Summer Camp 2015 YMCA OF GREATER LOUISVILLE

Sign up TODAY! Register online at ymcalouisville.org by May 6 and receive a FREE backpack!

BEST SUMMER EVER!Friendship, Accomplishment, Belonging

ymcalouisville.org

One week or the whole summer. Indoors and out. On their own or in a group. Archery to arts. Canoeing to cannonballs. Your kids will have an amazing experience this summer in a safe, inclusive and nurturing environment.

BEST SUMMER EVER!FRIENDSHIP • We’re here to inspire kids to work together and play together,

creating friendships that can last a lifetime.

• Staff are carefully chosen and trained to help children flourish socially, emotionally, cognitively and physically, role modeling our core values of caring, honesty, respect and responsibility.

ACCOMPLISHMENT • We are here to surround your kids with fantastic chances

to try new experiences, opportunities to try until they succeed. We show them all they can do when they believe in themselves.

• We’re here to surround every child with support, guidance and opportunities to learn and explore new talents and interests to discover what they are passionate about.

BELONGING • We’re here to make kids feel welcome. To help them quickly

realize YMCA Day Camp is a place where they belong and can be themselves.

• Over 30 locations available in Jefferson, Oldham and Bullitt Counties with options for financial assistance, third party pay and programs for children with special needs.

• The Y is for everyone. Financial assistance is available to make participation possible for all.

SUMMER LIKE THIS!Your Kids Have Never Had a

Chestnut Street Family YMCA502.587.7405

SUMMER FUN CAMP — AGES 5-13Camps will offer the opportunity to make new friends, learn to swim and explore Louisville. Campers will swim once a week and take two additional field trips each week to locations including skating, area museums and more (swim lessons will be included in camp). Weekly themes will also add excitement to a fun-filled, active summer. We are a Kids Cafe site offering breakfast, lunch and dinner daily this summer.

Fees and Weekly RatesRegistration Fee: $25 through May 6; $45 after May 6 $122 (Facility Member) • $132 (Program Member)

Camp Dates / Hours / LocationJune 1 - August 7 • 6:30 a.m. - 6 p.m. (Start date may change based on school calendar)

Chestnut Street Family YMCA • 930 West Chestnut Street

Bullitt County Family YMCA502.955.6433

COOL CAMP — AGES 5-13 All campers will swim once a week and take two additional field trips each week. Trip locations include bowling, skating, area water parks, museums and more. Weekly themes, dance classes, running club, chess club, bike club and fishing will also add excitement to a fun-filled, active summer.

Fees and Weekly RatesRegistration Fee: $25 through May 6; $45 after May 6 $122 (Facility Member) • $132 (Program Member)

Camp Dates / Hours / LocationsMay 26 - August 7 • 6 a.m. - 6 p.m. (Start date may change based on school calendar)

Brooks Elementary • 1430 Brooks Road Crossroads Elementary • 156 Erin Circle Pleasant Grove Elementary • 6415 Highway 44 East Roby Elementary • 1148 Highway 44 East

Childcare Enrichment Program (CEP) and Creative Adventures502.637.1575

CEP — GRADES K-8 CREATIVE ADVENTURES — GRADES K-8This summer your child has the opportunity to beat the heat and meet new friends as they explore the city on field trips, go swimming at the Northeast Y’s Calypso Cove Water Park and enjoy weekly, theme-based activities. 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 6; $45 after May 6

Weekly Rate (4-5 days)$122 first child; $112 additional children (Facility Member) $132 first child; $122 additional children (Program Member)

Weekly Rate (1-3 days)$112 first child; $107 additional children (Facility Member) $117 first child; $112 additional children (Program Member)

Camp Dates and HoursCEP — June 1 - July 31 • 7 a.m. - 6 p.m.

(limited sites August 3-7)

Creative Adventures — May 26 - August 7 • 7 a.m. - 6 p.m.

CEP SITE LOCATIONS: DowntownColeridge Taylor Montessori Elementary • 1115 West Chestnut Street

Northeast AreaChancey Elementary • 4301 Murphy LaneDunn Elementary • 2010 Rudy LaneField Elementary • 120 Sacred Heart LaneGreathouse Elementary • 2700 Browns LaneHite Elementary • 12408 Old Shelbyville RoadLowe Elementary • 210 Oxfordshire LaneZachary Taylor Elementary • 9620 Westport Road

Southeast AreaBloom Elementary • 1627 Lucia AvenueBlue Lick Elementary • 9801 Blue Lick RoadFarmer Elementary • 6405 Gellhaus LaneGoldsmith Elementary • 3520 Goldsmith LaneLuhr Elementary • 6900 Fegenbush LaneThomas Jefferson Middle • 1501 Rangeland RoadTully Elementary • 3300 College Drive

Southwest AreaCane Run Elementary • 3951 Cane Run RoadFoster Traditional Elementary • 1401 South 41st StreetKerrick Elementary • 2210 Upper Hunters TraceOlmsted Academy South • 5650 Southern ParkwayNoe Middle • 121 West Lee StreetTrunnell Elementary • 7609 St. Andrews Church Road

CREATIVE ADVENTURES SITE LOCATIONS:Christian Academy English Station • 711 South English Station Road

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 Valerie Slaten at 502.855.5390. Space is limited.

