SOUTH VALLEY FAMILY YMCA
Registration Form
(One form per child)
Child’s Name:
Date of Birth:
/
/
Gender: ¨ Female ¨ Male
Address:City/State/ZIP:
Parent/Guardian Name:
Relation:
Home Phone:
Emergency Phone:
Email:
Email is one of the fastest, most cost-effective, and environmentally friendly ways for us to communicate with you. We would
like to send you periodic emails and automated phone calls with Y news and special offers. We will never share or sell your email,
phone number or address to any third party. You may unsubscribe at any time. A picture ID is mandatory each day for pick up.
Please communicate with me by: ¨ Email ¨ Phone ¨ Other
Authorized for Pick-up:
Name:
Name:
¨ Currently enrolled in YMCA licensed child care. Name of School:
¨ Not enrolled in YMCA licensed child care
Name of School:
Holiday Baking Camp
¨ December 22-24, 2014
¨ December 29-31, 2014
Fee: One Week $195
Two Weeks $315
Leaders In Training Fieldwork
¨ December 22-24, 2014
¨ December 29-31, 2014
Fee: Per Week $90
Minecraft Build Adventure Game using LEGOS®
(ages 5 to 7)
¨ February 17-20, 2015
Fee: $268
Engineering FUNdamentals: Minecraft Build
using LEGOS® (ages 8 to 12)
¨ February 17-20, 2015
Fee: $268
LIT Fieldwork
¨ February 17-20, 2015
Fee: $99
LIT Fieldwork
¨ April 13-17, 2015
Fee: $110
Soccer Fundamentals
¨ April 13-17, 2015
Fee: $259
School Break Camps
SOUTH VALLEY FAMILY YMCA
Total Fee:
$
Program Membership: $
(Program fee waived if you are a Facility Member)
¨ My check or money order is enclosed
(Payable to YMCA Branch)
If paying by credit card, complete the following:
Credit Card #:
Expiration: Card Type: ¨ MasterCard
¨ Visa ¨ American Express ¨ Discover
Mail or drop off at:
South Valley Family YMCA
5632 Santa Teresa Blvd.
San Jose, CA 95123
Or fax to:
408 226 3324
HAVE FUN
LEARNING
AT CAMP
Name on Card:
¨ Financial assistance application enclosed
Signature
CAMPS
Holiday Baking Camp
Fee:
One Week
Two Weeks
$195
$315
Theme:
Baking for the holiday season
Dates:
December 22-24, 2014*
December 29-31, 2014*
*December 24, 2014 Camp closes @ 3pm
*December 31, 2014 Camp closes @ 3pm
Location:
Terrell Elementary School
Time:
AM Extended Care 7:00am-9:00am
Camp Hours 9:00am-4:00pm
PM Extended Care 4:00pm-6:00pm
From our 3 day to 6 day option our kitchen is always active
with opportunities for young chefs to break into the culinary
scene in our lip-smackingly delicious baking camp. A new
and unique menu is offered this Holiday Season. Every day
we make two to three recipes – always one savory and one
sweet – while whipping up batches of fun. We focus on
the basics along with kitchen games and tackle advanced
techniques and culinary challenges.
Leaders In Training Fieldwork
Fee:
Per Week
$90
Dates:
December 22-24, 2014*
December 29-31, 2014*
*December 24, 2014 Camp closes @ 3pm
*December 31, 2014 Camp closes @ 3pm
Location:
Terrell Elementary School
Time:
AM Extended Care 7:00am-9:00am
Camp Hours 9:00am-4:00pm
PM Extended Care 4:00pm-6:00pm
Leader in Training Fieldwork enables teens to put leadership
skills to the test. Teens are placed into an age-appropriate
camp with Trained YMCA staff. They assist directors, help
lead games, lead arts and crafts projects, and sing camp
songs. LIT’s also lead a group activity with younger campers
and are evaluated by staff at the end of the week. LIT teens
are not staff and will not be left alone with the younger
campers. Mandatory prerequisite: LITI and LITII combined in
current years or previous years. All new LIT participants must
have completed both courses before acceptance into fieldwork
is granted.
