indymca summer camp 2015
DESCRIPTION
indianapolis ymca summer camp guide 2015TRANSCRIPT
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1BEST.SUMMER.EVER!FRIENDSHIP, ACCOMPLISHMENT, BELONGING
www.OurCauseIsYou.org/camp YMCA Of gREATER IndIAnApOlIS
2015 SUMMER dAY CAMp
Y Member registration begins
2/21! (all others 2/28)
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2YMCA MISSIOn: to put Christian principles into practice through programs that build healthy spirit, mind, and body for all
THE YMCA IS gIVIng KIdS THEIR
BEST SUMMER EVER! Do you remember trading stories and sharing a favorite book or song with a new friend? Do your memories include being greeted with smiles and high-fives from staff and teammates after scoring the winning point? At camp, you always fit in, just for being you.
This is what the Ys day camp is all about, and we are ensuring kids get more out of summer: more friends, more exploration, and more achievement. For parents and guardians who enjoy seeing their childs face glow when retelling a camp story and want to see their child discover new things, the Y encourages you to enroll them in day camp!
The YMCA of Greater Indianapolis day camps offer a mix of fun and educational activities aimed at improving kids well-being. Our program focuses on three areas proven to impact kids development: friendship, accomplishment, and belonging.
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3TURn THE pAgES fOR: dAY CAMp lOCATIOnS ........................... 4
RATES & REgISTRATIOn ......................... 7
CAMp OpTIOnS .................................... 8
CAMpS BY lOCATIOn ......................... 14
REgISTRATIOn fORM ........................... 25
developing Our Youth: The YMCA of Greater Indianapolis is determined to make a significant difference in the lives of youth. The Y is committed to working in collaboration with schools, churches, neighborhood organizations, government agencies, and other human services groups to increase the availability and accessibility of the Search Institutes 40 Developmental Assets for all children and teens in the community.
ACA Accreditation: YMCA camps are accredited by the American Camp Association. This means they have met or exceeded the highest nationally recognized standards for health, safety, staff training, and program quality. ACA accreditation demonstrates a commitment to excellence, which makes your job of selecting the right camp much easier.
At the Y, we know that when kids are given an opportunity to accomplish new skills, make friends, and feel like they belong, they are comfortable expressing individuality and feel more confident, connected, and supported. We are focusing on these youth development areas to ensure that kids in our day camp program go home with so much excitement for all theyve accomplished and enjoyed that they cant wait to come back the next day. -Jorge Perez, VP Youth Development, YUSA
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4YMCA Of gREATER IndIAnApOlISEAST Benjamin Harrison Y Camps1. Benjamin Harrison YMCA 5736 Lee Rd., Indianapolis2. Off-site location: TBd (Visit www.OurCauseIsYou.org/camp for updated information!)
Ransburg Y Camps3. Ransburg YMCA 501 N. Shortridge Rd., Indianapolis4. grassy Creek Elementary 10330 E. Prospect St., Indianapolis 5. Warren Township Early Childhood Center 1401 N. Mitthoeffer Rd., Indianapolis6. Harris Elementary 200 W. Park Ave., Greenfield7. Center for Inquiry #2 725 N. New Jersey St., Indianapolis 8. paramount School of Excellence 3020 Nowland Ave., Indianapolis
nORTHJordan Y Camps 9. Jordan YMCA 8400 Westfield Blvd., Indianapolis10. Eagle Creek park 7840 W. 56th St., Indianapolis
nORTHEASTfishers Y CampsPlease call or visit www.OurCauseIsYou.org/camp for details/separate brochure for all camps run through the Fishers YMCA.
11. fishers YMCA 9012 E. 126th St., Fishers12. durbin Elementary 18000 Durbin Rd., Noblesville13. Brooks School Elementary 12451 Brooks School Rd., Fishers14. fall Creek Elementary 12131 Olio Rd., Fishers15. Stonycreek farms 11366 SR 38 E., Noblesville
nORTHWESTpike Y Camps16. deer Run Elementary 5401 N. High School Rd., Indianapolis
Witham family Y CampsPlease call or visit www.OurCauseIsYou.org/camp for details/separate brochure for all camps run through the Witham Family YMCA. 17. Witham family YMCA 2791 N. Lebanon St., Lebanon18. Sheridan Elementary 24795 Hinesley Rd., Sheridan
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5SOUTHBaxter Y Camps19. Baxter YMCA 7900 S. Shelby St., Indianapolis20. Arlington Elementary 5814 S. Arlington Ave., Indianapolis21. The gathering place at the Community Church of greenwood 1495 W. Main St., Greenwood22. perry Township location: TBd
(Visit www.OurCauseIsYou.org/camp for updated information!)
WESTHendricks Regional Health Y Camps23. Hendricks Regional Health YMCA 301 Satori Parkway, Avon24. Bridgeport Elementary 9035 W. Morris St., Indianapolis25. Hummel park 1500 S. Center St., Plainfield26. Avon Intermediate School East 174 S. Avon Ave., Avon
Indicates a YMCA center with on-site day camps
Indicates an off-site YMCA day camp location
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2015 dAY CAMp SITE lOCATIOnS
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6In pERSOn: Bring your completed registration form to any YMCA Center listed below.
BY fAX: Fax the completed registration form with a credit card number to any YMCA Center listed below.
BY MAIl: Send the completed registration form with a signed check or credit card number to any YMCA Center listed below.
OnlInE: Go to www.indymca.org/registration.asp. You will need a valid email address in order to register online. The registration form must still be completed and returned to a YMCA Center prior to your child attending camp.
AVOndAlE MEAdOWS Y 3908 Meadows Dr.Indianapolis, IN 46205Phone 317.549.9622Fax 317.549.8049
BAXTER Y7900 S. Shelby St.Indianapolis, IN 46227Phone 317.881.9347Fax 317.887.8787
BEnJAMIn HARRISOn Y5736 Lee Rd.Indianapolis, IN 46216Phone 317.547.9622Fax 317.547.9640
fISHERS Y9012 E. 126th St.Fishers, IN 46038Phone 317.595.9622Fax 317.577.2069
flAT ROCK RIVER Y CAMp6891 W. County Rd. 650 N.St. Paul, IN 47272Phone 888.828.9622Fax 765.525.2265 JORdAn Y8400 Westfield Blvd.Indianapolis, IN 46240Phone 317.253.3206Fax 317.259.5652
RAnSBURg Y501 N. Shortridge Rd.Indianapolis, IN 46219Phone 317.357.8441Fax 317.322.2793
HEndRICKS REgIOnAl HEAlTH Y301 Satori ParkwayAvon, IN 46123Phone 317.273.9622Fax 317.272.0939
IndY BIKE HUB Y242 E. Market StreetIndianapolis, IN 46204Phone 317.612.3083Fax 317.536.0750
pIKE Y7114 Lakeview Pkwy. W. Dr.Indianapolis, IN 46268Phone 317.297.9622Fax 317.297.9820 WITHAM fAMIlY Y2791 N. Lebanon St.Lebanon, IN 46052Phone 765.483.9622Fax 765.482.6231
Y AT THE ATHEnAEUM 401 E. Michigan St.Indianapolis, IN 46204Phone 317.685.9705Fax 317.685.9708
Y YOUTH dEVElOpMEnT OffICE615 N. Alabama St., Suite 400Indianapolis, IN 46204Phone 317.484.9622Fax 317.269.6068
A registration form is located at the end of this brochure and online at indymca.org/camp. Ways to register include:
Y MEMBER SUMMER dAY CAMp REgISTRATIOn BEgInS SATURdAY, fEBRUARY 21, 2015! Registration is open to the public on February 28, 2015.
