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Registration Starts Now! AT CAMP, I CAN! SUMMER CAMP GUIDE 2015 BRIDGEWATER YMCA HILLSBOROUGH YMCA SOMERVILLE YMCA BRANCHES OF THE SOMERSET COUNTY YMCA

Bridgewater YMCA, Hillsborough YMCA, Somerville YMCA Summer Camp Guide 2015

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We have over 60 different day camps to choose from! Camp schedules and registration forms are included in our camp guide.

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Page 1: Bridgewater YMCA, Hillsborough YMCA, Somerville YMCA Summer Camp Guide 2015

Registration Starts Now!

AT CAMP, I CAN!SUMMER CAMP GUIDE 2015

BRIDGEWATER YMCAHILLSBOROUGH YMCASOMERVILLE YMCABRANCHES OF THE SOMERSET COUNTY YMCA

Page 2: Bridgewater YMCA, Hillsborough YMCA, Somerville YMCA Summer Camp Guide 2015

“�Thank�you�for�making�our�son’s�first�year�at�camp�a�fantastic�time�filled�with�great�memories. Everyone was super nice, warm and welcoming.” – Denise

The Y is the perfect place for your children to spend their summer away from school. They’ll stay active and busy in our sports, arts, science and nature, and traditional camps. At Y camp, children can pursue their potential and explore new interests in a safe, nurturing environment. All children have the option of embarking on a weekly adventure. Your children will make lasting friendships and have fun discovering who they are and what they can do.

AT CAMP, I CAN MAKE FRIENDS!!

ABOUT OUR CAMPS With over 60 different camps to choose from, your child will be able to find the one that’s right for them. Our camps are for children entering grades K through 10. No matter which you choose, all camps reinforce the Y’s core values of caring, honesty, respect and responsibility.

ACA ACCREDITED We are accredited by the American Camp Association (ACA) which sets the highest standards for day camps in the nation. This important seal of approval means we comply with up to 300 health, safety and program quality standards set by the ACA (www.acacamps.org). We have gone to great lengths to provide a safe and quality environment.

LOCATIONS & HOURS Bridgewater, Hillsborough and Somerville. Camp day hours are 8:30 a.m. until 4:30 p.m. Pre- and post-camp care is available from 7 a.m. and/or until 6:30 p.m.

Y camp is open to all. Our full privilege members enjoy lower rates.

Page 3: Bridgewater YMCA, Hillsborough YMCA, Somerville YMCA Summer Camp Guide 2015

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AT CAMP, I CAN MAKE FRIENDS!!

TRADITIONAL CAMPSRemember when you were younger and couldn’t wait for summer so you could escape outside? Our traditional summer camp is a place where kids enjoy the fun and freedom of being outdoors while exploring the world around them. Through swim lessons, campers also will gain confidence in the water. In our traditional camps, children can discover nature, forge friendships, work together on daily activities and stay active, and most of all, have fun.

Discover nature. Swim. Be active.

Page 4: Bridgewater YMCA, Hillsborough YMCA, Somerville YMCA Summer Camp Guide 2015

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ENRICHMENT CAMPSWhether they’re studying bugs, carrying out a science experiment, learning to dance, designing jewelry or directing a video, our campers are inspired to pursue their passion. We encourage them to explore their creativity through hands-on, structured activities that will fill their day. They’ll also have the chance to swim. Designed for every age and ability, our unique enrichment camps allow your child to discover new interests and talents and shine as an artist, scientist, athlete or performer.

SPORTS CAMPSOur sports camps offer an active approach to camp. Blending skill development, fun activities and great games, the camps are designed for kids who want to try something new or improve in a sport they already love. At sports camp, kids will learn teamwork and build confidence. They’ll also swim and enjoy a variety of outdoor activities, making lasting friendships along the way.

Improve skills. Learn teamwork. Try something new.

AT CAMP I CAN... Dance. Carry out science experiments. Express myself. Get creative.

