ummer Camp 2013S - YMCALouisville.org...realizing their potential. At our camps, your child will make new friends, learn new skills and build self-esteem and confidence. A SENSE OF

WHAT’S COOL AT CAMP

A SENSE OF BELONGING Summer Camp 2013 YMCA OF GREATER LOUISVILLE

Register online at ymcalouisville.org by May 8 and receive a FREE backpack!

READY FOR SUMMER CAMP?

Berrytown Family YMCA 502 244 6187

ADVENTURE CAMP — AGES 5-14Summer Adventure Camp provides weekly sessions that allow campers the opportunity to be creative and have experiences that develop new skills and foster their imagination. Theme days help to create excitement throughout the summer.

Weekly Rates$110 (Facility Member) • $125 (Program Member)

Camp Dates / Hours / LocationJune 10 - August 16 • 7 a.m. - 6 p.m.

Berrytown Family YMCA • 1300 Heafer Road

For detailed descriptions of all camps, and to register, visit us at ymcalouisville.org.

A SENSE OF RELIEF!“ With so many great

activities and camp locations close to home and close to work, finding the right camp was easy.”

A SENSE OF SECURITY At YMCA Summer Camps, safety is our primary focus. We

carefully select, screen and train our staff to ensure that your child has a positive environment where they can be safe while having fun. All staff are certified in CPR/First Aid and follow firm guidelines for group ratios in order to ensure maximum leadership and individual attention. Our staff serve as role models for our four core values of Caring, Honesty, Respect and Responsibility.

A SENSE OF WELL-BEING We provide opportunities for children to make healthy choices.

Camp activities include field trips, swimming, games, sports and plenty of physical activity designed to encourage healthy living. Water is our drink of choice to provide proper hydration. Snacks are monitored for sugar and fat and include fresh fruits and vegetables. We encourage campers to be active each and every day.

A SENSE OF ACCOMPLISHMENT We believe that all kids deserve the opportunity to discover

who they are and what they can achieve. The values and skills learned early on are vital building blocks for quality of life. We work with your children every day to help them have fun, while realizing their potential. At our camps, your child will make new friends, learn new skills and build self-esteem and confidence.

A SENSE OF CONVENIENCE With over 30 locations throughout Jefferson, Bullitt and Oldham

counties, you are sure to find a camp that fits into your family’s busy schedule. Most camps are open from early morning until early evening, ensuring that children are engaged throughout the long summer days. Everyone is welcome at YMCA Summer Camps. We care for children with special needs, offer financial assistance and accept third party subsidy reimbursements at designated sites that are licensed by the State. Please visit ymcalouisville.org to find out more and decide which camp is right for you and your child.

All campers receive a FREE T-shirt.

Register online by May 8 at ymcalouisville.org and receive a FREE backpack!

Chestnut Street Family YMCA502 587 7405

CHESTNUT STREET SUMMER FUN DAY CAMP — AGES 5-13Children take stimulating field trips every week. They will explore the city parks and swim at our Calypso Cove water park while practicing social and decision-making skills under the guidance of their heroes – the Y camp counselors.

Fees and Weekly RatesRegistration Fee: $10 $117 (Facility Member) • $127 (Program Member)

Camp Dates / Hours / LocationsJune 10 - August 16 • 7 a.m. - 6 p.m.

Chestnut Street Family YMCA • 930 West Chestnut Street

Bullitt County Family YMCA502 955 6433

COOL CAMP — Ages 5-13 TEEN CAMP — Ages 11-14All camps will go on three field trips per week this summer. They will go swimming once per week and two alternative trips which could include bowling, libraries, movies, Fort Knox Water Park, Incredible Dave’s, etc.

Fees and Weekly RatesRegistration Fee: $25 through May 8; $45 after May 8 $117 (Facility Member) • $127 (Program Member)

Camp Dates / Hours / LocationsMay 21 - August 2 • 6 a.m. - 6 p.m. (Start date may change based on Bullitt County school calendar)

Cool Camp Pleasant Grove Elementary • 6415 Highway 44 East Old Mill Elementary • 11540 Highway 44 East Freedom Elementary • 4683 North Preston Highway Shepherdsville Elementary • 527 West Blue Lick Road

Teen Camp Pleasant Grove Elementary • 6415 Highway 44 East

Childcare Enrichment Program (CEP) and Creative Adventures502 637 1575

CEP — Grades K-8 CREATIVE ADVENTURES — Grades K-8CEP and Creative Adventures programs offer swimming and weekly field trips to local attractions such as museums, bowling, skating, and more. We offer rates based upon 1-3 days or 4-5 days of attendance. All sites are tentative and subject to change.