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7Rate levels are determined by camp activities, instructors, locations, etc. Please see the location pages for specifics camps and rate levels. In order to reserve a space in the camp(s) of your choice, a minimum $15 non-refundable deposit is required for each week each child is registered for camp. Outstanding balances must be paid by 8:00 pm on the Tuesday before the camp week begins. Failure to meet payment deadlines will result in the loss of the camp reservation and deposit.
MEMBER RATES Become a member and save! Youth memberships for those under 18 are only $21 per month. The Y also offers one and two adult household memberships for the whole family, including all dependents who live at the same address! Please inquire with the Membership staff at any of our Y Centers or go online at indymca.org/memberships.
CHOOSE YOUR AdVEnTURE! Choose from our three camp options to best fit your familys needs and interests...
TRAdITIOnAl CAMp (pg. 8) SpORTS CAMp (pg. 9) EnRICHMEnT CAMp (pg. 11)
CAMp RATESlEVEl 1 lEVEl 2 lEVEl 3 lEVEl 4 lEVEl 5 lEVEl 6
3-5 Days Y Members $99 $134 $156 $181 $249 $3223-5 Days All Others $99 $169 $197 $227 $298 $3701-2 Days* Y Members $691-2 Days* All Others $81
*Please note: 1-2 day pricing options are available for full-day preschool and traditional camps only.
SAME gREAT RATES SInCE 2013!
CAMp HOURS 6:30 AM to 6:00 pM
fInAnCIAl ASSISTAnCE At the Y, strengthening community is our cause. We believe all children should have the opportunity to learn, grow, and thrive. Financial assistance makes summer day camp available to those kids in need. Call 317.484.9622 for more information. Please be aware that financial assistance can only be used towards Level 2 camps. We also accept CCDF vouchers at 15 locations! Please see camps by location for more information.
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8TRAdITIOnAl CAMpS
dAY CAMp UpgRAdEWelcome to the classic summer camp experience: no themes, no restrictions, just pure enriching fun!
We have three areas of focus: friendship, accomplishment, and belonging. Campers will participate in a wide variety of age-appropriate clinics, including archery, arts & crafts, hiking, fort building, skits, environmental education, service learning, outdoor cooking, and more!
This summer, the camps at the Y put the tradition back in Traditional Camp. Traditional camps are available for campers ages 3-15, and camps are separated into age groups.
See pages 14-20 for Traditional Camps offered by location.
Did you know that YMCA camp staff attend over 40 hours of training,
including First Aid and CPR, before the 1st day of camp?
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9SpORTS CAMpS YMCA Sports Camps help children develop tools and techniques while learning the value of sportsmanship. Camp will include drills, skill development, learning the rules of the game, and actual play, all while reinforcing the core values of caring, honesty, respect, and responsibility.
We offer two tiers of camps to fit all interests and abilities.
Did you know that all campers swim at least once a
week at Y camp?
SpORTS CAMp TIERSTraditional Sports Camps (level 2 pricing)Designed for all ability levels and led by YMCA staff, the focus of these camps will be introducing and learning new skills. ARCHERY, AqUATICS*, BASEBAll, BASKETBAll, CHEER, dAnCE, dOdgEBAll, flAg fOOTBAll, HOCKEY, KICKBAll, SOCCER, SpORTS Of All SORTS*, T-BAll, TUMBlIng, TRACK & fIEld*, UlTIMATE fRISBEE, VOllEYBAll
Enrichment Sports Camps (levels 3, 4, and 5 pricing)Designed for the intermediate player and led by contracted professionals, technical skills will be the focus of this camp. BRITISH SOCCER*, CROUCHIng TIgERS MARTIAl ARTS*, gOlf*, TEnnIS*, TRIATHlOn*
*Turn the page for descriptions of these Sports Camps!
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SpORTS CAMpS dESCRIpTIOnS AqUATICS Rate: Level 2 (Y Members: $134 All Others: $169) If you love the pool, then aquatics camp is for you! Join us for aquatic skills and games each day! Half of the camp day will be spent in the water. Bring a swimsuit, towel, and goggles each day.
BRITISH SOCCERRate: Level 5 (Y Members: $249 All Others: $298)Amazing coaches, innovative practices, and a unique cultural twist combine for a one-of-a-kind camp experience! Each day includes individual foot skills, technical drills, tactical practices, small-sided games, coached scrimmages, and a daily World Cup tournament.
CROUCHIng TIgERS MARTIAl ARTSRate: Level 5 (Y Members: $249 All Others: $298)Join Crouching Tigers for a week of martial arts that your child will never forget! Crouching Tigers offers so much more than kicking, as the camp curriculum was created to incorporate the YMCAs 4 core values (caring, honesty, respect, and responsibility) throughout the week. The last day of camp ends with a board breaking ceremony!
gOlf Rate: Level 4 (Y Members: $181 All Others: $227)This camp is perfect for campers wanting to improve their golf technique or those wanting to take up the game of golf. Campers will receive instruction in all phases of the game. Physical techniques will include putting, chipping, iron selection, iron and wood play, and bunker play. This camp will also include etiquette and rules of golf. If your camper has clubs, please bring them. Please wear tennis/golf shoes to play golf.
SpORTS Of All SORTS Rate: Level 2 (Y Members: $134 All Others: $169)Calling all sports fanatics! Do you love sports of all sorts? Weve got the camp for you! Well spend each day learning and playing unique versions of your favorite sport activities and introduce you to NEW sports that you may not have had a chance to try. If you love being active, being part of a team, and are up for an adventure, this is the camp for you!
TEnnISRate: Level 3 (Y Members: $156 All Others: $197)Learn the basic skills of tennis in this one-week camp! Campers will work with a tennis pro each day to improve their game. All levels welcome!
TRACK & fIEld Rate: Level 2 (Y Members: $134 All Others: $169)Ready! Set! GO! Join us this week as campers prepare for a track and field meet. They will get the opportunity to try their hand a variety of events, and work to find their strengths. The camp will end with a city wide track meet on Saturday, June 6th! More detail about the track meet will be available during the week of camp.
TRIATHlOn Rate: Level 3 (Y Members: $156 All Others: $197)Join us for the ultimate swimming, biking and running camp! Led by a YMCA triathlon trainer, beginners and intermediate athletes are all welcome! Campers will be required to bring their swimsuit, goggles, bike and helmet to each day of camp. All campers will participate in a timed triathlon on Friday!
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EnRICHMEnT CAMpS
TRY SOMETHIng nEW!Is your child looking to discover something new at camp this summer? Try one of our enrichment camps!
This is an opportunity for your child to try something theyve never tried before! Your child will participate in a more technical curriculum for half the day, before returning to traditional camp style activities. Activities include molding works of art from clay with certified artists and camp staff, cooking up delicious creations in the kitchen, or spending half the day at Sky Zone jumping on trampolines!
Turn the page for descriptions of all Enrichment Camps!
Did you know that,
on average, children are
plugged into electronics
over 5 hours per day? Come UNPLUG at camp!
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lET IT gO!Rate: Level 3 (Y Members: $156 All Others: $197)You spent the entire year wrapped in Frozen hysteria. Now that things are thawing out, are you still not ready to let it go? Yeah, we arent either! Join us for a week of all things FROZEN! MAd SCIEnTISTRate: Level 3 (Y Members: $156 All Others: $197)Do you love science experiments? Come use the scientific process with us as we explore, discover, and create together. This camp will have three hours of science curriculum each day!