Minecraft Build Adventure Game using
LEGOS® (ages 5 to 7)
LIT Fieldwork
Soccer Fundamentals
Fee:
$99
Fee:
Fee:
$268
Dates:
February 17-20, 2015
Dates:
April 13-17, 2015
Dates:
February 17-20, 2015
Location:
Terrell Elementary School
Location:
Terrell Elementary School
Location:
Terrell Elementary School
Time:
AM Extended Care 7:00am-9:00am
Vendor Time
9:15am-12:15pm
PM Extended Care 4:00pm-6:00pm
Time:
AM Extended Care 7:00am-9:00am
Camp Hours 9:00am-4:00pm
PM Extended Care 4:00pm-6:00pm
Time:
AM Extended Care 7:00am-9:00am
Camp Hours 9:00am-4:00pm
PM Extended Care 4:00pm-6:00pm
Bring Minecraft to life using LEGOS ! Resourcefulness,
creativity, and cooperation come together in this unique
building adventure game; roll the dice to mine for resources,
and use these resources to build special items to help in
our adventures! Build a Zoo, create a Medieval Castle, and
design a Tree House Village! This LEGO® experience is an
original game designed by Play-Well instructors inspired by
the popular game, Minecraft. Students will have a blast, even
without any prior experience with Minecraft or LEGO®.
Leader in Training Fieldwork enables teens to put leadership
skills to the test. Teens are placed into an age-appropriate
camp with Trained YMCA staff. They assist directors, help
lead games, lead arts and crafts projects, and sing camp
songs. LIT’s also lead a group activity with younger campers
and are evaluated by staff at the end of the week. LIT teens
are not staff and will not be left alone with the younger
campers. Mandatory prerequisite: LITI and LITII combined in
current years or previous years. All new LIT participants must
have completed both courses before acceptance into fieldwork
is granted.
Engineering FUNdamentals: Minecraft Build
using LEGOS® (ages 8 to 12)
LIT Fieldwork
®
Fee:
$268
Dates:
February 17-20, 2015
Location:
Terrell Elementary School
Time:
AM Extended Care 7:00am-9:00am
Vendor Time
12:45pm-3:45pm
PM Extended Care 4:00pm-6:00pm
Bring Minecraft to life using LEGOS®! Build a motorized
walking Creeper, a terrifying Ghast, and a motorized Minecart!
This project-based camp, designed by Play-Well instructors,
combines the basic format of our core engineering-themed
programs based on the world of Minecraft. Students will
explore real-world concepts in physics, engineering, and
architecture while building their favorite Minecraft objects.
Students will have a blast, even without any prior experience
with Minecraft or LEGO®.
$259
In this camp, you child learns the basics and strategies of
soccer. Instruction includes scrimmages, passing, dribbling,
trapping, heading, shooting, defense and goal keeping.
Campers participate in contests to shape their skills
throughout the week. Afternoon, activities include other
sports, and group games. Be sure to sign up for our Soccer
Tournament week in the summer to test your abilities.
Fee:
$110
Dates:
April 13-17, 2015
Location:
Terrell Elementary School
Time:
AM Extended Care 7:00am-9:00am
Camp Hours 9:00am-4:00pm
PM Extended Care 4:00pm-6:00pm
Leader in Training Fieldwork enables teens to put leadership
skills to the test. Teens are placed into an age-appropriate
camp with Trained YMCA staff. They assist directors, help
lead games, lead arts and crafts projects, and sing camp
songs. LIT’s also lead a group activity with younger campers
and are evaluated by staff at the end of the week. LIT teens
are not staff and will not be left alone with the younger
campers. Mandatory prerequisite: LITI and LITII combined in
current years or previous years. All new LIT participants must
have completed both courses before acceptance into fieldwork
is granted.
For more information contact:
South Valley Family YMCA
408 226 9622
Lovedeep Sahota, Region I Camp Director
[email protected]
408 513 3160