Page 5: Bridgewater YMCA, Hillsborough YMCA, Somerville YMCA Summer Camp Guide 2015

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“ The science-based enrichment programs were a huge hit. And I was thrilled my son came home expressing interest to be a camp counselor in the future.” – Dina

Page 6: Bridgewater YMCA, Hillsborough YMCA, Somerville YMCA Summer Camp Guide 2015

CAMP TIMBER at the BRIDGEWATER YMCA

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2015 SUMMER CAMP SCHEDULE

WEEK 6: 7/27 - 7/31 WEEK 7: 8/3 - 8/7 WEEK 8: 8/10 - 8/14 WEEK 9: 8/17 - 8/21 WEEK 10: 8/24 - 8/28

CAMP TRIP - Funplex $30

CAMP TRIP - Tomahawk Lake $30

CAMP TRIP - Rock Climbing$30

CAMP TRIP - Liberty Science Center $30

CAMP TRIP - Crayola Factory$30

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Splash CampGrades 2-4 $315/$330

Water GamesGrades 3-7 $315/$330

Eco-Expedition Grades 4-7 $320/$335

LEGO Space Adventure Grades 2-6 $320/$335

WEEK 1: 6/22 - 6/26 WEEK 2: 6/29 - 7/3 WEEK 3: 7/6 - 7/10 WEEK 4: 7/13 - 7/17 WEEK 5: 7/20 - 7/24

CAMP TRIP - AMF Bowling $30

CAMP TRIP - Turtle Back Zoo $30

CAMP TRIP - Rebounderz$30

CAMP TRIP - Branchburg Sports Complex $30

CAMP TRIP - Keansburg Amusement & Water Park

$30Traditional Camp

Grades 1-6 $265*/$280Traditional Camp

Grades 1-6 $265*/$280Traditional Camp

Grades 1-6 $265*/$280Traditional Camp

Grades 1-6 $265*/$280Traditional Camp

Grades 1-6 $265*/$280

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Water GamesGrades 3-7 $315/$330

Beetles, Bugs, & ButterfliesGrades 1-3 $320/$335

Splash CampGrades 2-4 $315/$330

Survival CampGrades 2-5 $320/$335

Creative Writing & DrawingGrades 3-7 $320/$335

CAMP FOR KINDERGARTNERS A fun summer learning experience awaits.

We blend learning and play in a full-day

program designed to prepare children for

entering kindergarten. Children will enjoy

weekly field trips, water play and swimming.

Call Hillsborough (908-369-0490) to

sign up for Y Prep camp or Somerville

(908-722-4567) to enroll in Jr. Y camp.

*Member rate

Camp director: Matt Gray, [email protected]

Page 7: Bridgewater YMCA, Hillsborough YMCA, Somerville YMCA Summer Camp Guide 2015

CAMP STAR at the HILLSBOROUGH YMCA

WEEK 6: 7/27 - 7/31 WEEK 7: 8/3 - 8/7 WEEK 8: 8/10 - 8/14 WEEK 9: 8/17 - 8/21 WEEK 10: 8/24 - 8/28

CAMP TRIP - Bridgewater Sports Arena / Fireball

Mountain $30

CAMP TRIP - Keansburg Amusement & Water Park

$30

CAMP TRIP- Liberty Science Center $30

CAMP TRIP - Rock Climbing $30

CAMP TRIP - Branchburg Sports Complex $30

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Y Sports Camp Grades 1-6 $265/$280

Y Sports Camp Grades 1-6 $265/$280

Y Sports Camp Grades 1-6 $265/$280

Y Sports Camp Grades 1-6 $265/$280

Y Sports Camp Grades 1-6 $265/$280

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Golf AcademyJV Gr 1-3 Varsity Gr 4-7