CEP is a partnership with Jefferson

County Public Schools

Northeast Family YMCA502.425.1271

Camp Fees: Weekly deposit for Rising Star, Sports Camp and CIT — $25 per child, per week;Cedar Ridge Day Camp — $50 per child, per week

RISING STAR – AGES 5-6* *Open to 4-year-olds turning 5 by August 1, 2015YMCA Camp Rising Star is filled with fun activities that include physical activity, social interaction, educational opportunities, leadership building, personal growth and creativity. We focus on honesty, caring, respect, and responsibility in all of our activities, from swimming to arts & crafts and games. Each week our activities will center around a different fun-filled theme.

Weekly Rates$122 (Facility Member) • $142 (Program Member)

Camp Dates / Hours / LocationJune 1 - August 7 • 7 a.m. - 6 p.m.Northeast Family YMCA • 9400 Mill Brook Road

SPORTS CAMP – AGES 6-14YMCA Sports Camps help children explore different games, sports and activities while learning the value of sportsmanship and fair play. Each week will include a fun theme to spark imagination while reinforcing the core values of honesty, caring, respect and responsibility.

Weekly Rates$122 (Facility Member) • $142 (Program Member)

Camp Dates / Hours / LocationJune 1 - August 7 • 7 a.m. - 6 p.m.Tentative location: Westport Middle School • 8100 Westport Road

CEDAR RIDGE DAY CAMP – AGES 6-14YMCA Cedar Ridge Day Camp offers the fun and freedom of being outdoors while learning new skills and making friends. Each week offers adventures that teach campers to respect and enjoy nature while having fun, hiking, exploring, arts and crafts, swimming, singing camp songs and canoeing. The camp staff helps build teamwork and provide challenging, safe activities for each group.

Weekly Rates$140 (Facility Member) • $160 (Program Member)

Camp Dates / Hours / LocationJune 1 - August 7 • 7 a.m. - 6 p.m.Drop-off and pick-up at Northeast Family YMCA • 9400 Mill Brook Road, or at Camp Cedar Ridge • 4010 Old Routt Road Camp activities at Camp Cedar Ridge

COUNSELORS IN TRAINING (CIT) AT CEDAR RIDGE – AGES 15-17The camp environment provides a unique opportunity for youth to build leadership skills, particularly in assisting counselors with younger campers. The goal of the CIT camp program is to teach the general skills of leadership that can be used at school, home and community (not just at camp.) The program will give teens age-appropriate challenges that build their skills, confidence and capacity for leading activities.

Weekly Rates$122 (Facility Member) • $142 (Program Member)

Camp Dates / Hours / LocationJune 1 - August 7 • 7 a.m. - 6 p.m.Drop-off and pick-up at Northeast Family YMCA • 9400 Mill Brook Road, or at Camp Cedar Ridge • 4010 Old Routt Road Camp activities at Camp Cedar Ridge

YMCA at Norton Commons502.882.9622

CAMP QUEST – AGES 5-10Camp Quest is a full day camp that will feature three field trips a week, plus swimming two days a week. Children will get to explore the outdoors, participate in activities, sports and other fun-filled, themed weekly adventures.

Fees and Weekly RatesDeposit: $25 per child, per week

$140 (Facility Member) • $160 (Program Member)

Camp Dates / Hours / LocationJune 1 - August 7 • 7 a.m. - 6 p.m.(Start date may change based on school calendar)

YMCA at Norton Commons • 11000 Brownsboro Road, Prospect, KY

Oldham County Family YMCA502.222.9358

Southwest Family YMCA502.933.9622

KAMP KERMIT– AGES 4-5 SUMMER DAY CAMP – AGES 6-14The Southwest Family YMCA is proud to offer a summer of fun and special events designed to help campers make new friends and build self-confidence. Children will get to spend the majority of their day enjoying the great outdoors. Weekly activities and trips are scheduled around themes, and campers will have the opportunity to go on two field trips a week as well as swim at least twice a week.

Fees and Weekly RatesRegistration Fee: $25 $122 (Facility Member) • $142 (Program Member)

Camp Dates / Hours / LocationJune 1 - August 7 • 7 a.m. - 6 p.m.

Southwest Family YMCA 2800 Fordhaven Road

Camp Piomingo800.411.5822

OVERNIGHT CAMP — AGES 7-17Overnight camp is a fantastic opportunity to make friends, build character and have tons of fun. For over 75 years, Piomingo has provided a safe environment where campers discover more about themselves while building friendships that will last a lifetime, under the leadership of great role models. One and two week traditional sessions, Equestrian camp and Teen Adventure camps are available.

CAMP PIOMINGO DAY CAMPServing Meade and Hardin Counties, our day camp has all the fun and activities of overnight camp – but you sleep in your own bed at night. Each week of camp comes with swim lessons and lunch is included. Pick up locations are in Brandenburg, Flaherty, and Radcliff. Pick up times begin at 7:30 am with drop off times extended to 5:30 pm.

