YMCA of Western North Carolina Corpening Memorial Branch
SUMMER DAY CAMP 2012 REGISTRATION CHECKLIST
The following information must be received before a child is able to start the program. Please note that many programs fill quickly, and early registration is recommended. There is a one week waiting period from the date the completed application is received until the date the child is able to start the program. Incomplete forms can elay a childs start date.
Forms Youth Information Form - You are required to complete a new Youth Information Form annually. Please note that we cannot use the form from the previous summer camp or school year. However, we can use this Summer Day Camp form for the upcoming school year per your request when you register for the 2012-2013 Afterschool Program. Summer Day Camp and Afterschool Policy Signature Form Please read our policies and procedures. Parent signature required. Camp Selection Form - Select the camp dates you would like your child to attend. Individualized Care Plan Form (Optional) Please complete if you noted on the Youth Information Form that your child will be taking a prescription medication at the Y program, has a special need/disability. Discipline and Behavior Management PolicyPlease read, sign, and return Application for C.I.T. Camp (If Rising 9th through Rising 12th Grade) - C.I.T. (Counselor In Training Camp) is by application only. Only qualified applicants will be invited to camp. Please check if submitting multiple registrations and list the names of the children: ____________________________________________________________________ Current Copy of Immunization Record - We can use the immunization record on file if the information is the same and there are no updates. Current Photo of Child (please place on the Youth Information Form in the spot labeled photo.)
*Child Care Subsidy Vouchers (optional)
*YMCA Financial Assistance Application (optional)
Registration Fee and Deposit
The Registration Fee and Deposit of $15 per week is due upon registration to secure your childs spot. The deposit will be credited towards your weekly balance. The first 50 people to register will get the registration fee waived!!
Registration Fee: $35 per child Weekly Deposit:
Payment Method:
or
$50 per family
Attending ________ # of weeks x $15/week = $____________ due Cash
Check # _______
Money Order Credit Card Other
_____________
Total Payment Amount Enclosed Now $ ___________
Parent/Guardian Signature______________________________________
*Weekly Balance
Your balance for each week of camp is due the Friday of the previous week to the Front Desk by 6pm.