2
Please indicate ALL sessions your child will be attending each week, including Wrap Around Camp. Entering Grades in Fall June 18 - 22 June 25 - 29 July 2 - 6* July 9 - 13 July 16 - 20 July 23 - 27 July 30 - Aug. 3 Aug. 6 - 10 Aug. 13 - 17 Aug. 20 - 24 Aug. 27 - 31 QUEST Without Wrap Around Camp 9:00am - 4:00pm 6-9 With Wrap Around Camp 7:00am - 6:00pm Bellevue Family YMCA Coal Creek Family YMCA Sammamish Community YMCA Snoqualmie Valley YMCA JR. LIFEGUARD CAMP Without Wrap Around Camp 9:00am - 4:00pm 7-10 With Wrap Around Camp 7:00am - 6:00pm Bellevue Family YMCA Coal Creek Family YMCA Sammamish Community YMCA EXPEDITION: MOUNTAINS TO SOUND Expedition: Mountains to Sound** 9:00am - 4:00pm 8-12 *No camp July 4. **Expedition: Mountains to Sound Camp runs Monday-Thursday with an overnight Wednesday night. QUESTIONS? Regional Offices 425 644 8417 Bellevue Family YMCA 425 746 9900 Coal Creek Family YMCA 425 282 1500 Sammamish Family YMCA 425 391 4840 Snoqualmie Valley YMCA 425 256 3115 [email protected] Sorry, no phone reservations accepted. Y summer program dates may be affected by school calendar changes due to unexpected weather or emergency situations. Please call your local Y or visit ykids.org for updated schedules. Additional Registration Information. You will be emailed or given additional forms to complete your child’s registration, which must be returned prior to your child’s first day of camp. For your convenience, remaining payment will be charged automatically to the card or checking account used for deposit the Saturday immediately preceding the camp session. Please contact your Y office if you need to make other arrangements. Payment and Cancellations. Automatic payments will run on Saturday between 12:01 am - 5:00 am. Cancellations or transfers require written notice by Wednesday at noon prior to the start of the camp session. After Wednesday, deposits are non-refundable and non-transferrable. The Y reserves the right to charge a $25 fee for multiple registration changes. RESERVE YOUR SPACE! Choose your child’s sessions. If you are enrolling more than one child, either photocopy the form or call your local branch for an additional copy. Reservation forms are also available on our website at ykids.org. Enter a $15 deposit for each session your child will attend. If you are reserving space for more than one child, enter $15 per session for each child. Complete the deposit form below. Deposit amount should match the total on the session form, reverse side. To reserve your space by mail, enclose the completed deposit form with your deposit or full payment by check. To reserve your space by email, scan and email reservation form to [email protected]. To reserve your space online, go to ykids.org. To reserve your space in person, come in to your local Y and register. We’re sorry, but no phone reservations are accepted. 3 2 1 Select location for Wrap Around Camp / Drop-Off & Pick-Up for each week of enrollment. Select location for Wrap Around Camp / Drop-Off & Pick-Up for each week of enrollment. Additional forms are available from your local Y, by visiting ykids.org or you may photocopy this form. Please print legibly. All deposits and payments will be credited to your family’s summer program fees. Parent / Guardian Home Phone Work Phone ( ) ( ) Parent / Guardian date of Birth (used for identification purpose only) / / / (month / date / year) Mailing Address City State Zip Email Parent / Guardian Signature Visa MasterCard Discover American Express Credit Card # Expiration Date (month/year) Cardholder’s Signature Date PAYMENT METHOD Please schedule my automatic payments as outlined in payment policy on cover. Please contact me to schedule my payments via the above referenced credit card. Please contact me to schedule payments through my bank account. TOTAL AMOUNT TO BE CHARGED TO CREDIT CARD $ ____________ Check Enclosed (Payable to YMCA of Greater Seattle) $ ____________ Cash (in person only) $ ____________ Please list only the last four digits of your credit card. Regional Offices 13750 Newcastle Golf Club Rd Newcastle, WA 98059 [email protected] Bellevue Family YMCA 14230 Bel-Red Rd, Bellevue, WA 98007 [email protected] Coal Creek Family YMCA 13750 Newcastle Golf Club Rd Newcastle, WA 98059 [email protected] Sammamish Community YMCA 831 228th Ave SE Sammamish, WA 98075 [email protected] Snoqualmie Valley YMCA 35018 SE Ridge Street Snoqualmie, WA 98065 [email protected] SUMMER CAMP 2018 RESERVATION FORM EASTSIDE YMCAs