Fees and Rates Registration Fee: $25 through May 8; $45 after May 8

Weekly Rate (4-5 days)$117 first child; $107 additional children (Facility Member) $127 first child; $117 additional children (Program Member)

Weekly Rate (1-3 days)$102 first child; $94 additional children (Facility Member) $112 first child; $104 additional children (Program Member)

Camp Dates and HoursCEP — June 10 - August 9 • 7 a.m. - 6 p.m.

(limited sites August 12-15)

Creative Adventures — May 28 - August 9 • 7 a.m. - 6 p.m.

CEP SITE LOCATIONS: Northeast Area • Chancey Elementary School, 4301 Murphy Lane • Dunn Elementary School, 2010 Rudy Lane • Field Elementary School, 120 Sacred Heart Lane • Greathouse Elementary School, 2700 Browns Lane • Hite Elementary School, 12408 Old Shelbyville Road • Lowe Elementary School, 210 Oxfordshire Lane • Zachary Taylor Elementary School, 9620 Westport Road

Southwest Area • Carter Elementary School., 3600 Bohne Avenue • Cane Run Elementary School, 3951 Cane Run Road • Doss High School, 7601 St. Andrews Church Road • Olmsted South Middle School, 5650 Southern Parkway • Kerrick Elementary School, 2210 Upper Hunters Trace • Minors Lane Elementary School, 8510 Minors Lane • Stuart Elementary School, 4601 Valley Station Road

Downtown Area • Coleridge Taylor Elementary School,

1115 West Chestnut Street • Noe Middle School, 121 West Lee Street

Southeast Area • Farmer Elementary, 6405 Gellhaus Lane • Highland Middle School, 1700 Norris Place • Smyrna Elementary, 6401 Outer Loop • Thomas Jefferson Middle School, 1501 Rangeland Road • Tully Elementary, 3300 College Drive • Watterson Elementary, 3900 Breckinridge Lane

CREATIVE ADVENTURES SITE LOCATIONS: • Christian Academy English Station, 711 South English Station Road • St. Leonard Catholic School, 440 Zorn Avenue

TEEN SCENE — AGES 15-21Teen Scene is for special needs teens ages 15-21. For more information on fees, location, program registration and availability please call 502.637.1575. Space is limited.

CEP is a partnership with Jefferson

County Public Schools

Northeast Family YMCA502 425 1271

Camp FeesDeposit for all Northeast Camps - $25 per child, per week

CAMP ALL STAR – AGES 3-5A half-day camp with sports, games, songs and swimming.


Camp Dates / Hours / LocationJune 10 - August 16 • 9 a.m. - 2 p.m.Northeast Family YMCA • 9400 Mill Brook Road

KAMP KERMIT – AGES 3-5A full day camp with weekly themes, crafts and special events.


Camp Dates / Hours / LocationJune 10 - August 16 • 7 a.m. - 6 p.m.Location TBD

CAMP RISING STAR – AGES 5-6A camp with sports, swimming, reading and field trips.


Camp Dates / Hours / LocationJune 3 - August 16 • 7 a.m. - 6 p.m.Northeast Family YMCA • 9400 Mill Brook Road

SPORTS DAY CAMP – AGES 6-11Sports themes plus traditional camp activities like swimming, field trips and crafts.


Camp Dates / Hours / LocationJune 10 - August 9 • 7 a.m. - 6 p.m.Westport Traditional Middle School • 8100 Westport Road

SUMMER DAY CAMP – AGES 6-11A traditional outdoor camp experience with hiking, canoeing, fishing, archery, water trampoline and more.


Camp Dates / Hours / LocationJune 3 - August 16 Camp Drop off: 7 a.m. - 8:15 a.m. Pickup: 5 p.m. - 6 p.m.Drop Off and Pick Up at the NE Y. Camp activities at Cedar Ridge.

MOVIN’ ON – AGES 11-14This camp is designed specifically for middle school youth. Campers have the opportunity to plan their own field trips and events each week.


Camp Dates / Hours / LocationJune 10 - August 9 • 7 a.m. - 6 p.m.Westport Traditional Middle School • 8100 Westport Road

CIT (Counselor in Training) – AGES 12-15A unique leadership development program aimed at teaching youth job skills and helping them discover their potential. Application required.


Camp Dates / Hours / LocationJune 10 - August 16 • 7 a.m. - 6 p.m.CITs will be assigned to various Northeast Camps

NE SPORTS SKILL DEVELOPMENT – AGES 6-16Includes lacrosse, field hockey and sports conditioning. Great for improving skills before fall sports tryouts.


Camp Dates / Hours / LocationJune 10 - August 16 • 9 a.m. - 12 p.m. UPS Fields • 1400 North Hurstbourne Parkway

A SENSE OF FUN!At Y camps, children enjoy a variety of imaginative activities that nurture their spirits, challenge their minds and strengthen their bodies.

