1609 S. Luther Avenue, Lombard, IL | (630) 629-0886 |
www.ycpdfun.com
Ages: Teens going into 6th-9th grade
2016
TABLE OF CONTENTS
Registration Information; Pick Up and Drop Off Procedures
2
Absence, Illness, Injury, and Communication
3-4
Outdoor Activities, Food, and Great America Information
4-5
Confidential Information Sheet, Health Form and Registration Waiver
6-8
Discipline Policy and Disciplinary Record
9-10
Medication Dispensing Form
11
Park Permission Slip, Photo Release, and Movie Form
12
Field Trip Permission Slip & Pool Permission Slip
13
Sign In and Out Sheet and Field Trip Change Permission Slip
14
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Daily Activities
Attached Forms:
• Field Trip Calendar Schedule
1
REGISTRATION INFORMATION
Registration Information:
There is a $25 one-time nonrefundable family registration fee.
Note: Days may not be made up or transferred. There are no refunds for days missed. PAYMENT IS DUE 10
DAYS BEFORE EACH SESSION ($25 late fee will occur after the registration deadlines)
Teens on The Go Summer Camp will be canceled if the minimum registration is not met.
Refunds: NO REFUNDS, NO CREDITS, NO TRANSFERING DAYS, and NO EXCHANGES FOR ANY
REASON.
American Disabilities ACT (ADA): Persons with disabilities please note. The York Center Park District will not
discriminate against eligible residents for participation on the basis of a disabling condition. "WE NVITE ANY
PARTICIPANT WITH A SPECIAL NEED TO CONTACT OUR STAFF UPON REGISTRATION SO THAT A SMOOTH
INCLUSION MAY OCCUR." In addition to the programs listed here, our district provides additional specialized
services for persons with disabilities through Gateway Special Recreation Association. Feel free to call Gateway at
(63()) 3253 857, or see the Gateway information page in our brochure.
Staff-Teen Ratio: There will be one staff member for every ten teens. Each counselor has experience with middle
school and junior aged children. The staff is dedicated to providing a beneficial and enjoyable experience for each
participant enrolled in the program.
PICK UP AND DROP OFF PROCEDURES
Drop-Off and Pick-Up Procedures: Parents, you will have to come into the building to sign your teen in and out. If
someone other than yourself is to pick up or drop off your teen, their name must be on the Information Sheet and
they will be asked for their driver's license. No one will be able to leave with your teen unless special arrangements
have been made before hand. NOTE: If your teen wishes to ride a bike or walk home, we will need a
permission slip from the parent/guardian and no sign out is required.
Late/Early Pick-Up and Drop Off:
We will have extended camp from 7:30a.m.—6:00p.m. The doors do not open before 7:30a.m. If your teen is
dropped off before his/her designated time, you will be charged $5.00 for every five minutes you are early. If you
pick up your teen after 6:00p.m., you will also be charged $5.00 for every five minutes you are late. If you are
running later than 9:00a.m., please call the park district so we can inform staff.
2
Camp Hours
Mondays, Wednesdays, and Thursdays drop off for your teen will be at 9:00 a.m. and pick-up for your
teen will be at 3:00 p.m., and 4:00 p.m. on Fridays unless we have notified you of a later pick-up time due
to the distance of the trip. Tuesdays you should pick up your child at 5:00 p.m. On Fridays and Tuesdays,
the teens need to arrive at the park district by 8:30 a.m., as the bus will leave at 9:00 a.m. If your child is
not here by 9:00 a.m. we will leave and you will not be given a refund.
Parking Procedures: All parents are required to park in a marked parking space when picking up and
dropping off their teen. You may not park or leave your car running in the driveway. Also, do not leave
siblings unattended in the car. For the safety of the children, please follow the One Way and Do Not Enter
signs, and the local speed limits.
ABSENCE ILLNESS AND INJURY
Absence: Anytime your teen will not be able to attend Teens on The Go, whether due to illness, vacation, etc., please
notify the York Center Park District office staff. Staff needs to know in advance who will be attending to adapt the trip
plans for that day. There are no refunds, transfer of days, exchanges or credits given for any absences.
Illness and Iniury: In cases of communicable diseases such as measles, mumps, chicken pox, etc., please notify the
York Center Park District office so that other parents can be notified. Teens with colds sore throats flu. fever, etc.,
should stay at home for the protection of all involved. If your teen develops symptoms of illness during the program,
he/she will be separated from the group and their parents will be notified. A teen should not return to the program
until he/she is able to engage in a full program of indoor and outdoor activities. If your teen vomits or gets a fever
during Teens on The Go, parents will be notified to pick up their teen immediately. If we are on a trip, arrangements
will be made depending on the circumstance.
First Aid Policy: All counselors are trained in CPR and First Aid. First Aid will be administered if necessary and an
ambulance will be called when required.
Insurance: York Center Park District does not provide medical insurance coverage for individuals who participate in
our programs or use our facilities. To do so would make programs and user fees prohibitive.
Medicine Policy:
If your child is required to take any medication such as: Ritalin, antibiotics, etc., you must complete a
Medication Form. Under no circumstances will the child be able to carry or hold his/her own pill medication. Special
life-saving medications such as Epipens and inhalers must be discussed with the counselors as well as listed on the
Medication Form. If no medications are needed, please sign and write "n/a (not applicable)" on form. If medications
change at anytime, please update your form.
3
COMMUNICATION
Before/After Hours Phone Procedures: If you are running late or have some type of emergency you can call the
Park District at (630) 629-0887, before 9:00.m. or after 6:00 p.m. Any time between 9:00a.m. and 5:00 p.m. you
can contact the office at (630) 629-0886. In case of power outage, park district staff may be contacted at (630) 3921924.
