A SUMMER TO DISCOVER Staten Island YMCA Summer Day Camp 2012

Is your child ready for a summer of adventure?

The Staten Island 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

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,

Cynthia Bayiokos

Day Camp Director

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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

campers to read and learn over the summer

months. All YMCA Day Camps are licensed

by the NYC Department of Health and Ac-

credited by the American Camping Associa-

tion (ACA).

STATEN ISLAND YMCA DAY CAMPS

TABLE OF CONTENTS

CAMP LOCATIONS & CONTACT INFORMATION

Staten Island YMCA Summer Day Camp at Pouch Camp

1465 Manor Road, Staten Island, NY 10314 P: 718-227-3200 F: 718-356-5122 P: 718-667-5210 (Camp phone line)

For more information, please contact:

Cynthia Bayiokos, Camp Director at 718-227-3200 or cbayiokos@ymcanyc.org

Camp Broadway Staten Island YMCA Broadway Branch 651 Broadway, Staten Island, NY 10310 P: 718-981-4933—F: 718-720-4365

For more information, please contact:

Allison Sicuranza, Early Childhood Director at 718-981-4933 or asicuranza@ymcanyc.org

Camp Rainbow Staten Island YMCA South Shore Branch

3939 Richmond Ave., Staten Island, NY 10312 P: 718-227-3200—F: 718-356-5122

For more information, please contact:

Bonnie Schiuma, Early Childhood Director at 718-227-3200 or bschiuma@ymcanyc.org

2 LETTER FROM THE CAMP DIRECTOR 3 CAMP LOCATIONS

& CONTACTS 4-5 WHAT YOU NEEDTO KNOW 6-8 EXPLORE, PLAY & GROW 9-10 FEES 11-14 REGISTRATION & MEDICAL FORMS

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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 Staten Island YMCA Summer Day Camp helps campers ages 5-13 years old and teens ages 14-16 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 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, dra-ma, art and sports. Through fun, themed curric-ulum that incorporates key academic compo-nents, children will practice and further their academic skills, learn to plan and create pro-jects, 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 Staten Island YMCA Summer Day Camp operates out of Pouch Camp, located at 1465 Manor Road, in the Greenbelt of Staten Island.

DATES & HOURS OF OPERATION The Staten Island YMCA Summer Day Camp is an eight-week program that runs from July 2 -August 24 from 9:00am to 4:00pm. A one-week Transitional Pre-Camp will run from June 25 - June 29 and our Post Camp will run from August 27 - August 31 from 9:00am to 4:00pm.

OPEN HOUSES Saturday, March 3, 2012 10am – 4 pm Saturday, April 28, 2012 10am – 4 pm Saturday, May 19, 2012 10am – 4 pm Saturday, June 2, 2012 10am – 1 pm Saturday, June 9, 2012 10am – 1 pm

Open Houses for the Staten Island YMCA Day Camp at Pouch Camp will be held in Berlin Lodge at Pouch Camp, located at 1465 Manor Road.

For more information on our Early Childhood Camps, please contact the Early Childhood Directors to schedule a tour.

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REGISTRATION MADE EASY Follow instructions and fill out all registration packet forms making sure

they are completed and signed

Have 2 passport size photos of your child stapled to Registration form for submission

Bring everything in with payment for your child’s first session with addition-al 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 paying off your entire

balance by Saturday, May 19.

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

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 ORIENTATION Parent Orientation is mandatory. Parent or guardian must attend one mandatory meeting in Berlin Lodge at Pouch Camp on either June 26, 27 or 28 at 5:30p.m.

FINANCIAL ASSISTANCE The YMCA of Greater New York awards scholar-ships to campers based on a parent or a family’s annual income. The scholarship applications must be submitted by May 19, 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 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 Youth & Family Director. 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 shirts and a camp bag. Swim caps will be given during the camper’s first day of swimming. Camp t-shirts must be worn every day. Additional shirts may be purchased at $8 each. Swim gear must consist of a towel, swimsuit, swim cap, a change of clothing, water shoes and a plastic bag (or other receptacle for wet swim gear). Camp gear is distributed during the camper first day of camp.