JR. LIFEGUARD CAMP - ykids.seattleymca.orgykids.seattleymca.org/files/images/content/2018 Reservation Form... · LIFEGUARD CAMP Without Wrap Around Camp 9:00am - 4:00pm 7-10 With

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Page 1: JR. LIFEGUARD CAMP - ykids.seattleymca.orgykids.seattleymca.org/files/images/content/2018 Reservation Form... · LIFEGUARD CAMP Without Wrap Around Camp 9:00am - 4:00pm 7-10 With

Please indicate ALL sessions yourchild will be attending each week,

including Wrap Around Camp.EnteringGrades in

Fall June

18

- 2

2

June

25

- 2

9

July

2 -

6*

July

9 -

13

July

16

- 2

0

July

23

- 2

7

July

30

- A

ug. 3

Aug

. 6 -

10

Aug

. 13

- 1

7

Aug

. 20

- 2

4

Aug

. 27

- 3

1

QUESTWithout Wrap Around Camp 9:00am - 4:00pm 6-9

With Wrap Around Camp 7:00am - 6:00pm

Bellevue Family YMCA

Coal Creek Family YMCA

Sammamish Community YMCA

Snoqualmie Valley YMCA

JR. LIFEGUARD CAMPWithout Wrap Around Camp 9:00am - 4:00pm 7-10

With Wrap Around Camp 7:00am - 6:00pm

Bellevue Family YMCA

Coal Creek Family YMCA

Sammamish Community YMCA

EXPEDITION: MOUNTAINS TO SOUNDExpedition: Mountains to Sound** 9:00am - 4:00pm 8-12

*No camp July 4. **Expedition: Mountains to Sound Camp runs Monday-Thursday with an overnight Wednesday night.

QUESTIONS? Regional Offi ces 425 644 8417

Bellevue Family YMCA 425 746 9900Coal Creek Family YMCA 425 282 1500

Sammamish Family YMCA 425 391 4840Snoqualmie Valley YMCA 425 256 3115

[email protected], no phone reservations accepted.

Y summer program dates may be affected by school calendar changes due to unexpected weather or emergency situations. Please call your local Y or visit ykids.org for updated schedules.

Additional Registration Information. You will be emailed or given additional forms to complete your child’s registration, which must be returned prior to your child’s fi rst day of camp. For your convenience, remaining payment will be charged automatically to the card or checking account used for deposit the Saturday immediately preceding the camp session. Please contact your Y offi ce if you need to make other arrangements.

Payment and Cancellations. Automatic payments will run on Saturday between 12:01 am - 5:00 am. Cancellations or transfers require written notice by Wednesday at noon prior to the start of the camp session. After Wednesday, deposits are non-refundable and non-transferrable. The Y reserves the right to charge a $25 fee for multiple registration changes.

RESERVE YOUR SPACE!Choose your child’s sessions. If you are enrolling more than one child, either photocopy the form or call your local branch for an additional copy. Reservation forms are also available on our website at ykids.org.

Enter a $15 deposit for each session your child will attend. If you are reserving space for more than one child, enter $15 per session for each child.

Complete the deposit form below. Deposit amount should match the total on the session form, reverse side.

To reserve your space by mail, enclose the completed deposit form with your deposit or full payment by check.

To reserve your space by email, scan and email reservation form to [email protected].

To reserve your space online, go to ykids.org.

To reserve your space in person, come in to your local Y and register.

We’re sorry, but no phone reservations are accepted.

3

2

1

Select location for Wrap Around Camp / Drop-Off & Pick-Up for each week of enrollment.

Select location for Wrap Around Camp / Drop-Off & Pick-Up for each week of enrollment.

Additional forms are available from your local Y, by visiting ykids.org or you may photocopy this form. Please print legibly. All deposits and payments will be credited to your family’s summer program fees.

Parent / Guardian

Home Phone Work Phone

( ) ( )Parent / Guardian date of Birth (used for identifi cation purpose only)

/ / / (month / date / year)

Mailing Address

City

State Zip

Email

Parent / Guardian Signature

Visa MasterCard Discover American Express

Credit Card # Expiration Date (month/year)

Cardholder’s Signature Date

PAYMENT METHOD

Please schedule my automatic payments as outlined in payment policy on cover.