MESSY ARTRate: Level 3 (Y Members: $156 All Others: $197)Create messy and fun abstract paintings and a sticky collage of art materials. Also learn about different painting tools, such as spray bottles, sticks, squirt bottles, and other uncommon items!
MInI gOlfRate: Level 3 (Y Members: $156 All Others: $197)Swing away in this fun camp for all! Learn the basics of mini golf and work towards getting a hole in one!
pIRATES Of THE CARABInER Rate: Level 4 (Y Members: $181 All Others: $227)Arrrr! Time to climb! Join us as we scale walls and develop rock climbing skills with a pirate twist! Camps are held indoors through our collaboration with Climb Time, Inc. Please be aware that guardians are required to sign an additional waiver for this camp.
pOTTERYRate: Level 4 (Y Members: $181 All Others: $227)Heres your chance to create many wonderful works of art by hand! Tools, techniques, and processes will be explored. Some projects are made from scratch, so creativity is greatly encouraged! Beginners to advanced are welcome!
BOWlIngRate: Level 3 (Y Members: $156 All Others: $197)This camp is perfect for campers wanting to improve their bowling technique. Half the camp day will be spent working on bowling skills at a local bowling alley. CAMpfIRE COOKIngRate: Level 3 (Y Members: $156 All Others: $197)Have you ever wanted to learn to cook over a campfire? Join us for Campfire Cooking camp! Well try several new recipes throughout the week, all made from our very own campfire! Kids will learn fire building & safety, basic cooking skills, and create a recipe book to take home!
gRAffITI ART Rate: Level 3 (Y Members: $156 All Others: $197)Express your creativity and artistic ability in this new camp! Learn about the history, designs, and shapes of todays modern graffiti art. At the end of the week, get an opportunity to show off your work at the Graffiti Art Show!
HIp HOp dAnCERate: Level 3 (Y Members: $156 All Others: $197)Dip, bend, and pop! Come learn new and exciting hip hop moves in this fun dance camp with choreography and routines that will help you be the hit of the dance floor!
lASER TAgRate: Level 4 (Y Members: $181 All Others: $227)Venture with us to a local laser tag facility to play laser tag games, compete in tournaments, and enjoy the activities and games in the arcade.
lEgO Rate: Level 3 (Y Members: $156 All Others: $197)For those who LOVE to build with Legos! This educational camp takes physical science and technology concepts and applies them in a fun, architectural way.
EnRICHMEnT CAMpS dESCRIpTIOnS
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pRInCESS In TRAInIngRate: Level 4 (Y Members: $181 All Others: $227)Calling all princesses! Join us for a magical week of sparkles and surprises as we learn what it takes to be the perfect princess! Dress-up, tea parties, princess crafts, games, and a surprise princess guest will teach you how to be a princess in and out of camp! RISE Of THE MInIOnSRate: Level 3 (Y Members: $156 All Others: $197)Bee-Do! Bee-Do! Its time to take on summer day camp...Minion Style! This week will be filled with specialized Minion challenges, games, crafts, and much more! Learn all about the Minion language and get the chance to create your own Camp Minion!
ROCKETRY Rate: Level 4 (Y Members: $181 All Others: $227)Travel to the moon and back in Rocketry camp! This camp will teach the mechanics and fun behind rockets! The camp will also include several demonstrations and hands-on building!
ROllER COASTER TEEn TRAVElRate: Level 6 (Y Member: $322 All Others: $370)We will visit 3 theme parks in this teen travel camp. Campers will spendMonday discussing and planning out their trip. Campers will participate in an overnight adventure! Experience friendships to last a lifetime and roller coaster thrills that will make this summer the best summer ever! There is an additional waiver for this camp.
ROllER SKATIng STEM ClUBRate: Level 3 (Y Members: $156 All Others: $197)Love roller skating AND science? Lets skate together and learn the science and engineering behind the skates! STEM stands for science, technology, engineering, and math.
SAfE SITTERRate: Level 3 (Y Members: $156 All Others: $197)Are you ready to start babysitting or staying at home alone? This camp includes Babysitting as a Business, Success on the Job, Child Care Essentials, Safety for the Sitter, Injury Management, Preventing Problem Behavior, CPR, and Care of Choking Infant and Child. It introduces Preventing Injuries and Behavior Management as well! All participants receive a Safe Sitter kit with everything they need to begin babysitting.
SKY ZOnERate: Level 5 (Y Members $249 All Others: $298)Jump for the sky in this extremely popular camp! Jump every day for at least two hours while getting instruction from Sky Zone staff. Be ready for a week of extreme fun and excitement! Please be aware that guardians must sign a separate waiver for this camp. SO YOU THInK YOU CAn BAKE?Rate: Level 3 (Y Members: $156 All Others: $197)Learn the skills of baking! We will cover basic recipes, measuring, and a little friendly competition too! If you love to bake, this is the camp for you!
SUpER dUpER SECRET AgEnTS Rate: Level 3 (Y Members: $156 All Others: $197)Shh! Were going on a secret mission! Grab your magnifying glass, and join us for a week of secretive, sneaky fun! Create your own spy kit, participate in scavenger hunts, and work together to solve mysteries to keep troubleaway from camp!
SUpERHERO VS. VIllAInRate: Level 3 (Y Members: $156 All Others: $197)Do you have a favorite superhero or villain? Join us for a week of superheroes and villains through games, crafts, and more! Costumes are encouraged each day!
TOp CHEfSRate: Level 3 (Y Members: $156 All Others: $197)Calling all chefs! This camp will be one big, friendly competition as a chef! We will cook every day, learn basic culinary skills, and compete to win the top chef award of the week! Join us for an amazing cooking camp experience!
WATER WARSRate: Level 3 (Y Members: $156 All Others: $197)Join us for the best week of wet and wild fun! We will have one big week full of water and competition as we beat the heat and super soak our camp friends!
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EASTCAMpS THROUgH THE BEnJAMIn HARRISOn YCAMp TYpE lOCATIOn AgES
CCd
f 6/1-6/5 6/8-6/12 6/15-6/19 6/22-6/26 6/29-7/2 (No Camp
7/3)
7/6-7/10 7/13-7/17 7/20-7/24 7/27-7/31 8/3-8/4 (No Camp 8/5-8/7)
TRADITIONAL (camps are separated by ages)
Benjamin Harrison Y
Ages 3-15
Y TRADITIONAL CAMP OFFERED WEEKLY!
SPORTS Location TBD
Ages 5-6
YTrack &
FieldSports of All Sorts
SoccerFlag
FootballBasketball Kickball
Sports of All Sorts
SoccerFlag
Football
Try our Traditional
Camp!
Ages 7-8
YTrack &
FieldFlag
FootballBasketball Kickball Soccer
Sports of All Sorts
Flag Football
Basketball Kickball
Ages 9-11
YTrack &
FieldBasketball
Flag Football
Sports of All Sorts
Basketball Soccer Hockey KickballSports of All Sorts
Ages 7-11
Y Cheer Dance Tumbling Cheer Dance Tumbling Cheer Dance Tumbling
ENRICHMENTBenjamin Harrison Y
Ages 6-8
N Graffiti ArtSuperhero vs. Villain
So You Think You Can Bake?
Mad Scientist Try our
Traditional or Sports Camps!
Let It Go Hip Hop Messy Art Water WarsTry our
Traditional Camp!Ages
9-11N Graffiti Art
Superhero vs. Villain
LegoMad
Scientist
So You Think You Can Bake?