Camp Dates / LocationJune 7 - August 1 • Brandenburg, KY

Register online or discover more at ymcacamppiomingo.org.

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 fun 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! Campers will get to spend the majority of their day enjoying the great outdoors.

COUNSELOR IN TRAINING (CIT) – AGES 13-15Youth learn important leadership development skills that can be used at school, home and the community.

Fees and Weekly RatesDeposit - $10 per child, per week

Summer Day Camp: $122 (Facility Member) • $146 (Program Member)

Counselor in Training (CIT): $95 (Facility Member) • $105 (Program Member)

Camp Dates / Hours / LocationJune 1 - August 7 • 7 a.m. - 6 p.m.

Southeast Family YMCA • 5930 Six Mile Lane

CAMP DISCOVERY — AGES 4-6 EXPLORERS — AGES 6-10 ADVENTURERS — AGES 11-14Campers will love bike riding on the nature trail, indoor and outdoor swimming opportunities, field trips, archery, Frisbee golf, playing in the GaGa pit, spending time with their friends and our annual overnight. Best of all, activities are designed toward the interest and skill levels appropriate for each age group, and all activities promote the four character development principles of honesty, caring, respect and responsibility.

Fees and Weekly RatesDeposit: $25 per child, per week $135 (Facility Member) • $160 (Program Member)

Camp Dates / Hours / LocationJune 9 - August 7 • 7 a.m. - 6 p.m. (Start date may change based on school calendar)

Oldham County Family YMCA (Drop-off and pick-up in the Indoor Arena) 20 Quality Place, Buckner, KY

YMCA Summer Day Camp 2015 Registration 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 6 and receive a FREE backpack!

EMAIL To receive important program updates and confirmation

METRO UNITED WAY INFORMATION

Number of family members living in the household: 1 person 2 people 3 people 4 people 5 people 6 or more people

School lunch classification: Free Reduced Full pay Ethnicity: Hispanic Non-Hispanic

Highest education level completed by head of household: Some high school GED High school diploma Some college Associate degree Bachelor’s degree Post graduate degree Other (please list)

Name Relationship to child

Address City State Zip

Date of Birth / / Employer

Phone (Work) Phone (Home)

Phone (Cell) Would you like to opt in for text message alerts? Yes No

If yes to above, please list your carrier

Name Relationship to child

Address City State Zip

Date of Birth / / Employer

Phone (Work) (Cell) (Home)

PARENT/GUARDIAN

1st

2nd

2nd

1st First name Middle initial Last name

Date of Birth / / Race Gender M F Age Grade in Fall 2014

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 2014

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)

1st

2nd

Insurance Carrier Policy Number

Physician Name Phone

Preferred hospital in the event child needs to be transported for medical attention:

PHYSICIAN/INSURANCE INFORMATION

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:

Name Relationship to child

Phone (Work) (Cell) (Home)

Name Relationship to child

Phone (Work) (Cell) (Home)

1st

2nd

A) May 26-29

B) June 1-5

C) June 8-12

D) June 15-19

E) June 22-26

F) June 29-July 2

G) July 6-10

H) July 13-17

I) July 20-24

J) July 27-31

K) Aug 3-7

SUMMER 2015 CAMP REGISTRATION — CAMP/SESSION CHOICES

Please indicate the session dates requested. 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. DATES MAY CHANGE DUE TO THE SCHOOL CALENDAR.

WEEK CAMP NAME CAMP LOCATION DEPOSIT/REGISTRATION FEE

Name

CAMPER

1st

Check here if either parent is JCPS 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 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

Total Deposits/Registration Fees

Name

CAMPER

2nd

A) May 26-29

B) June 1-5

C) June 8-12

D) June 15-19

E) June 22-26

F) June 29-July 2

G) July 6-10

H) July 13-17

I) July 20-24

J) July 27-31

K) Aug 3-7

WEEK CAMP NAME CAMP LOCATION DEPOSIT/REGISTRATION FEE

You may also register online at ymcalouisville.org

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

NORTHEAST CAMP CEDAR RIDGE Please check drop-off/pick-up location. Northeast YMCA Camp Cedar Ridge

ANNUAL CAMPAIGN 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

PAYMENT INFORMATION Please check one.

YMCA OF GREATER LOUISVILLE 545 South Second StreetLouisville, Kentucky 40202

THE Y’S DAY CAMP PROGRAM IS SO MUCH MORE THAN FUN AND PLAY!Come see why at our 2015 Summer Camp KickoffMeet the staff, get camp information and pick up a camper t-shirt. For locations, dates and times of the kickoff and to register for camp, visit us today at ymcalouisville.org. Sites fill up quickly!

AT YMCA SUMMER DAY CAMP... We know when kids discover what they can accomplish — learn and master skills, make new friends, and feel like they belong — they are developing the confidence, character and teamwork they need to be successful in life. We focus on these areas to help kids reach their full potential.