School’s Out Days Sample Schedule: 7:00 - 9:00am Arrival, Morning Snack & Free Play 9:00 - 10:30am Large Group Activity 10:30am - 12:00pm Open Gym Time 12:00 - 12:30pm Lunch 12:30 - 1:30pm Rest, Reading and Relaxation 1:30 - 3:30pm Open Swim or Enrichment Activity 3:30 - 5:00pm Crafts 5:00 - 6:00pm Free Time and Pick Up Please be there by 9:00 a.m. or contact the director for later arrival. Payment, Fees, and Other Information: $34/Full Day Return this completed form at any Y Front Desk no later than seven days prior to date enrolled.

Payment is due at the time of registration. WI Shares accepted. Provider #1000558721

Northside YMCA location #069

Program runs 7:00am - 6:00pm.

We need to have at least twelve children enrolled by the deadline to run the program.

Photo ID is required in order to pick up your child from School’s Day Out.

Northside YMCA Accepting Registrations for 2017-18 CAMP-IS-IN DAYS The YMCA offers supervised care for children ages 4-12, on days when many local schools are not in session. Enroll your child for a fun-filled day of activities including games, sports and crafts. Snacks are provided. Children must bring a cold lunch, swimsuit and a towel daily. *Additional child discount is not applicable.

[] My Child is in the YMCA School Age program for the 2018-19 school year. (No health history or emergency care plan needed.) [] My child has attended a School’s Out Day during the academic school year and I already have completed the health history form. [] My child is NEW this academic school year (August 2018-May 2019). (Must complete health history and emergency care plan-form attached)

School’s Out Days Please check desired dates:

[ ] September 28 [ ] January 25

[ ] October 12 [ ] February 15

[ ] October 19 [ ] February 18

[ ] October 22 [ ] February 19

[ ] November 6 [ ] March 8

[ ] November 16 [ ] March 15

[ ] November 26 [ ] March 18

[ ] December 7 [ ] April 2 [ ] December 26 [ ] April 15

[ ] December 27 [ ] April 16

[ ] December 28 [ ] April 17

[ ] January 2 [ ] April 18

[ ] January 3 [ ] April 19

[ ] January 4 [ ] April 22

[ ] January 21

We need to have at least twelve (12) children enrolled by the deadline to run the program. Families will be charged for all days checked unless schedule change is given to a Y staff member seven (7) days prior to schedule change.

_____________________________________ Parent/Guardian Signature Date _______________

Child’s Name______________________________ School Location______________________