Save time and register online at ymcalouisville.org.

KIDVENTURE CAMP — Ages 5-10 TEEN EXTREME CAMP — Ages 11-14Our Summer Camps give kids the opportunity to explore nature, try new things, develop their creativity, take field trips and make lasting friendships and memories. We provide youth with supervised activities that teach core values and leadership skills.

Fees and Weekly RatesDeposit: $25 per child, per week $130 (Facility Member) • $147 (Program Member)

Camp Dates / Hours / LocationMay 28 - August 9 • 7 a.m. - 6 p.m.

Oldham County Family YMCA (Indoor Arena) 20 Quality Place, Buckner, KY

Oldham County Family YMCA502 222 9358

Southeast Family YMCA 502 491 9622

SUMMER DAY CAMP — AGES 5-12Summer Day Camp at the Southeast Y is an adventure like no other! Each day is different as our campers make new friends, play exciting games and try new activities. Each week is based on an exciting theme and features field trips, swimming and roller skating. Our camp kids expand their minds and keep their bodies moving while building great relationships!

Fees and Weekly RatesDeposit - $10 per child per week $125 (Facility Member) • $146 (Program Member)


Southeast Family YMCA • 5930 Six Mile Lane

CIT (Counselor in Training) – AGES 12-14Youth learn important leadership development skills. Details and application available online.

Southwest Family YMCA502 933 9622

KAMP KERMIT– AGES 4-5 SUMMER DAY CAMP – AGES 6-14Southwest Y Camps offer a fun and active camp experience for your child! Campers will build friendships, learn new skills, play games, take exciting field trips, enjoy daily theme-based activities and get lots of time in the pool!

Fees and Weekly RatesRegistration Fee: $25 $121 (Facility Member) • $137 (Program Member)


Southwest Family YMCA • 2800 Fordhaven Road

Camp Piomingo800 411 5822

OVERNIGHT CAMP — AGES 6-16Nestled in the beautiful woods of Otter Creek Outdoor Recreational Area, Camp Piomingo develops independence and builds interpersonal and leadership skills. Let our overnight camp give your child an appreciation of nature, the opportunity to build more self-esteem and make new friends all in a safe, fun and nurturing environment!

Camp Dates / LocationJune 9 - August 2 • Brandenburg, KY

Visit ymcacamppiomingo.org to find out more today!

REGISTRATION

First name Middle initial Last name

Date of Birth / / Race Gender M F Age Grade in Fall 2013

Physical conditions/special needs Medications/allergies

To better serve your child, please indicate if he/she has been diagnosed with any of the following: ADD/ADHD Convulsions Bleeding/Clotting Disorders Autism Aspergers Fragile X Cerebral Palsy Bipolar Disorder Tourettes Rhett Syndrome Down Syndrome Chronic Health Problems Asthma/Severe Allergies Diabetes Heart defect/disease Other

Does this child have an IEP (Individual Education Plan)? Yes No

First name Middle initial Last name

Date of Birth / / Race Gender M F Age Grade in Fall 2013

Physical conditions/special needs Medications/allergies

To better serve your child, please indicate if he/she has been diagnosed with any of the following: ADD/ADHD Convulsions Bleeding/Clotting Disorders Autism Aspergers Fragile X Cerebral Palsy Bipolar Disorder Tourettes Rhett Syndrome Down Syndrome Chronic Health Problems Asthma/Severe Allergies Diabetes Heart defect/disease Other

Does this child have an IEP (Individual Education Plan)? Yes No

CAMPER Must be siblings to register on the same registration

2nd

1st

PARENT/GUARDIAN

Name Relationship to child

Address City State Zip

Date of Birth / / Employer

Phone (Work) (Cell) (Home)


Address City State Zip

Date of Birth / / Employer


2nd

1st

EMERGENCY CONTACT/AUTHORIZED PICK-UP Anyone picking up your child must be at least 18 years of age or older. A picture ID is required at pick-up.

In addition to the parents/guardians listed above, I authorize the following to pick up the child/children and or be contacted in an emergency:





2nd

1st

Insurance Carrier Policy Number

Physician Name Phone

PHYSICIAN/INSURANCE INFORMATION

EMAIL To receive important program updates and confirmation

To register for summer camps, submit the completed registration form and the deposit/registration fee. CEP, Creative Adventures, Bullitt County and Chestnut Street participants must also provide a copy of their immunization record and recent photo.

Be sure to fill out both sides of the registration form.Or save time and register online at ymcalouisville.org. For assistance, call 502.582.3623.

All campers receive a FREE T-shirt. Register online at ymcalouisville.org by May 8 and receive a FREE backpack!