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

EARLY CHILDHOOD CAMP

(AGES 3-6)

The Staten Island YMCA’s Early Childhood Day Camp Program focuses on providing a safe, nurturing environment where children can thrive. Kids have fun while building self-confidence, appreciating teamwork and gaining independence. Our Early Childhood camps—Camp Rainbow (located at the South Shore Branch) and Camp Broadway (located at the Broadway Branch)—offer air-conditioned classrooms, outdoor play-grounds, indoor pools and gyms. Children are divided into the following age groups: 3-4 year olds and 5-6 year olds.

Our primary goal is for each child to develop a positive self-image. The staff is made up of carefully selected teachers and assistant teachers who will provide guid-ance and supervision so that each child can achieve self-confidence and awareness. Children are encouraged to develop self-help skills that foster independence and a positive self-image. Our campers participate in a wide variety of activities, including arts and crafts, swim, gym, music, and organized games. Each week will feature a special theme and all activities are geared to meet individual needs, abilities and interests. This camp offers a half day and full day option.

Day Camp Hours

8:45am - 3:15pm

Half Day AM: 8:45am – 11:30pm

Half Day PM: 12:30pm – 3:15pm

Extended Hours AM: 7:30am - 8:45am

Extended Hours PM: 3:15pm-6:00pm

Please note: Campers must be completely

potty trained in order to attend Camp

Broadway or Camp Rainbow.

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TRADITIONAL CAMP (AGES 5 – 13) The Staten Island YMCA’s Traditional Camp Program, located at Pouch Camp, offers a variety of fun supervised activities. Campers participate in swimming, arts and crafts, health and fitness, group games, science and nature, music and drama, rock climbing, and sports. Each session, campers have the op-portunity to participate in a trip. Each session features a new theme to spark your camper’s curiosity and broaden their horizon as they explore art, music, science and the natural world through hands-on learning and camp trips. Campers will also learn to express themselves in a safe, bully-free environment while developing strong citizenship and integrity with the help of our four core values: Caring, Honesty, Respect and Responsibility. Traditional Camp will give your camper a vari-ety of new experiences along with memories and lifelong friendships.

Sessions are two weeks in length and campers are encouraged to register for 5 days a week though 3 day camp options are available on M/W/F only. Lunch must be provided from home every day.

Traditional Camp Hours 9:00am – 4:00pm Extended Hours AM: 7:15am-9:00am Extended Hours PM: 4:00pm-6:15pm

SPORTS CAMP (AGES 5 – 13) Our 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. Sports camps offered this summer include soccer, basketball and swim camp.

Basketball Camp (Ages 5-13 years) The Staten Island YMCA Basketball Camp will focus on all aspects of team building, skill development, mechanics and position-specific drills. We will review dribbling, ball handling, passing, catching, footwork, rebounding, and shooting. Our basketball camp is designed to help all children re-gardless of their skill level. Whether begin-ner or advanced, on a team or new to the sport, the children will progress at their own level. Mostly we are hoping to have a lot of fun while you learn or just improve your game and make new friends. This camp will be held during Session 3 at the Broadway Branch and Session 4 at the South Shore Branch.

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Swim Camp (Ages 5-12 years) Get healthy and into shape! Swim camp is great for children of all swim levels. Campers are taught not only swimming skills, but also how to enjoy aquatic activities throughout their lives. Skills include personal safety, survival and rescue skills, water sports and structured games. Children will be divided into three levels and given red (beginner), yellow (intermediate) or green (advanced) swim camps to indicate their swim level. This camp will be held during Session 1 at the Broadway and during Session 2 at South Shore Branch.

Soccer Camp (Ages 5-13 years) The Staten Island YMCA Soccer Camp will focus on step-by-step teaching methods which will create a crystal clear picture of each skill through demonstration, ex-planation and participation. The premise of the camp is to develop and improve individual skills and team play through inspiring training and instruction. The camp will focus on group physical and mental conditioning with qualified soccer counselors. In addition, the camp will be designed to help facilitate increased development and highest performance through speed, movement, vision, reac-tion and communication. Players are divided into the following age categories: 5-6 years, 7-9 years, and 10-13 years. Particular emphasis will be placed on striking the ball, passing, dribbling and strengthening players’ ball skills. This camp will be held during Session 4 at the South Shore Branch’s Youth Baseball and Recreation Field.

