activity Restriction _________________________________________________________

General Appraisal __________________________________________________________________________________________________________________________________

I have examined the person herein described, reviewed his/her health history and it is my opinion that he/she is physically able to engage in Summer Day Camp.

____________________________________________________________M.D. ____________________________________________________________M.D. Physician’s Name (Please Print) Examining Physician (Signature)

Address ___________________________________________________________________________________________________________________________________

Date of Examination ______________________________________________________ Phone # __________________________________________

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

PHYSICAL EXAMINATION PHYSICAL EXAMINATION PHYSICAL EXAMINATION PHYSICAL EXAMINATION To be filled out by your child’s physician

Dodge YMCA

225 A

tlan

tic Ave

Bro

oklyn

, NY 1

1201

(212) 9

12-2

414

www.ymca

nyc

.org

/dodge

dodge 2012 summer day camp program guide

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