SUMMER 2013 CAMP REGISTRATION (you may also register online at ymcalouisville.org)

CAMP/SESSION CHOICES Please check the session dates required. Write in the name of the camp that you select for that session and the corresponding deposit. IMPORTANT! In order to reserve a space in the camp(s) of your choice, a non-refundable deposit or registration fee is required. Deposit and registration fee amounts vary from camp to camp.

Check here if either parent is School partnership employee YMCA employee YMCA family facility member Financial assistance recipient 3-C recipient

I am currently on automatic draft. Please use the account on file ending in _____ _____ _____ _____ to draft my account for registration

fee(s)/deposits and to set up my weekly payments. Authorized account holder signature: ____________________________________________

I am authorizing a NEW bank draft from my checking account and I have attached a voided check.

I am authorizing a NEW credit card draft and I have provided all the information below:

Credit Card Type: Visa MasterCard Discover

Name on card Authorized cc signature

Card number Expiration date

Billing street address Billing zip code

I have the legal authority to sign up the child/children named on this form and to the best of my knowledge; the information on this application form is complete and accurate. I further understand that this is an application and the named child/children’s participation is contingent upon space being available in the program(s) in which I want the child to participate. I also understand that once my application is confirmed, I must complete payment(s) by the deadlines of said program(s). I understand that the YMCA prohibits staff members from being alone with children they meet in YMCA programs outside of the YMCA. This includes but is not limited to baby-sitting, tutoring, sleep-overs, etc. This health history is correct as far as I know, and the child herein described has my permission to engage in all activities and field trips except as noted by me. In the event I cannot be reached in an emergency, I hereby give permission to the director of the program or designee to secure emergency medical services, including transportation and medical care. I also give permission for the attending physician to order injections, anesthesia or surgery for this child as named above. I understand that medical and accident insurance is the responsibility of the parent or guardian.

The YMCA has permission for my children to be photographed and/or interviewed for promotional purposes Yes No

Signature of Parent/Guardian Date

PAYMENT INFORMATION Please check one.

Total Deposits/Registration Fees

CEP PARTICIPANTS Please indicate your weekly schedule. 1-3 Days 4-5 Days

ANNUAL GIVING I would like to help a child attend YMCA Summer Camp Please indicate your gift amount here. It will be added to your total. $10 $25 $50 $100 Other/please contact me

A) May 20-24

B) May 28-31

C) June 3-7

D) June 10-14

E) June 17-21

F) June 24-28

G) July 1-5

H) July 8-12

I) July 15-19

J) July 22-26

K) July 29-Aug 2

L) Aug 5-9

M) Aug 12-16

WEEK CAMP NAME CAMP LOCATION DEPOSIT/REGISTRATION FEE

Name

CAMPER

2nd

A) May 20-24

B) May 28-31

C) June 3-7

D) June 10-14

E) June 17-21

F) June 24-28

G) July 1-5

H) July 8-12

I) July 15-19

J) July 22-26

K) July 29-Aug 2

L) Aug 5-9

M) Aug 12-16

WEEK CAMP NAME CAMP LOCATION DEPOSIT/REGISTRATION FEE

Name

CAMPER

1st

YMCA OF GREATER LOUISVILLE 545 South Second StreetLouisville, Kentucky 40202

A SENSE OF EXCITEMENT Summer Camp 2013 YMCA OF GREATER LOUISVILLE

• 2013 SUMMER CAMP KICKOFF •Each location

will have a CAMP KICKOFF

where you can meet the camp

staff, get camp information and

pick up a camper T-shirt. Visit

us at ymcalouisville.org for

specific locations, dates

and times.WHAT’S COOL AT CAMPBerrytown Family YMCA • Inflatable Water Slide • Kids Cafe • Arts & Crafts • Field Trips

Bullitt County Family YMCA • Clubs • Swimming • Field Trips • Guest Speakers

Chestnut Street Family YMCA • Summer Reading • Camp Piomingo Overnight • Swimming (Calypso Cove) • Field Trips & Kids Cafe

Northeast Family YMCA • Sports Camps • Canoeing • Water Trampoline • Swimming (Calypso Cove)

Oldham County Family YMCA • Annual Overnight • Field Trips • Swimming • Biking Our Nature Trail

Southeast Family YMCA • Gaga Ball • Educational Fun • Swimming • Field Trips

Southwest Family YMCA • Bike Riding & Rock Wall • Gaga Ball • Swimming • Field Trips

Camp Piomingo • Overnight Camp • Outdoor Adventure • Swimming•EquestrianPrograms

CEP / Creative Adventures • Summer Reading • Educational Fun • Field Trips • Swimming (Calypso Cove)

Visit us today at ymcalouisville.org. Sites fill up quickly!

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ummer Camp 2013S - YMCALouisville.org...realizing their potential. At our camps, your child will make new friends, learn new skills and build self-esteem and confidence. A SENSE OF