Sports Camp Hours 12:15pm-3:15pm

COMBO CAMP (AGES 5 – 13) This camp combines our Traditional and Sports Camp programs. Your camper will arrive at Pouch Camp at 9:00am where they will spend the first half of their day. The locations for each camp will alter-nate between the South Shore and Broadway Branches (please see camp description for location and sport de-tails). Your camper will be transported by bus to his/her selected camp and return to Pouch Camp for regular dismissal each day at 4:00pm.

Combo Camp Hours 9:00am – 4:00pm

COUNSELOR–IN-TRAINING (AGES 14-16) Our 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. CIT is designed to give teens who are interested in one day becoming a camp counselor or leaders in the community, a head start on that experience. Each of these selected teens will have an opportunity to attain valua-ble training to further their knowledge of working with youth in a recreational set-ting. All the while, we focus on treating these campers as professionals, giving them opportunities to discover their leadership potential and explore their strengths. A pre-registration interview with the Camp Director is required.

Counselor-In-Training Hours 9:00am – 4:00pm

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A SUMMER OF FUN 2012 Summer Day Camp Sessions and Fees

EARLY CHILDHOOD CAMPS (AGES 3 - 6)

Camp Rainbow & Camp Broadway Please check off the session(s) you would like your child to attend. For Extended Hours, please note if you are selecting AM, PM or BOTH.

SESSION DATES

Transition: June 11 – June 22

Session 1: June 25 – July 6

Session 2: July 9 – July 20

Session 3: July 23 – August 3

Session 4: August 6 – August17

FEES PER SESSION MEMBER

5 Full Days $382

3 Full Days $286

2 Full Days $202

5 Half Days $255

3 Half Days $150

2 Half Days $106

PROGRAM PARTICIPANT

5 Full Days $408

3 Full Days $310

2 Full Days $222

5 Half Days $310

3 Half Days $176

2 Half Days $134

EXTENDED HOURS

5 DAY AM: $52 PM: $92 BOTH: $122

3 DAY AM: $42 PM: $72 BOTH: $92

2 DAY AM: $34 PM: $48 BOTH: $66

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YMCA DAY CAMP SESSION DATES

Please check off the session(s) you would like your child to attend.

SESSION LOCATION DATES Transitional Pre-Camp: Pouch Camp June 25 – June 29 Session 1: Pouch Camp July 2 – July 13 Session 2: Pouch Camp July 16 – July 27 Session 3: Pouch Camp July 30 – August 10 Session 4: Pouch Camp August 13 – August 24 Transitional Post-Camp: South Shore Branch August 27 – August 31

MEMBER PROGRAM PARTICIPANT 5 Full Days $513 $564

3 Full Days $309 $338

Transitional Pre-Camp $256 $282

Transitional Post-Camp $256 $282

Counselor-In-Training $336 $394

TRADITIONAL DAY CAMP (Per session fees / 3-day option available M/W/F/only. )

SPECIALTY CAMP (Per session fees. / 5-day option only. )

COMBO CAMP (Per session fees / 5-day option only. )

PROGRAM SESSION LOCATION TYPE OF CAMP MEMBER PARTICIPANT 1 Broadway Swim $573 $617

2 South Shore Swim $573 $617

3 Broadway Basketball $573 $617

4 South Shore Soccer $573 $617

4 South Shore Basketball $573 $617

PROGRAM SESSION LOCATION TYPE OF CAMP MEMBER PARTICIPANT 1 Broadway Swim $331 $375

2 South Shore Swim $331 $375

3 Broadway Basketball $331 $375

4 South Shore Soccer $331 $375

4 South Shore Basketball $331 $375

CAMP EXTENDED HOURS (Per session fees. )

5 DAY AM: $177 PM: $177 BOTH: $259

3 DAY AM: $107 PM: $107 BOTH: $158

CAMP TRANSPORTATION (Per session fees. Available only for 5-day campers)

One-way AM: $200 One-way PM: $200 AM & PM: $300

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REGISTRATION FORM

CAMPER INFORMATION

Child’s Name Age D.O.B.