$315/$330

BowlingGrades 1-7 $315/$330

Varsity BasketballGrades 4-7 $315/$330

Varsity SoccerGrades 4-7 $315/$330

JV BasketballGrades 1-3 $315/$330

Cheer/DanceGrades 2-6 $315/$330

VolleyballGrades 3-7 $315/$330

JV BaseballGrades 2-4 $315/$330

Water GamesGrades 3-7 $315/$330

Wonders of WizardryGrades 3-7 $320/$335

Advanced Dance CampGrades 4-7 $320/$335

Video ProductionGrades 4-7 $320/$335

Robotics BGrades 2-6 $330/$345

C.S.I. CampGrades 3-6 $320/$335

Ooey Gooey CampGrades 1-4 $320/$335

Future Engineers JrGrades 2-4 $320/$335

Robotics AGrades 2-6 $330/$345

LEGO Mining and CraftingGrades 2-4 $320/$335

Creative Writing & DrawingGrades 3-7 $320/$335

Future VetsGrades 3-6 $320/$335

Advanced Art CampGrades 4-7 $320/$335

Eco-Expedition Grades 4-7 $320/$335

SculptingGrades 3-6 $320/$335

Model MakingGrades 2-5 $320/$335

Dragons, Fairies, & Princess Grades 1-3 $320/$335

Intermediate Art CampGrades 2-4 $320/$335

Magic CampGrades 2-5 $320/$335

Treasure Hunt Grades 1-4 $320/$335

Drama CampGrades 3-7 $640/$670

WEEK 1: 6/22 - 6/26 WEEK 2: 6/29 - 7/3 WEEK 3: 7/6 - 7/10 WEEK 4: 7/13 - 7/17 WEEK 5: 7/20 - 7/24

CAMP TRIP - Funplex $30

CAMP TRIP - AMF Bowling$30

CAMP TRIP - Crayola Factory / Dutch Springs $30

CAMP TRIP - Rebounderz$30

CAMP TRIP - Philadelphia Zoo / Turtle Back Zoo $30

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Y Sports Camp Grades 1-6 $265/$280

Y Sports Camp Grades 1-6 $265/$280

Y Sports Camp Grades 1-6 $265/$280

Y Sports Camp Grades 1-6 $265/$280

Y Sports Camp Grades 1-6 $265/$280

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Cheer Camp Grades 2-6 $315/$330

Varsity BasketballGrades 4-7 $315/$330

JV SoccerGrades 1-3 $315/$330

JV BasketballGrades 1-3 $315/$330

JV Soccer Grades 1-3 $315/$330

Water GamesGrades 3-7 $315/$330

SoftballJV Gr 1-3 Varsity Gr 4-7

$315/$330

Junior LifeguardsGrades 5-7 $315/$330

Splash CampGrades 2-4 $315/$330

Going for the GoldGrades 3-6 $315/$330

Photography Camp Grades 4-7 $320/$335

Video Production JrGrades 2-4 $320/$335

Beginner Dance Grades 1-3 $320/$335

MADEGrades 2-6 $320/$335

Intermediate Dance Grades 2-4 $320/$335

Future Teachers Grades 2-5 $320/$335

Galaxy Explorers Grades 3-6 $320/$335

Myth Testers Grades 3-6 $320/$335

Young EinsteinsGrades 2-4 $320/$335

Future EngineersGrades 5-7 $320/$335

Survival CampGrades 2-5 $320/$335

Where in the World?Grades 4-7 $320/$335

Enthusiastic Entrepreneurs Grades 4-7 $320/$335

Discover HillsboroughGrades 3-7 $320/$335

LEGO Amusement ParkGrades 3-6 $320/$335

Beginner Art CampGrades 1-3 $320/$335

Snakes and ScalesGrades 1-3 $320/$335

Green Thumbs UpGrades 2-5 $320/$335

Beetles, Bugs, & ButterfliesGrades 1-3 $320/$335

Dino CampGrades 1-3 $320/$335

Pure PaintGrades 2-5 $320/$335

Craft CampGrades 3-6 $320/$335

Culinary CreationsGrades 3-7 $320/$335

Game Show ShowcaseGrades 2-5 $320/$335

Extreme Room Makeover Grades 3-6 $320/$335

Fashion and Jewelry CampGrades 3-7 $640/$670

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2015 SUMMER CAMP SCHEDULE

*Member rate

Camp director: Matt Gray, [email protected]

Page 8: Bridgewater YMCA, Hillsborough YMCA, Somerville YMCA Summer Camp Guide 2015

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CAMP YAGUNA at the SOMERVILLE YMCA

WEEK 6: 7/27 - 7/31 WEEK 7: 8/3 - 8/7 WEEK 8: 8/10 - 8/14 WEEK 9: 8/17 - 8/21 WEEK 10: 8/24 - 8/28

CAMP TRIP - Liberty Science Center $30

CAMP TRIP - Funplex $30

CAMP TRIP - Keansburg Amusement & Water Park

$30

CAMP TRIP - Rebounderz $30

CAMP TRIP - AMF Bowling$30

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Drama Camp Grades 3-7 $320/$335