Hip Hop Water Wars Messy Art
lEVEl 1 lEVEl 2 lEVEl 3 lEVEl 4 lEVEl 5 lEVEl 6
3-5 Days Y Members $99 $134 $156 $181 $249 $322
3-5 Days All Others $99 $169 $197 $227 $298 $370
1-2 Days* Y Members $69
1-2 Days* All Others $81
*Please note: 1-2 day pricing options are available for full-day preschool and traditional camps only.
Camp is outside all day with a mix of sun and shade Camp splits time inside and outside OR outside but shaded all day
Questions? [email protected]
317.484.9622
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Camp is outside all day with a mix of sun and shade Camp splits time inside and outside OR outside but shaded all day
EASTCAMpS THROUgH THE RAnSBURg YCAMp TYpE lOCATIOn AgES
CCd
f 6/1-6/5 6/8-6/12 6/15-6/19 6/22-6/26 6/29-7/2 (No Camp 7/3)
7/6-7/10 7/13-7/17 7/20-7/24 7/27-7/31 8/3-8/7
TRADITIONAL (camps are separated by ages)
Ransburg YAges 5-15
Y TRADITIONAL CAMP OFFERED WEEKLY!
Warren Township Early Childhood Center
Ages 3-5
Y TRADITIONAL CAMP OFFERED WEEKLY! Member rates offered for ALL PARTICIPANTS! No Camp- please call for alternate
locations.
Grassy Creek Elementary
Ages 5-11
YTRADITIONAL CAMP OFFERED WEEKLY! Member
rates offered for ALL PARTICIPANTS! Join us at the Ransburg Y!
Member rates offered for ALL PARTICIPANTS!
Join us at the Ransburg Y!
Harris Elementary Ages 5-11
Y TRADITIONAL CAMP OFFERED WEEKLY! Member rates offered for ALL PARTICIPANTS! Join us at the Ransburg Y!
Center for Inquiry #2
Ages 5-11
Y Join us at the Ransburg Y! TRADITIONAL CAMP OFFERED WEEKLY! Join us at the
Ransburg Y!Paramount School of Excellence
Ages 5-11
Y TRADITIONAL CAMP OFFERED WEEKLY!
SPORTS Ransburg Y
Ages 6-8
YTrack &
FieldBaseball Soccer
Flag Football
Sports of All Sorts
Hockey Kickball Soccer Aquatics
Try our Traditional
Camps!
Ages 9-11
YTrack &
FieldFlag
FootballBasketball Kickball
Sports of All Sorts
Baseball Hockey Aquatics Basketball
Ages 7-11
Y Cheer Dance Volleyball Cheer Dance Volleyball Cheer Dance Volleyball
ENRICHMENT Ransburg Y
Ages 6-8
N Graffiti ArtSuperhero vs Villain
So You Think You Can Bake?
Mad Scientist Try our
Traditional or Sports Camps!
Bowling Messy ArtRise of the
Minions Try our Traditional or Sports Camps!
Try our Traditional
Camps!Ages 9-11
N Graffiti ArtSuperhero vs. Villain
So You Think You Can Bake?
Mad Scientist
Bowling Messy ArtRise of the
Minions
lEVEl 1 lEVEl 2 lEVEl 3 lEVEl 4 lEVEl 5 lEVEl 6
3-5 Days Y Members $99 $134 $156 $181 $249 $322
3-5 Days All Others $99 $169 $197 $227 $298 $370
1-2 Days* Y Members $69
1-2 Days* All Others $81
*Please note: 1-2 day pricing options are available for full-day preschool and traditional camps only.
Questions? [email protected]
317.484.9622
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nORTHCAMpS THROUgH THE JORdAn Y
CAMp TYpE lOCATIOn AgES
CCd
f 5/28-5/29 (No Camp
5/25-5/27)
6/1-6/5 6/8-6/12 6/15-6/19 6/22-6/26 6/29-7/2 (No Camp
7/3)
7/6-7/10 7/13-7/17 7/20-7/24 7/27-7/31 8/3-8/7
TRADITIONAL (camps are separated by ages)
Jordan YAges 3-11
Y TRADITIONAL CAMP OFFERED WEEKLY! (Teen camp located at Eagle Creek Park)
Eagle Creek Park
Ages 5-15
N TRADITIONAL CAMP OFFERED WEEKLY! (Bus leaves Jordan Y at 8:30am and returns at 2:30pm)
SPORTS Jordan Y
Ages 5-6
YSports of All Sorts
Track & Field
Dodgeball Soccer AquaticsSports of All Sorts
T-ballFlag
FootballAquatics Kickball
Join us for Traditional Camp this
week!
Ages 5-6
Y KickballTrack &
FieldFlag
FootballKickball Hockey Basketball Soccer Dodgeball Basketball
Sports of All Sorts
Ages 7-8
YFlag
FootballTrack &
FieldAquatics Volleyball Baseball Dodgeball
Flag Football
Soccer Kickball Basketball
Ages 7-8
YFlag
FootballTrack &
FieldBasketball Hockey Soccer Hockey Kickball Aquatics
Sports of All Sorts
Dodgeball
Ages 9-11
Y BasketballTrack &
FieldBaseball Dodgeball
Flag Football
Soccer BasketballSports of All Sorts
HockeyUltimate Frisbee
Ages 6-11
Y CheerTrack &
FieldTumbling Cheer Dance Tumbling Cheer Dance Tumbling Cheer
ENRICHMENT Jordan Y
Ages 6-11
N Tennis Pottery Laser Tag Sky ZonePirates of the
CarabinerMini Golf Laser Tag Sky Zone Tennis Bowling Join us for
Traditional Camp this
week! Ages 6-11
N Let It GoCrouching
Tiger Martial Arts
Mad Scientist
Rise of the Minions
LegoCampfire Cooking
Messy ArtPrincess in
TrainingTop Chefs
Superhero vs. Villain
lEVEl 1 lEVEl 2 lEVEl 3 lEVEl 4 lEVEl 5 lEVEl 6
3-5 Days Y Members $99 $134 $156 $181 $249 $322
3-5 Days All Others $99 $169 $197 $227 $298 $370
1-2 Days* Y Members $69
1-2 Days* All Others $81
*Please note: 1-2 day pricing options are available for full-day preschool and traditional camps only.
Questions? [email protected]
317.484.9622
Camp is outside all day with a mix of sun and shade Camp splits time inside and outside OR outside but shaded all day
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nORTHWESTCAMpS THROUgH THE pIKE Y
CAMp TYpE lOCATIOn AgES
CCd
f 6/1-6/5 6/8-6/12 6/15-6/19 6/22-6/26 6/29-7/2 (No Camp
7/3)
7/6-7/10 7/13-7/17 7/20-7/24 7/27-7/31
TRADITIONAL (camps are separated by ages)
Deer Run Elementary
Ages 3-15
Y TRADITIONAL CAMP OFFERED WEEKLY!
SPORTSDeer Run Elementary
Ages 5-8
YTrack &
FieldBasketball
Sports of All Sorts
Kickball Soccer Dodgeball BaseballFlag
FootballSports of All
Sorts
Ages 9-11
YTrack &
FieldSports of All
SortsDodgeball Baseball
Flag Football
Sports of All Sorts
Soccer Basketball Kickball
lEVEl 1 lEVEl 2 lEVEl 3 lEVEl 4 lEVEl 5 lEVEl 6
3-5 Days Y Members $99 $134 $156 $181 $249 $322
3-5 Days All Others $99 $169 $197 $227 $298 $370
1-2 Days* Y Members $69
1-2 Days* All Others $81
*Please note: 1-2 day pricing options are available for full-day preschool and traditional camps only.
