Download - YMCA of Silicon Valley

Camp planner for Furlough Week, Winter Break, President’s Week and Spring BreakFurlough Week Grades K-2 Grades 3-6Monday, October 1 Fun with Food Fun with FoodTuesday, October 2 Creative Crafts Creative CraftsWednesday, October 3 Uesugi Farms Uesugi FarmsThursday, October 4 Wheels Day Wheels DayFriday, October 5 Sports Speculator Sports SpeculatorWinter Break (Week 1) Grades K-2 Grades 3-6Wednesday, December 26 Wheels Day Wheels DayThursday, December 27 Steinhart Aquarium Steinhart AquariumFriday, December 28 Silly + Weird Science Silly + Weird ScienceWinter Break (Week 2) Grades K-2 Grades 3-6Wednesday, January 2 Wheels Day Wheels DayThursday, January 3 Discovery Museum Tech MuseumFriday, January 4 Games-a-palooza Games-a-paloozaMonday, January 7 Creative Genius Creative GeniusPresident’s Week Grades K-2 Grades 3-6Monday, February 18 Cooking Craziness Cooking CrazinessTuesday, February 19 Sports Spectacular Sport SpectacularWednesday, February 20 Cucina Bambini PetroglyphThursday, February 21 Wheels Day Wheels DayFriday, February 22 Silly + Weird Science Silly + Weird ScienceSpring Break Grades K-2 Grades 3-6Monday, April 8 Wacky + Mad Science Wacky + Mad ScienceTuesday, April 9 Culinary Delights Culinary DelightsWednesday, April 10 Fuze Fit BowlingThursday, April 11 Wheels Day Wheels DayFriday, April 12 Building Artists Building ArtistsNOTE: All activities subject to change based on availability Field Trip Cooking Wheels Day (Kids can bring their bikes, scooters orskateboards but MUST have protective gear.)Registration FormOne form per child. Return with a completed Health History Form and acopy of your child’s immunization records*.Child’s NameE-mailq Please add me to your e-mail list to receive your newsletter.Birthday / / q Male q Female Grade AgeAddressCityParent/GuardianDay Phone - - Day Phone - -Camp Payment and Cancellation Policy*PROGRAM MEMBERSHIP: I understand that my child needs to have a Program orFacility membership. If my child needs a Program Membership, then I understand thatthe first $25 paid will be used for the payment of that membership.*Cancellations may be made in writing up to 2 weeks prior to the start of the sessionto receive a refund less the deposit. Otherwise, payments made will not be refunded.By signing up for the programs indicated below, I understand and accept the abovepolicies and that I am responsible for payment: Initial DateZipPlease select the camp(s) you are registering for:furlough weekq MON 10/1 $60q TUE 10/2 $60q WED 10/3 $70q THU 10/4 $60q FRI 10/5 $60winter break week iq WED 12/26 $60q THU 12/27 $70q FRI 12/28 $60winter break week iiq WED 1/2 $60q THU 1/3 $70q FRI 1/4 $60q MON 1/7 $60president’s weekq MON 2/18 $60q TUE 2/19 $60q WED 2/20 $70q THU 2/21 $60q FRI 2/22 $60Open daily from 6:30 am - 6 pm.A late fee of $1/minute will be assessed for all children picked up after 6 pm.*Financial assistance available.Pick one up at our front desk or download one online.Total Fees: $Program Membership: $25 per year, if not already paid(Not applicable for facility members) $Total Enclosed: $If paying by credit card, complete the following:Credit Card Number: - - - Expiration: /Financial Assistance Application Enclosed: qspring break weekq MON 4/8 $60q TUE 4/9 $60q WED 4/10 $70q THU 4/11 $60q FRI 4/12 $60Volunteer opportunities for ages 13+: I am interested in volunteering for a...q Field Trip q Specific Day q Specific ActivityPlease complete volunteer packet prior to week of service. See Director for details.Day:The deadline to register is two full weeks prior to start date of program.The minimum number of children needed to operate the camp is decided two weeksprior to start of camp.*Additional licensing forms will need to be completed on site atBooksin Child Care.Return this form (including full payment of fees) to:Central YMCA1717 The Alameda, San Jose CA 95126408 298 1717 • ymcasv.org/centralOffice Use Only:Receipted By: Date: / /Payment Type: q Check q Credit Card q Cashbooksin ymca child care center1590 Dry Creek Road, San Jose CA 95125408 265 3588