Drawing/Sketching Grades 4-7 $320/$335

Intro to Dance Grades 1-3 $320/$335

My First Camp (half-day) Grades K-1 $140/$155

Creative Storytelling Grades 1-4 $320/$335

LEGO Amusement ParkGrades 3-6 $320/$335

Mad Scientists Lab Grades 2-4 $320/$335

LEGO Mining and CraftingGrades 2-4 $320/$335

Super Snack Grades 4-7 $320/$335

Kidventure Camp Grades 3-7 $320/$335

Ooey Gooey Grades 1-3 $320/$335

Advanced Gymnastics Grades 1-9 $325/$340

Splash Camp Grades 2-4 $315/$330

Myth Testers Grades 3-6 $320/$335

Y Sports Grades 1-3 $315/$330

Tennis Camp Grades 2-5 $315/$330

Varsity Basketball Grades 4-7 $315/$330

Y Sports Grades 4-7 $315/$330

WEEK 1: 6/22 - 6/26 WEEK 2: 6/29 - 7/3 WEEK 3: 7/6 - 7/10 WEEK 4: 7/13 - 7/17 WEEK 5: 7/20 - 7/24

CAMP TRIP - TreeTop Adventure $30

CAMP TRIP - Crayola Factory $30

CAMP TRIP - Branchburg Sports Complex $30

CAMP TRIP - Philadelphia Zoo $30

CAMP TRIP - Rock Climbing $30

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Traditional Camp Grades 1-6 $265*/$280

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Jr Youth Leaders Grades 7-8 $230/$245

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Youth Leaders Grades 9-10 $215/$230

Edible Art Grades 1-3 $320/$335

2D Art Studio Grades 1-3 $320/$335

Sculpture Grades 3-5 $320/$335

Hip Hop Dance Grades 4-7 $320/$335

Fashion and Jewelry Grades 3-6 $320/$335

Survival Camp Grades 2-6 $320/$335

Crazy for Chemistry Grades 3 -6 $320/$335

Green Thumbs Up Grades 2-5 $320/$335

Beetles, Bugs & Butterflies Grades 1-3 $320/$335

Dino Dig Grades 1-3 $320/$335

Cheer/Tumble Grades 2-6 $325/$340

Splash Camp Grades 2-4 $315/$330

Gymnastics Grades 1-6 $325/$340

Discover Somerville Grades 2-6 $320/$335

Gymnastics Grades 1-6 $325/$340

JV Soccer Grades 1-3 $315/$330

Varsity Soccer Grades 4-7 $315/$330

JV Baseball Grades 1-3 $315/$330

JV Basketball Grades 1-3 $315/$330

Varsity Baseball Grades 4-7 $315/$330

2015 SUMMER CAMP SCHEDULE

*Member rate

Camp director: Jessica Brock, [email protected]

Page 9: Bridgewater YMCA, Hillsborough YMCA, Somerville YMCA Summer Camp Guide 2015

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PLEASE USE ONE FORM PER CHILD PER BRANCH. PLEASE PRINT.

CAMPER’S NAME: LAST FIRST

HOME ADDRESS: CITY: STATE: ZIP:

HOME PHONE: BIRTH DATE: GRADE IN FALL 2015: GENDER:

(Page 1 of 2)

BRIDGEWATER YMCA • HILLSBOROUGH YMCA • SOMERVILLE YMCA 2015 SUMMER CAMP REGISTRATION FORM

If mailing or dropping off, please do so with our Credit Card Authorization Form or a Check for the correct amount.

PARENT/GUARDIAN NAME: CITY: CELL #:

EMPLOYER/BUSINESS NAME: CITY: WORK #:

PARENT/GUARDIAN NAME: CITY: CELL #:

HOME ADDRESS: CITY: STATE: ZIP:

EMPLOYER/BUSINESS NAME: CITY: WORK #:

(Please indicate if a non-custodial parent has limits on visitation or pick-up. If a non-custodial parent has been denied visitation or has limited visitation by court order, a copy of the order must be given to the YMCA and kept on file as well as the divorce document awarding custody.)

PRIMARY E-MAIL: SECONDARY E-MAIL: (E-mail is our primary method of communicating information, including pre-camp information, weekly newsletters, schedules and any possible last minute changes throughout the summer. Family Memberships enable two email addresses. Please refer to our website for Camp Information & Parent Handbook.)

EMERGENCY NOTIFICATION AND ALTERNATE PICK-UP AUTHORIZATION: In cases of emergency, if after both primary guardians cannot be reached, please list any additional people who can be contacted and/or would be authorized to pick up your camper. Photo ID will be required. Those not listed here will not be authorized to pick up.

1. NAME: PHONE #: RELATION:

2. NAME: PHONE #: RELATION:

3. NAME: PHONE #: RELATION:

Each camp week requires a $60 deposit due at registration. Camp balances are due May 11, 2015 for Weeks 1-5, and June 8, 2015 for Weeks 6-10.