Questions? [email protected]
317.484.9622
Camp is outside all day with a mix of sun and shade Camp splits time inside and outside OR outside but shaded all day
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18
SOUTHCAMpS THROUgH THE BAXTER Y
CAMp TYpE lOCATIOn AgES
CCd
f 5/28-5/29 (No Camp
5/25-5/27)
6/1-6/5 6/8-6/12 6/15-6/19 6/22-6/26 6/29-7/2 (No Camp
7/3)
7/6-7/10 7/13-7/17 7/20-7/24
TRADITIONAL (camps are separated by ages)
Baxter Y Ages 3-15
N TRADITIONAL CAMP OFFERED WEEKLY!
Arlington Elementary
Ages 5-11
Y
Join us for camp at the Baxter Y!
TRADITIONAL CAMP OFFERED WEEKLY! Join us for camp at the Baxter Y!Perry Township Ages
5-11Y TRADITIONAL CAMP OFFERED WEEKLY!
Gathering Place of Greenwood
Ages 5-11
N TRADITIONAL CAMP OFFERED WEEKLY!
TEEN LEADERSHIP
Baxter Y
Ages 12-15
N
Join us for Traditional
Camp!
LIT LIT LIT LIT LIT LIT LIT LIT
Ages 11-14
N Safe Sitter Safe Sitter Safe Sitter Safe Sitter
Ages 16-17
N CIT CIT CIT CIT CIT CIT CIT CIT
lEVEl 1 lEVEl 2 lEVEl 3 lEVEl 4 lEVEl 5 lEVEl 6
3-5 Days Y Members $99 $134 $156 $181 $249 $322
3-5 Days All Others $99 $169 $197 $227 $298 $370
1-2 Days* Y Members $69
1-2 Days* All Others $81
*Please note: 1-2 day pricing options are available for full-day preschool and traditional camps only.
Questions? [email protected]
317.484.9622
Camp is outside all day with a mix of sun and shade
Camp splits time inside and outside OR outside but shaded all day
lIT (leaders In Training)/CIT (Counselors In Training) Camp: Through leadership courses and hands-on experience with assigned camper groups, LITs and CITs receive a well-rounded experience that helps them develop as a leader and serve as role models for younger campers. The goals of LIT and CIT camp programs are to teach leadership skills that can be applied at camp and beyond, strengthening confidence at school, home, and community. Any youth interested in participating in the LIT and CIT Camp programs must go through an application, interview, and selection process. Camp registration is required in order to apply.
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19
SOUTHCAMpS THROUgH THE BAXTER Y
CAMp TYpE lOCATIOn AgES
CCd
f 5/28-5/29 (No Camp
5/25-5/27)
6/1-6/5 6/8-6/12 6/15-6/19 6/22-6/26 6/29-7/2 (No Camp
7/3)
7/6-7/10 7/13-7/17 7/20-7/24
SPORTS
Baxter Y
Ages 5-6
N
Join us for Traditional
Camp at the Baxter Y!
Track & Field Flag Football Basketball Cheer T-ball TumblingBritish Soccer
Dodgeball
Ages 7-8
N Track & Field Archery Flag Football Tumbling Basketball DodgeballBritish Soccer
Cheer
Ages 9-11
N Track & Field Basketball Dodgeball Golf Triathlon CheerBritish Soccer
Archery
Ages 6-11
NAquatics
(Ages 6-8)Aquatics
(Ages 9-11)Aquatics
(Ages 6-8)Aquatics
(Ages 9-11)Aquatics
(Ages 6-8)Aquatics
(Ages 9-11)Aquatics
(Ages 6-8)Aquatics
(Ages 9-11)
Gathering Place of Greenwood
Ages 5-11
N Track & Field Tumbling SoccerSports of All
SortsCheer Flag Football Basketball Dodgeball
Arlington Elementary
Ages 5-11
Y Track & Field Tumbling SoccerSports of All
SortsCheer Flag Football Basketball
Join us at another location!
ENRICHMENT Perry Township
Ages 5-6
N
Join us for Traditional
Camp at the Baxter Y!
Crouching Tiger Martial Arts
Hip HopPrincess in
TrainingLego Messy Art
Super Duper Secret Agents
Rise of the Minions
Join us for Traditional or Sports
Camp at the Baxter Y!
Ages 7-8
NSuper Duper
Secret AgentsRise of the
MinionsPottery Hip Hop
Princess in Training
Messy ArtCrouching Tiger
Martial Arts
Ages 9-11
N Messy ArtCrouching Tiger
Martial ArtsMini Golf Hip Hop
Pirates of the Carabiner
Rocketry Sky Zone
Ages 12-15
NRoller Coaster Teen Travel
Rocketry Hip Hop Graffiti ArtPirates of
the CarabinerCrouching Tiger
Martial ArtsSky Zone
lEVEl 1 lEVEl 2 lEVEl 3 lEVEl 4 lEVEl 5 lEVEl 6
3-5 Days Y Members $99 $134 $156 $181 $249 $322
3-5 Days All Others $99 $169 $197 $227 $298 $370
1-2 Days* Y Members $69
1-2 Days* All Others $81
*Please note: 1-2 day pricing options are available for full-day preschool and traditional camps only.
Questions? [email protected]
317.484.9622
Camp is outside all day with a mix of sun and shade Camp splits time inside and outside OR outside but shaded all day
-
20
WESTCAMpS THROUgH THE HEndRICKS REgIOnAl HEAlTH Y
CAMp TYpE lOCATIOn AgES
CCd
f 6/1-6/5 6/8-6/12 6/15-6/19 6/22-6/26 6/29-7/2 (No Camp
7/3)
7/6-7/10 7/13-7/17 7/20-7/24 7/27-7/31* (See below)
TRADITIONAL (camps are separated by ages)
HRH YAges 3-15
N TRADITIONAL CAMP OFFERED 6/1-7/28!*
Bridgeport Elementary
Ages 5-11
Y
Join us for camp at another location!
TRADITIONAL CAMP OFFERED 6/1-7/29!*
Hummel ParkAges 5-11
N TRADITIONAL CAMP OFFERED 6/1-7/31!*
SPORTSAvon Intermediate School East
Ages 6-12
YTrack &
FieldJoin us for camp at another location!
BasketballSports of All
SortsKickball Baseball
Flag Football Join us for
Traditional Camp!
ENRICHMENT HRH YAges 6-11
N PotteryCrouching
Tiger Martial Arts
Rise of the Minions
Pirates of the
CarabinerBowling Messy Art
Princess in Training
Roller Skating
STEM Club
lEVEl 1 lEVEl 2 lEVEl 3 lEVEl 4 lEVEl 5 lEVEl 6
3-5 Days Y Members $99 $134 $156 $181 $249 $322
3-5 Days All Others $99 $169 $197 $227 $298 $370
1-2 Days* Y Members $69
1-2 Days* All Others $81
*Please note: 1-2 day pricing options are available for full-day preschool and traditional camps only.
Questions? [email protected]
317.484.9622
Camp is outside all day with a mix of sun and shade Camp splits time inside and outside OR outside but shaded all day
-
21
gET THE MOST OUT Of YOUR SUMMER! YMCA dAY CAMp SWIM lESSOnS
YMCA Day Camp allows you to take advantage of extra enrichment classes in which your child can stay at the Y and receive quality swim instruction by our trained Aquatics staff at the YMCA.