Please contact me to schedule my payments via the above referenced credit card.

Please contact me to schedule payments through my bank account.

TOTAL AMOUNT TO BE CHARGED TO CREDIT CARD $ ____________

Check Enclosed (Payable to YMCA of Greater Seattle) $ ____________

Cash (in person only) $ ____________

Please list only the last four digits of your credit card.

Regional Offi ces13750 Newcastle Golf Club RdNewcastle, WA [email protected]

Bellevue Family YMCA14230 Bel-Red Rd, Bellevue, WA [email protected]

Coal Creek Family YMCA13750 Newcastle Golf Club RdNewcastle, WA [email protected]

Sammamish Community YMCA831 228th Ave SESammamish, WA [email protected]

Snoqualmie Valley YMCA35018 SE Ridge StreetSnoqualmie, WA [email protected]

S U M M E R C A M P 2 0 1 8

RESERVATION FORMEASTSIDE YMCAs

Page 2: JR. LIFEGUARD CAMP - ykids.seattleymca.orgykids.seattleymca.org/files/images/content/2018 Reservation Form... · LIFEGUARD CAMP Without Wrap Around Camp 9:00am - 4:00pm 7-10 With

For

Inte

rnal

Use

:St

aff

Init

ials

___

___

Dat

e Re

ceiv

ed _

____

____

__

Dat

e ✓

d __

____

____

____

____

____

Pack

et S

ent

____

____

____

____

__

Tota

l num

ber o

f wee

ks fo

r Ch

ild: _

____

___

x $1

5 =

Tota

l Pro

gram

Dep

osit:

$ __

____

____

____

____

___

Please indicate ALL sessions yourchild will be attending each week,

including Wrap Around Camp.EnteringGrades in Fall Ju

ne 1

8 -

22

June

25

- 2

9

July

2 -

6*

July

9 -

13

July

16

- 2

0

July

23

- 2

7

July

30

- A

ug. 3

Aug

. 6 -

10

Aug

. 13

- 1

7

Aug

. 20

- 2

4

Aug

. 27

- 3

1

OUTDOOR DAY CAMP AT YMCA CAMP TERRYWithout Wrap Around Camp 8:45am - 4:00pm 1-6

With Wrap Around Camp 7:00am - 6:00pm

Bellevue Family YMCA

Benjamin Rush Elementary

Central Washington University - Sammamish Campus

Coal Creek Family YMCA

Horace Mann Elementary

Snoqualmie Valley YMCA

YMCA Camp Terry

CAMP TERRY PLUS AT YMCA CAMP TERRYNature’s Artists 9:00am - 4:00pm 4-7

Old School Adventures 9:00am - 4:00pm

All About Archery 9:00am - 4:00pm

Hot Off the Grill 9:00am - 4:00pm

Rocks & Ropes 9:00am - 4:00pm

Science, Streams and Salmon 9:00am - 4:00pm

Outdoor Survivial 9:00am - 4:00pm

With Wrap Around Camp 7:00am - 6:00pm

Bellevue Family YMCA

Benjamin Rush Elementary

Central Washington University - Sammamish Campus

Coal Creek Family YMCA

Horace Mann Elementary

Snoqualmie Valley YMCA

YMCA Camp Terry

DISCOVERY CAMPWithout Wrap Around Camp 9:15am - 3:45pm 1-3

With Wrap Around Camp 7:00am - 6:00pm

Bellevue Family YMCA

Benjamin Rush Elementary

Hazelwood Elementary

Samantha Smith Elementary

Sammamish Community YMCA

Snoqualmie Valley YMCA

KIDS ON THEIR WAY (Must be 5 the first day of camp)

Without Wrap Around Camp 9:15am - 3:45pm K

With Wrap Around Camp 7:00am - 6:00pm

Arbor School

Bellevue Family YMCA

Hazelwood Elementary

Snoqualmie Valley YMCA

*No camp July 4.