CAMP DATES

WEEK #

CAMP NAMEPLEASE REFER TO THE GRID FOR CAMP NAMES & PRICING DEPOSIT

CAMP FEETRIP FEE PRE-CAMP

$25POST-CAMP

$30 TOTAL WEEK COST

6/22 - 6/26 1 $60

6/29 - 7/3 2 $60

7/6 - 7/10 3 $60

7/13 - 7/17 4 $60

7/20- 7/24 5 $60

7/27 - 7/31 6 $60

8/3 - 8/7 7 $60

8/10 - 8/14 8 $60

8/17 - 8/21 9 $60

8/24-8/28 10 $60

TOTAL DEPOSIT: TOTAL BALANCE:

Member Non-Member

Page 10: Bridgewater YMCA, Hillsborough YMCA, Somerville YMCA Summer Camp Guide 2015

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PARENT/GUARDIAN AND Y AGREEMENTRULES FOR ACCEPTANCE AND PARTICIPATION IN CAMP – are the same for everyone without regard to race, color, national origin, sex, age or disability. It is understood that all campers will be treated as individuals and respect will be shown for differences in tastes, preferences, abilities and range of behavior patterns. The Y reserves the right to dismiss a child from camp whose needs we are not able to meet, who is a danger to themselves or others, or whose conduct is not in the best interest of the camp, without refund.

CURRENT MEMBERSHIP AND A $60 DEPOSIT PER WEEK ARE REQUIRED UPON REGISTRATION – Deposits are applied to the total camp bill. Registration requires a $60 non-refundable deposit per week, per child to be credited toward balance due. Refund policy: Deposits are non-transferrable. Refunds will be offered based on the following schedule: Full refund if cancellation is received by March 1 (including $60 weekly deposit and trip option fee). Refund of camp fee less $60 deposit and trip fee if cancellation is received by May 11. Refund of half the camp fee less the $60 deposit and trip fee if cancellation is received by June 8. No refund after June 8. Medical refunds will be considered in case of illness or injury lasting more than five days and will require a doctor’s verification. Anything less than that will be considered on a case by case basis. Weekly camp fees (not including pre, or post camp) will increase by $10 after June 8, and trip fees will increase by $5.

CAMP POLICIES & PROCEDURES – I will review and reinforce the camper conduct and camp policies expressed in the Camp Parent Handbook with my child prior to the start of camp. Campers and families not following the conduct policy may be suspended or expelled from camp with no refund. The Camp Parent Handbook is available at www.ymcasomersetvalley.org I also understand that it is my responsibility to read all camp newsletters sent via email which will include the details for trips I have registered my child for separately.

OTHER FEES – should they occur, include: a $25 late fee if payment is not made by the due date, a returned check fee of $25 to be paid immediately by cash or credit card, a $25 processing fee per request for any changes made after May 11, a late pick-up fee of $25 per 15 minute interval starting from your child’s scheduled pick up time. All requested changes and/or credit requests must be submitted in writing and in a timely manner.

PERMISSION TO TREAT – INFORMED CONSENT – By signing this agreement, I believe that my child is qualified physically, mentally and emotionally for camp and understand there is some risk involved in all physical activities. I agree to place my child in the care of the camp staff, subject to its program policies. I give permission for him/her to take part in all camp activities, including programming, swimming, walking trips, and field trips. In the event the responsible parents/guardians cannot be reached, I give my permission to the medical personnel selected by the camp to transport, hospitalize, secure proper treatment for, and to order injections, x-rays, routine tests, anesthesia or surgery for my child and to release any records for treatment, referral, billing and insurance purposes.

MEDIA RELEASE POLICY – I give the Y permission to use any and all photographs and/or videos taken of my child in camp activities in Y publicity. The Somerset Valley YMCA values the privacy of its members. No photos or videos of any type are to be made of any camp or staff member without the consent of the Y staff.

I HAVE READ ALL OF THE ABOVE INFORMATION AND I AM FULLY AWARE OF THE TERMS AND PRINCIPLES CONTAINED HEREIN. ALL QUESTIONS HAVE BEEN ANSWERED TO MY SATISFACTION. I AGREE THAT CERTAIN ACTIVITIES AT THE Y HAVE RISKS WHICH ARE INHERENT TO THE ACTIVITY. NO INSURANCE HAS BEEN INCLUDED IN MY MEMBERSHIP OR PROGRAM FEES. I FURTHER AGREE TO INDEMNIFY AND HOLD HARMLESS THE Y FROM ANY CLAIMS OR DEMANDS ARISING OUT OF ANY SUCH INJURIES AND LOSSES.

