Child�s Name: _____

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					Child’s Name: ________________________

Weeks Attending: _______________________

                        Summer Day Camp Registration Checklist
_____ YWCA Membership application form with payment OR current YWCA Membership

_____ Payment of last WEEK of program for the child/ren Receipt# __________

_____ Front Desk information page with bottom section completed by YWCA Employee

      Charge Card used? _____ yes         _____ no

_____ Summer Day Camp Enrollment Form / with T-shirt size circled and Financial

      Acknowledgement signed, email section complete.

_____ Medical Health History Form (front) completed by parent, signed and dated

_____ Medical Health History Form (back) immunizations and sunscreen portion completed, signed,

       dated by: Doctor, Nurse Practitioner or Physicians Assistant.

      ALL CAMPERS NEED THIS COMPLETED!

_____ Current Physical- No older than 2 years (If we have one on file, this may be used)

_____ Written Medication Consent (if needed for on site medications)

_____ Birth Certificate- needed for Canadian field trips

_____ Permission Slip for Week 3- Fallsview, Canada



DSS Clients:

_____ Approval Letter from DSS

_____ Caseworker Name: _______________

_____ Caseworker Phone Number: _______________


            INCOMPLETE REGISTRATIONS WILL NOT BE ACCEPTED

  *To begin camp on 6/25, all completed paperwork must be submitted to the
 YWCA by 4:30pm, on 6/18. Paperwork received after 6/18 will result in your child not
                              beginning camp until Week 2.

				
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