Rate per Week (Mon-Thurs): $28 for Y Members; $53 for all others
Y CENTER AGES 3-5 AGES 6-11Benjamin Harrison Y 4:00-4:30pm or
4:35-5:05pm4:00-4:40pm or 4:50-5:30pm
HRH Y 4:00-4:45pmJordan Y 11:00-11:30am 4:00-4:45pmRansburg Y 9:30-10:00am 4:10-4:50pm
Please note: If your child is attending an off-site camp (at a location other than the YMCA), you must provide transportation to the Y for these swim lessons.
Baxter Y: Session A (6/2-6/25) and Session B (6/30-7/23) Rate per Session (Tues and Thurs): $53 for Y Members, $102 for all others Ages 3-5: 9:30-10:15am Ages 6-11: 4:00-4:45pm
-
22
lOOKIng fOR An OVERnIgHT EXpERIEnCE?
CHOOSE YOUR AdVEnTURES & TAKE On nEW CHAllEngES!
Zip line * Swimming * Horseback Riding Canoeing/Kayaking * Mountain Biking
Archery * Sports * Rock ClimbingFishing*CreativeArts*RifleryEnvironmental Science * dance
Alpine Tower & Much, Much More!
flAT ROCK RIVER YMCA CAMp Ages 7-17
One- & two-week Overnight Sessions begin June 7th
Three-night mini-camp also available for ages 7-9
www.flatrockymca.org
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23
TURn THE pAgE TOgET STARTEd!
-
IMMUnIZATIOn InfORMATIOn EVERY CAMpER attending camp at a location that accepts CCdf vouchers is required to submit an immunization form. This is required regardless of whether or not you are personally using a CCdf voucher.
If your child is attending day camp at any of the locations listed below, please complete the immunization information on the following page, and include it along with your registration form.
Arlington Elementary Avon Intermediate School West Benjamin Harrison YMCA Bridgeport Elementary Deer Run Elementary Durbin Elementary Grassy Creek Elementary Harris Elementary
Other sites may also be accepting CCDF vouchers and will therefore require ALL campers to complete this form. Please check with your YMCA when registering.
plEASE nOTE:If you are completing this form prior to the end of the school year, and your childs school has a certified school nurse, he/she can be considered the health care provider and can sign the form.
Your childs immunization (shot) record must also be attached to the completed form.
Thank you!
Center for Inquiry #2 Jordan YMCA Paramount School of Excellence Perry Township Location Ransburg YMCA Sheridan Elementary Warren Township Early Childhood Center
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THIS
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____
____
____
____
_
Wor
k Ph
one:
___
____
____
____
____
____
____
____
____
____
____
____
____
__
Alt
erna
te P
hone
: ___
____
____
____
____
____
____
____
____
____
____
____
__
E-M
ail A
ddre
ss: _
____
____
____
____
____
____
____
____
____
____
____
____
P
leas
e in
itia
l onl
y to
OPT
OU
T of
occ
asio
nal Y
MCA
t
ext
mes
sage
s _
____
___
2.G
uard
ian
Nam
e: _
____
____
____
____
____
____
____
____
____
____
____
___
Rela
tion
ship
:___
____
____
____
___D
.O.B
(req
uire
d) :_
___/
____
/___
__
Mai
ling
Add
ress
: __
____
____
____
____
____
____
____
____
____
____
____
_
City
: __
____
____
____
____
____
____
____
____
_ St
:___
___
Zip:
____
____
___
Prim
ary
Phon
e: __
____
____
____
____
____
____
____
____
____
____
____
____
_
Plac
e of
Em
ploy
men
t: _
____
____
____
____
____
____
____
____
____
____
_
Wor
k Ph
one:
___
____
____
____
____
____
____
____
____
____
____
____
____
__
Alt
erna
te P
hone
: ___
____
____
____
____
____
____
____
____
____
____
____
__
E-M
ail A
ddre
ss: _
____
____
____
____
____
____
____
____
____
____
____
____
Plea
se in
itia
l onl
y to
OPT
OU
T of
YM
CA t
ext
mes
sage
s
re
gard
ing
your
chi
lds
cam
p _
____
___
CAM
pER
pIC
K-U
p In
fOR
MAT
IOn
Pare
nt/g
uard
ian(
s) li
sted
at
left
are
aut
hori
zed
to p
ick
up
child
(ren
), un
less
oth
erw
ise
note
d. Y
ou m
ay a
lso
auth
oriz
e on
ly
the
peop
le n
amed
bel
ow t
o pi
ck u
p yo
ur c
hild
(ren
).
Not
e: F
or y
our
child
s s
afet
y, h
e/sh
e w
ill n
ot b
e re
leas
ed t
o an
yone
els
e. A
ll au
thor
ized
per
sons
mus
t be
18
yea
rs o
f ag
e or
old
er. N
o ch
ange
s to
thi
s lis
t w
ill b
e m
ade
unle
ss t
he
pare
nt o
r le
gal g
uard
ian
who
se s
igna
ture
app
ears
on
the
next
pa
ge r
eque
sts
such
cha
nges
in w
riti
ng. P
hoto
iden
tifi
cati
on is
re
quir
ed a
t pi
ck u
p at
all
loca
tion
s. _
____
___(
init
ial)
1.
Nam
e: _
____
____
____
____
____
____
____
____
____
____
____
____
____
____
___
Add
ress
: ___
____
____
____
____
____
____
____
____
____
____
____
____
____
__
Wor
k Ph
one:
___
____
____
____
____
____
____
____
____
____
____
____
____
_
Oth
er P
hone
:___
____
____
____
____
____
____
____
____
____
____
____
____
_
Rel
atio
nshi
p:__
____
____
____
____
____
____
____
____
____
____
____
____
__
2.
Nam
e: _
____
____
____
____
____
____
____
____
____
____
____
____
____
____
___
Add
ress
: ___
____
____
____
____
____
____
____
____
____
____
____
____
____
__
Wor
k Ph
one:
___
____
____
____
____
____
____
____
____
____
____
____
____
_
Oth
er P
hone
:___
____
____
____
____
____
____
____
____
____
____
____
____
_
Rel
atio
nshi
p:__
____
____
____
____
____
____
____
____
____
____
____
____
__
3.
Nam
e: _
____
____
____
____
____
____
____
____
____
____
____
____
____
____
___
Add
ress
: ___
____
____
____
____
____
____
____
____
____
____
____
____
____
__
Wor
k Ph
one:
___
____
____
____
____
____
____
____
____
____
____
____
____
_
Oth
er P
hone
:___
____
____
____
____
____
____
____
____
____
____
____
____
_
Rel
atio
nshi
p:__
____
____
____
____
____
____
____
____
____
____
____
____
__
pRO
MO
TIO
n A
gR
EEM
EnT
(In
ITIA
l O
nlY
TO
OpT
OU
T)Pl
ease
init
ial b
elow
if t
he Y
dO
ES n
OT
have
you
r pe
rmis
sion
to
use
phot
ogra
phs
of y
our
child
(ren
) fo
r pr
omot
iona
l pu
rpos
es.
____
____
(init
ial)
Chi
ld(r
en)s
Nam
e(s)
: ___
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
_
CAM
p pA
YMEn
T n
OTE
S In
ord
er t
o re
serv
e a
spac
e in
the
cam
p(s)
of
your
ch
oice
, a m
inim
um o
f a
$15
non
-ref
unda
ble
depo
sit
is
requ
ired
for
eac
h w
eek
each
chi
ld is
reg
iste
red
for
cam
p.