PARENT/GUARDIAN SIGNATURE: DATE:

CAMPER’S NAME: LAST FIRST

CAMPER HEALTH HISTORY:

LIST ANY CURRENT ALLERGIES OR DIETARY RESTRICTIONS:

LIST ANY CURRENT OR PAST MEDICAL TREATMENT THAT WOULD AFFECT YOUR CHILD’S DAY AT CAMP:

ARE THERE ANY ACTIVITIES YOUR CHILD SHOULD BE RESTRICTED FROM?

HAS THE CHILD RECEIVED ANY PSYCHIATRIC OR COUNSELING THERAPIES: YES / NO IF YES, PLEASE ATTACH A RELEASE FROM THE DOCTOR ATTESTING TO THE CHILD’S EMOTIONAL FITNESS TO ATTEND CAMP.

LIST ANY CURRENT MEDICATIONS (PRESCRIPTION AND OVER THE COUNTER):

REASONS FOR ABOVE MEDICATION:

Per NJ licensing and ACA requirements, medications to be administered at camp must be in original container accompanied by written and signed instructions from the parents or doctor on the Camp Medication Form. Campers may not carry medication at any time. Emergency medication such as epi-pens or inhalers will stay with your child’s lead counselor during their time at camp.

CURRENT IMMUNIZATIONS: Vaccinations are required by the NJ Department of Health and American Camp Association prior to camp attendance. Leave no blanks. We cannot use previously submitted information; information must be updated each year for licensing purposes. PLEASE LIST MOST RECENT DATES BELOW, OR ATTACH MOST RECENT IMMUNIZATION RECORD.DIPHTHERIA, TETANUS, PERTUSSIS (DPT): ___ /___ /___ MEASLES, MUMPS, RUBELLA (MMR): ___ /___ /___ ORAL POLIO VACCINE (TOPV): ___ /___ /___ TUBERCULIN TEST GIVEN: ___ /___ /___ RESULTS:

YOUR CHILD’S MEDICAL INSURANCE CARRIER: GROUP POLICY #:

NAME OF PHYSICIAN: PHONE #:

NAME OF DENTIST: PHONE #:

(Page 2 of 2)

Page 11: Bridgewater YMCA, Hillsborough YMCA, Somerville YMCA Summer Camp Guide 2015

AT CAMP, THERE ARE NO LIMITS TO WHAT I CAN DO

AT CAMP I CAN... Gain confidence. Become independent. Have fun.

Page 12: Bridgewater YMCA, Hillsborough YMCA, Somerville YMCA Summer Camp Guide 2015

NONPROFIT ORGANIZATION U.S. POSTAGE

PAID New Brunswick, NJ PERMIT NO. 1011

SOMERVILLE YMCA2 GREEN STREETSOMERVILLE, NJ 08876

BRIDGEWATER YMCA601 GARRETSON ROAD908-526-0688

HILLSBOROUGH YMCA 19 EAST MOUNTAIN ROAD 908-369-0490

SOMERVILLE YMCA2 GREEN STREET(908) 722-4567

www.ymcasomersetvalley.org

Photography by Terry Boudreau

CAMP OPEN HOUSESSaturday, January 24 – HILLSBOROUGH YMCA & SOMERVILLE YMCA

10 a.m. -1 p.m. BRIDGEWATER YMCA 1 - 3 p.m.

Sunday, February 22 – HILLSBOROUGH YMCA & SOMERVILLE YMCA 11 a.m. -2 p.m. BRIDGEWATER YMCA 2 p.m. - 4 p.m.

Saturday, March 21 – HILLSBOROUGH YMCA & SOMERVILLE YMCA 12 - 3 p.m. BRIDGEWATER YMCA 10 a.m. -12 p.m.

Saturday, April 25 – Healthy Kids Day, all branches 10 a.m. - 1 p.m.

EVERY CHILD DESERVES TO GO TO CAMPFinancial Assistance is available for those who qualify. Please see our web site or visit any branch to apply.

“�My�daughter’s�confidence�has grown and she’s more willing to try new things. She has blossomed in camp,” - Julie

BRANCHES OF THE SOMERSET COUNTY YMCA