Please indicate ALL sessions yourchild will be attending each week,

including Wrap Around Camp.EnteringGrades in

Fall June

18

- 2

2

June

25

- 2

9

July

2 -

6*

July

9 -

13

July

16

- 2

0

July

23

- 2

7

July

30

- A

ug. 3

Aug

. 6 -

10

Aug

. 13

- 1

7

Aug

. 20

- 2

4

Aug

. 27

- 3

1

PRESCHOOL SPECIALTY CAMPS (No Camp on Friday)

At Bellevue Family YMCA 1:30 - 4:00pm PreschoolAges3-5Sports Of All Sorts

Little Picassos

Bugging Out

Heroes Among Us

Stir It Up

Exploring My Community

At Coal Creek Family YMCA 1:30 - 4:00pm

Little Picassos

Bugging Out

Sports of All Sorts

Heroes Among Us

Wild About Water

Stir It Up

At Sammamish Community YMCA 1:00 - 3:30pm

Wild About Water

Stir It Up

Sports of All Sorts

Little Picassos

Once Upon A Page

SPECIALTY CAMPSAt Ben Rush Elementary 9:15am - 3:45pm 3-6

Hip Hop Dance and Performance with Expioe Dance

Mind Craft Mashup with TechVenture

Super Science Sampler with Mad Science

Gymnastics with Jet Gymnastics

LEGO® Robotics with Robot U

Code Camp Games and Robotics with TechVenture

Magic Camp with Sterling Dietz

Fired Art with Studio 2 You

At Coal Creek Family YMCA 9:15am - 3:45pm 3-6

Code Camp Games and Robotics with TechVenture

Magic Camp with Sterling Dietz

LEGO® Robotics with Robot U

Hip Hop Dance and Performance with Expioe Dance

Crazy Chem Works with Mad Science

Gymnastics with Jet Gymnastics

From Trash to Art with Branch Out

At Samantha Smith Elementary 9:15am - 3:45pm 3-6

Gymnastics with Jet Gymnastics

Code Camp Games and Robotics with TechVenture

Fine Arts with Studio 2 You

LEGO® Robotics with Robot U

From Trash to Art with Branch Out

Eureka with Mad Science

At Snoqualmie Valley YMCA 9:15am - 3:45pm 3-6

From Trash to Art with Branch Out

Gymnastics with Jet Gymnastics

Digital Photography with TechVenture

Fired Arts with Studio 2 You

Spy Academy with Mad Science

With Wrap Around Camp 7:00am - 6:00pm

*No camp July 4.

Select location for Wrap Around Camp / Drop-Off & Pick-Up for each week of enrollment.

Select location for Wrap Around Camp / Drop-Off & Pick-Up for each week of enrollment.

Select location for Wrap Around Camp / Drop-Off & Pick-Up for each week.

Select location for Wrap Around Camp / Drop-Off & Pick-Up for each week of enrollment.

EAST

SID

E YM

CAs

- RE

SERV

ATIO

N F

ORM

201

8Pl

ease

pri

nt.

All i

nfor

mat

ion

is re

quir

ed.

Child

’s N

ame

(firs

t &

last

) ___

____

____

____

____

____

____

____

____

____

____

____

_ __

____

____

____

____

____

____

____

____

____

____

____

__

Pare

nt’s

Nam

e (fi

rst

& la

st) _

____

____

____

____

____

____

____

____

____

____

____

___

____

____

____

____

____

____

____

____

____

____

____

____

____

____

_

Dat

e of

Bir

th (m

onth

/day

/yea

r) __

____

/__

____

/__

____

M

/ F

____

____

Ph

one

( ___

____

___ )

____

____

____

____

____

____

__

Emai

l ___

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

Hea

lth

Conc

erns

and

/or A

llerg

ies

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

__

Plea

se li

st a

ny o

n-go

ing,

em

erge

ncy

or k

now

n as

-nee

ded

med

icat

ions

: ___

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

___

Beha

vior

al N

eeds

and

/or C

once

rns

____

____

____

____

____

____

____

____

____

____

____

____

__

Grad

e in

Fal

l 201

8 __

____

____

Su

nscr

een:

Y

prov

ided

I will

pro

vide

my

own

Com

fort

leve

l wit

h sw

imm

ing:

N

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omfo

rtab

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wat

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able

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ing,

but

not

sw

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sha

llow

wat

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sw

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in d

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th:

Smal

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ium

La

rge

Ad

ult:

Smal

l

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ium

Firs

t

Las

tFi

rst

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ast