Out
stan
ding
bal
ance
s m
ust
be p
aid
by 8
:00
pm
on
the
Tues
day
befo
re t
he c
amp
wee
k be
gins
. Fai
lure
to
mee
t pa
ymen
t de
adlin
es w
ill r
esul
t in
the
loss
of
the
cam
p re
serv
atio
n an
d de
posi
t. _
____
__(i
niti
al)
Plea
se b
e aw
are
ther
e is
a la
te f
ee o
f $1
per
min
ute
per
child
for
tho
se p
icki
ng u
p af
ter
6:0
0 p
m.
Add
itio
nal
info
rmat
ion
abou
t ca
mp
dead
lines
and
pay
men
t pr
oced
ures
may
be
foun
d at
ww
w.in
dym
ca.o
rg/c
amp
___
____
(ini
tial
)
An
nU
Al
CAM
pAIg
n
The
YMCA
is u
niqu
e be
caus
e yo
ur m
embe
rshi
p ra
tes
and
prog
ram
fee
s ar
e ba
sed
on t
otal
hou
seho
ld in
com
e. T
he
Y is
abl
e to
off
er a
slid
ing
fee
scal
e th
anks
to
gene
rous
do
nors
who
se c
ontr
ibut
ions
to
our
Ann
ual C
ampa
ign
enab
le u
s to
live
our
mis
sion
of
bein
g op
en a
nd
acce
ssib
le f
or a
ll. P
leas
e as
k at
you
r Ce
nter
s f
ront
des
k fo
r de
tails
if y
ou n
eed
this
ass
ista
nce
and/
or w
ish
to
cont
ribu
te t
o th
is f
und
to h
elp
othe
rs.
fOR
Y O
ffIC
E U
SE O
nlY
- IN
ITIA
L IN
FO E
NTE
RED
IN
UN
ITY:
Pick
Up
List
: ___
____
___
Hea
lth
Info
:___
____
___
I cer
tify
tha
t I a
m t
he p
aren
t or
lega
l gua
rdia
n of
thi
s ch
ild a
nd h
ave
the
lega
l aut
hori
ty t
o m
ake
the
repr
esen
tati
ons
and
gran
t th
e au
thor
izat
ions
con
tain
ed h
erei
n.
____
____
____
____
____
____
____
____
____
____
____
____
____
__
____
____
____
____
____
____
____
____
____
____
____
____
____
__
__
____
____
____
____
____
____
___
Si
gnat
ure
of p
aren
t or
leg
al g
uard
ian
p
rint
nam
e
dat
e
-
HEA
lTH
InfO
RM
ATIO
n -
CH
Ild
1CH
Ild
1 n
AM
E___
____
____
____
____
____
____
____
____
____
____
____
____
____
____
Fam
ily P
hysi
cian
: __
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
Phon
e:__
____
____
____
____
____
____
____
____
Dat
e of
las
t ph
ysic
al e
xam
:___
____
__
Insu
ranc
e Ca
rrie
r: _
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
_
Polic
y #:
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
___
HEA
lTH
InfO
RM
ATIO
n -
CH
Ild
2CH
Ild
2 n
AM
E___
____
____
____
____
____
____
____
____
____
____
____
____
____
____
Fam
ily P
hysi
cian
: __
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
Phon
e:__
____
____
____
____
____
____
____
____
Dat
e of
las
t ph
ysic
al e
xam
:___
____
__
Insu
ranc
e Ca
rrie
r: _
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
_
Polic
y #:
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
___
c A
DD
/AD
HD
c A
utis
m
c A
sthm
a
c C
onvu
lsio
ns
c H
eart
Def
ect/
Dis
ease
c B
leed
ing/
Clot
ting
Dis
orde
rs
c D
iabe
tes
c F
requ
ent
Ear
Infe
ctio
n
c H
yper
tens
ion
c T
etan
us Inn
oc.*
D
ate:
___
____
____
____
_ *
If n
o da
te is
giv
en, t
he Y
w
ill h
ave
a te
tanu
s sh
ot a
dmin
iste
red
in c
ase
of e
mer
genc
y.
c C
ampe
r is
up-
to-d
ate
wit
h al
l im
mun
izat
ions
nee
ded
for
e
nrol
lmen
t in
sch
ool.
____
____
____
__ (
init
ial)
Det
ails
of
abov
e: _
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
Curr
ent
med
icat
ions
(se
nd p
resc
ript
ion
in o
rigi
nal b
ottl
e): _
____
____
____
_
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
Ope
rati
ons
or s
erio
us in
juri
es: _
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
Dis
abili
ty d
ue t
o ch
roni
c or
rec
urri
ng il
lnes
s: _
____
____
____
____
____
____
____
__
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
Any
spe
cifi
c ac
tivi
ties
to
be e
ncou
rage
d or
lim
ited
by
phys
icia
ns
advi
ce: _
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
__
Spec
ial
need
s (p
hysi
cal,
men
tal
or p
sych
olog
ical
) fo
r ca
mp
coun
selo
r aw
aren
ess:
___
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
__
Swim
Abi
lity:
c N
one c
Beg
inne
r c
Int
erm
edia
te c
Adv
ance
d
c A
DD
/AD
HD
c A
utis
m
c A
sthm
a
c C
onvu
lsio
ns
c H
eart
Def
ect/
Dis
ease
c B
leed
ing/
Clot
ting
Dis
orde
rs
c D
iabe
tes
c F
requ
ent
Ear
Infe
ctio
n
c H
yper
tens
ion
c T
etan
us Inn
oc.*
D
ate:
___
____
____
____
_ *
If n
o da
te is
giv
en, t
he Y
will
hav
e a
teta
nus
shot
adm
inis
tere
d in
cas
e of
em
erge
ncy.
c C
ampe
r is
up-
to-d
ate
wit
h al
l im
mun
izat
ions
nee
ded
for
e
nrol
lmen
t in
sch
ool.