Female Male

Medical on File? Yes No (Must be on file prior to the first day of camp)

Mailing Address Apt.#

City State Zip

Home Phone ( )

School Name Grade Completed in June 2012

T-Shirt Size Child: S M L Adult: S M L XL

PARENT INFORMATION

Mother’s Name Email:

Work Phone ( ) Cell Phone ( )

Father’s Name Email:

Work Phone ( ) Cell Phone ( )

EMERGENCY CONTACTS

Name Relationship

Phone No. ( ) ______

Name Relationship

Phone No. ( ) ______

Name Relationship

Phone No. ( ) ______

At dismissal, the following people are authorized to pick up my child:

(We will not release your child to anyone not listed below without your written consent.)

1.

2.

3.

4.

5.

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REGISTRATION FORM (continued)

IF MEDICAL CARE IS NEEDED

Doctor’s Name:__________________________________________ Phone Number:______________________________ Does your child have any allergies? Please list them here: ________________________________________________________________________________________________________________ Is your child currently taking any medication? (If so, list type and what for): ________________________________________________________________________________________________________________ I am the legal parent/guardian of ______________________________ and do hereby give my permission for any medical treatment deemed necessary in case of an emergency. All information concerning your child will be available to the Camp Supervisory Staff as well as their Counselors, at the discretion of the Camp Director. I acknowledge that I have received the Parent Handbook and Health Examination Form to be returned before the child attends camp. I assume all financial responsibilities for my child. I understand that camp deposit and registration fees are nonrefundable. I give permission for my child to attend field trips under the supervision of the Staten Island YMCA staff. My child is permitted to participate in all camp activities as described in the camp brochure and Parent Handbook. STANDARD RELEASE FORM I HEREBY CONSENT to the use, publication, and display, by or on behalf of the Staten Island YMCA, any photograph, digital image or videotape and any reproduction thereof in which I or my minor child may be portrayed or identified by name. It is understood that the YMCA of Greater New York and member organizations may use, publish and display such photographs or digital images or reproductions thereof, in whole or in part, for any business purpose in their individual discretion. I waive all claim for any compensation for such use. I understand that my child will participate in all camp activities. _______________________________________________________________ _____________________________ Signature Date

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STATEN ISLAND YMCA MEDICAL FORM (This side to be filled in by parent before presentation to physician)

/ / M F

Child’s Last Name First Name Date of Birth Sex

Parent or Guardian _________ Phone

Place of Employment: (Father) Phone

Place of Employment: (Mother) Phone

In case of emergency, notify: Phone

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

1. _________ Phone

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, giving approximate dates)

Ear Infections Allergies Diseases Rheumatic Fever

Convulsion Diabetes Behavior Asthma Hay Fever

Ivy Poisoning Insect Stings Penicillin Other Drugs

Chicken Pox Measles Mumps German Measles

Dates:

Other Contagious Illnesses:

Other Past Illnesses:

Operations or Serious Injuries (Dates):

Chronic or Recurring Illness:

Any specific activities to be encouraged?

Conditions that require activity to be restricted?

Permissions for all program activities unless otherwise noted by Dr.

Appliance worn (glasses, contacts, etc.):

Medication taken:

Suggestion from Parent/Guardian:

CONSENT FOR EMERGENCY MEDICAL TREATMENT

I do hereby give authority to the Staten Island YMCA Summer Camp staff to

obtain necessary emergency medical treatment for my child with the

understanding that the family will be notified as soon as possible.

Name: Signature:

Relationship: Date: Telephone:

Department of Health The City of New York Bureau of Inspections

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STATEN ISLAND YMCA MEDICAL FORM (To be filled out by your physician)

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 Camp.

MEDICAL EXAMINATION - To be filled out by licensed physician.

Examination is acceptable when performed no more than 6 months prior to arrival at camp.

Codes: S = Satisfactory X = Not Satisfactory (Explain) 0 = 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 Abnormal Finding and/or Handicapping Conditions:

Has child ever received products containing horse serum?

Allergy: (Please specify)

Recommendations and restrictions while in camp.

Special Diet: Special Medicine (name it):

Is parent/guardian sending special medicine?

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. Telephone _____ Address ________ Examining Physician (Signature)

Date of Examination Physician’s Name (Please Print)

IMMUNIZATION HISTORY - This is a record of dates of basic immunization and

most recent booster doses. Type Date Date Date Date Date

DtaP, DTP or TD

OPV/IPV

MMR

Hem. Influenza Type B

Hepatitis B

Varicella

Other (Specify):

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

• Challenge Courses • Teambuilding

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

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