____
____
____
__ (
init
ial)
Det
ails
of
abov
e: _
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
Curr
ent
med
icat
ions
(se
nd p
resc
ript
ion
in o
rigi
nal b
ottl
e): _
____
____
____
_
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
Ope
rati
ons
or s
erio
us in
juri
es: _
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
Dis
abili
ty d
ue t
o ch
roni
c or
rec
urri
ng il
lnes
s: _
____
____
____
____
____
____
____
__
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
Any
spe
cifi
c ac
tivi
ties
to
be e
ncou
rage
d or
lim
ited
by
phys
icia
ns
advi
ce: _
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
__
Spec
ial
need
s (p
hysi
cal,
men
tal
or p
sych
olog
ical
) fo
r ca
mp
coun
selo
r aw
aren
ess:
___
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
__
Swim
Abi
lity:
c N
one c
Beg
inne
r c
Int
erm
edia
te c
Adv
ance
d
pAR
EnT/
gU
AR
dIA
n A
UTH
OR
IZAT
IOn
& S
Ign
ATU
RE
pAR
EnT
AU
THO
RIZ
ATIO
n a
nd R
ElEA
SE:
My
child
(ren
) ha
s m
edic
al
appr
oval
to
part
icip
ate
in t
he a
ctiv
itie
s of
the
You
ng M
ens
Chr
isti
an
Ass
ocia
tion
of
Gre
ater
Ind
iana
polis
(Y
MCA
.),
and
in m
y ju
dgm
ent
my
child
(ren
) is
in g
ood
heal
th a
nd p
hysi
cal c
ondi
tion
and
abl
e sa
fely
to
par
tici
pate
in t
he a
ctiv
itie
s of
the
YM
CA. M
y ch
ild(r
en) ha
s m
y pe
rmis
sion
to
enga
ge in
all
acti
viti
es o
ffer
ed b
y th
e YM
CA e
xcep
t as
not
ed b
y m
e in
wri
ting
. I f
urth
er u
nder
stan
d th
at n
eith
er t
he
YMCA
nor
any
of
its
paid
sta
ff o
r vo
lunt
eer
wor
kers
can
be
held
re
spon
sibl
e in
the
eve
nt o
f an
acc
iden
t. I p
rom
ise
and
agre
e on
be
half
of
mys
elf, m
y sp
ouse
or
part
ner
or o
ther
fam
ily m
embe
r no
t to
sue
and
agr
ee t
o w
aive
, rel
ease
, dis
char
ge, a
nd h
old
harm
less
and
in
dem
nify
the
YM
CA, i
ts a
gent
s, e
mpl
oyee
s, m
embe
rs a
nd v
olun
teer
s fr
om a
ll cl
aim
s, d
eman
ds, r
ight
s an
d ca
uses
of
acti
on o
f an
y ki
nd,
whe
ther
ari
sing
fro
m m
y ow
n ac
ts, t
he a
cts
of m
y ch
ild(r
en),
or t
hose
of
the
YM
CA. I
her
eby
wai
ve a
ll cl
aim
s fo
r in
jury
or
dam
age,
suf
fere
d by
my
child
(ren
), m
ysel
f, m
y sp
ouse
, my
part
ner,
or o
ther
fam
ily
mem
ber
in c
onne
ctio
n w
ith
or a
risi
ng o
ut o
f th
e pa
rtic
ipat
ion
of m
y ch
ild(r
en) in
YM
CA a
ctiv
itie
s. I c
erti
fy t
hat
my
child
(ren
) is
am
enab
le
to d
isci
plin
e an
d fr
ee f
rom
hab
its
or a
ttit
udes
, whi
ch w
ould
mak
e hi
m/h
er a
n un
desi
rabl
e pa
rtic
ipan
t. I h
ave
stud
ied
the
broc
hure
and
un
ders
tand
the
con
tent
s th
ereo
f.
CAM
p A
CTIV
ITY
An
d T
RA
nSp
OR
TATI
On
AU
THO
RIZ
ATIO
n:
I he
reby
giv
e pe
rmis
sion
for
my
child
(ren
) to
par
tici
pate
in c
amp
acti
viti
es a
nd t
o tr
avel
by
bus
wit
h th
e Y
Day
Cam
p st
aff.
I un
ders
tand
tha
t on
ly li
cens
ed a
nd q
ualifi
ed p
erso
nnel
will
ope
rate
an
y ve
hicl
e to
and
fro
m D
ay C
amp,
and
tha
t th
ere
will
be
at le
ast
one
Day
Cam
p st
aff
mem
ber
pres
ent
at a
ll ti
mes
. I a
gree
to
rele
ase
the
Youn
g M
ens
Chr
isti
an A
ssoc
iati
on o
f G
reat
er Ind
iana
polis
, its
offi
cers
an
d di
rect
ors,
and
the
Y D
ay C
amp
staf
f fr
om a
ny a
nd a
ll cl
aim
s of
da
mag
es, d
eman
ds o
r lia
bilit
ies
whi
ch m
ay a
rise
as
a re
sult
of
my
child
(ren
)s p
arti
cipa
tion
in c
amp
acti
viti
es a
nd b
us t
rips
.
EMER
gEn
CY A
UTH
OR
IZAT
IOn
: I h
ereb
y gi
ve p
erm
issi
on t
o th
e m
edic
al p
erso
nnel
sel
ecte
d by
the
cam
p di
rect
or t
o or
der
X-r
ays,
ro
utin
e te
sts
and
trea
tmen
t fo
r m
e or
my
child
(ren
), an
d, in
the
eve
nt
I am
not
abl
e to
com
mun
icat
e or
can
not
be r
each
ed in
an
emer
genc
y, I
here
by g
ive
perm
issi
on t
o th
e ph
ysic
ian
sele
cted
by
the
cam
p di
rect
or
to h
ospi
taliz
e, s
ecur
e pr
oper
tre
atm
ent
for,
and
orde
r in
ject
ion(
s) a
nd/
or a
nest
hesi
a an
d/or
sur
gery
for
me
or m
y ch
ild(r
en) as
nam
ed p
rior
. I w
ill b
e fu
lly r
espo
nsib
le f
or a
ny c
osts
of
such
tre
atm
ent,
eve
n if
not
co
vere
d by
insu
ranc
e.
pAR
EnT
OR
gU
AR
dIA
n p
ERM
ISSI
On
: My
sign
atur
e be
low
indi
cate
s th
at I h
ave
the
lega
l aut
hori
ty t
o si
gn-u
p th
e ch
ild(r
en) na
med
on
this
for
m a
nd t
hat
to t
he b
est
of m
y kn
owle
dge
the
info
rmat
ion
on
this
app
licat
ion
form
is c
ompl
ete
and
accu
rate
. I f
urth
er u
nder
stan
d th
at t
his
is a
n ap
plic
atio
n an
d th
e na
med
chi
ld(r
en)s
par
tici
pati
on
is c
onti
ngen
t up
on s
pace
bei
ng a
vaila
ble
in t
he p
rogr
am(s
) in
whi
ch
I w
ant
the
child
(ren
) to
par
tici
pate
. I a
lso
unde
rsta
nd t
hat
once
my
regi
stra
tion
is c
onfi
rmed
, I m
ust
com
plet
e pa
ymen
t(s)
by
the
dead
lines
of
sai
d pr
ogra
m(s
) as
out
lined
pri
or a
nd t
hat,
fur
ther
mor
e, a
ll ne
cess
ary
heal
th, s
ecur
ity
and
wai
ver
form
s m
ust
be s
igne
d an
d on
file
w
ith
the
Y p
rior
to
my
child
(ren
) at
tend
ing
the
prog
ram
(s).
Failu
re t
o co
mpl
y w
ith
this
cou
ld r
esul
t in
the
loss
of
the
cam
p sp
ace.
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_
Si
gnat
ure
of p
aren
t or
leg
al g
uard
ian
p
rint
nam
e
dat
e
DIS
EASE
S**
c G
erm
an M
easl
es
c M
umps
c C
hick
en P
ox
ALL
ERG
IES*
*
c F
ood
c M
edic
ine
c P
oiso
n Iv
y, E
tc.
c I
nsec
t St
ings
DIS
EASE
S**
c G
erm
an M
easl
es
c M
umps
c C
hick
en P
ox
ALL
ERG
IES*
*
c F
ood
c M
edic
ine
c P
oiso
n Iv
y, E
tc.
c I
nsec
t St
ings
-
30
2015
Y d
AY C
AM
p B
EHAV
IOR
pO
lICY
O
ur t
op p
rior
ity
is t
o pr
ovid
e a
safe
and
enr
ichi
ng e
xper
ienc
e fo
r al
l chi
ldre
n. T
o do
thi
s, w
e m
ust
wor
k to
geth
er t
o de
velo
p th
e be
st p
lan
for
each
indi
vidu
al c
hild
. In
orde
r to
ens
ure
this
pos
itiv
e en
viro
nmen
t, w
e m
ay n
ot b
e ab
le t
o se
rve
child
ren
who
rep
eate
dly
disp
lay
disr
upti
ve b
ehav
ior.
Dis
rupt
ive
beha
v