Personal Phone Calls: Please do not call your teen during the progam unless it is an emergency.
This becomes disruptive to the program when they are in the middle of an activity or away on a trip.
Cell Phones: If you would like your teen to have their cell phone that is alright. The cell phone must stay off and
be put away when on field trips. We will be limiting the cell phone use this summer. The York Center Park District
will not be responsible for any lost, stolen, or damaged cell phones.
Visiting: You are welcome to visit our programs and the York Center Park District Community Center at any time.
However, you must check in at the office first to receive permission. Note: The doors will be locked during program
hours. Please enter at the front entrance.
Newsletter: A newsletter will be emailed each week so please make sure we have your email address. Please read
this for changes in schedules, important information, etc.
Ouestions: The counselors welcome and encourage any and all questions about your teen or the program.
We hope that you and your teen find the program enjoyable. We are always open to suggestions, comments
and of course compliments.
Outdoor Activities: Please be sure your teen applies sunscreen everyday! Teens should also carry this with them, as
many daily activities will be held outside in the sun. Also, please let the staff know if your child has any medical
problems with things such as heat, allergies to insects, plants, etc.
Inclement Weather Days: Weather may be a factor for some of the field trips planned. If staff and/or the field trip
facility feel any risk in regards to the weather conditions, the field trip will be canceled and teens will either remain
at the park district or go on an alternate field trip. Parents will be notified of changes in plans if it is known at the
time of drop off. If it is not known at the time of drop off, then your teen can notify their parent if they ask for
permission. A parent can also call the supervisor or the office and ask where their teen will be going for the day.
Places that the teens will be going on inclement weather days are the movies, bowling, and much more.
Field Trips: We will be going to various destinations that will have places for your teens to purchase items such as
food and souvenirs. Trips include entrance fee and transportation only. Please be sure to send money with your
teen when necessary if you wish.
4
Six Flags: Our teens will be traveling to either Great America or Hurricane Harbor once a week. Because of this we
recommend the purchase of a season pass ($81.99), which would allow the campers entrance to Great America and
Hurricane Harbor Water Park without paying each time. Passes can be purchased at any Jewel Osco or at the Six
Flags admission gate. If you choose not to purchase this, you will need to purchase a one-day admission ticket
($64.99) for the selected days we will be visiting these parks. Remember to bring a lunch. If purchasing a lunch at
the park, please bring adequate money. The food is expensive (about $12 a meal). Please have your teen bring their
swim suit every day we go to Great America.
Lunch
All campers are encouraged to bring bottled water with their name on it. We have well water in the building and
some of the children do not like the taste of it. Teens need to bring a lunch everyday unless otherwise informed.
Lost & Found: We do have a lost and found at the Park District. Please look in it from time to time; we accumulate
many things throughout the summer. A week after summer camp ends all unclaimed items will be given away.
What do you get for your money?
College aged students or older trained in CPR & First Aid
Most staff are Education Majors
Counselors must pass a drug screening process and
background check
A safe environment for your teen
I counselor for every 10 teens
Planned activities everyday
Equipment/Supplies
Identification wristbands for field trips
Admission Fees
Parking Fees
Transportation Costs
First aid suppli
5
York Center Park District
Teens on the Go
Confidential Information Sheet and Health Form
Circle sessions enrolling for:
Session II
6th
7th
8th
9th
Daily Rate
1A
2A
3A
4A
5A
Daily Rate
1B
2B
3B
4B
5B
T
W
R
F
Circle grade going into:
Circle Package:
Session I
Circle days attending:
M
Session III
Participant’s Name: ___________________________________Home Phone:_________________________
Birthdate:______________Age:_________Sex(Female)____(Male)____
Father: _______________________________________ Home Phone: ___________________________
Company Name: ________________________________ Work Phone: ___________________________
Company Address: _______________________________ Cell Phone: ____________________________
Parent Email Address: _______________________________________
Mother: _______________________________________ Home Phone: ___________________________
Company Name: ________________________________ Work Phone: ___________________________
Company Address: _______________________________ Cell Phone: ____________________________
Parent Email Address: _______________________________________
Parent Marital Status: (Please circle one) Single Married Divorced Seperated Widowed
Home Phone: ___________________________
Guardian: _______________________________
Work Phone: ___________________________
Cell Phone: _____________________________
In case of an emergency notify (in case parents cannot be reached)
1. Name: ___________________________________________________________
Address: _________________________________________________________
Phone: _______________________________ Relationship to child: ____________________________
Cell Phone: _____________________________
(Continued on Back)
6
2. Name: _____________________________________________
Address: ____________________________________________
Phone: ___________________________ Relationship to child: ____________
Cell Phone: _____________________
Please list anyone (other than yourself) who has permission to pick up your child. If the person named is
not on this list, they cannot pick up your teen from camp, unless you fax or call us with permission to do
so.
1.
______________________________________________ Relationship: __________________
2.
______________________________________________ Relationship: __________________
3.
______________________________________________ Relationship: __________________
4.
______________________________________________ Relationship: __________________
5.
______________________________________________ Relationship: __________________
Allergies: Food ______________________________________________
Insect _____________________________________________
Other _____________________________________________
Is there any information that might help the staff that is working with your child?
Is your child presently taking any medication? If so please give the name and the amount taking_
(Medication Form must be
completed)
Is there any other pertinent information that you would like to share with the child's instructors?
Confirmation Letter
1
have read the Teens on The Go
handbook and have discussed with my teen his/her responsibilities in the program and the
consequences of failing to carry out those responsibilities.
7
REGISTRATION/BROCHURE WAIVER & RELEASE
IMPORTANT INFORMATION
The York Center Park District is committed to conducting its recreation programs and activities in a safe manner
and holds the safety of participants in high regard. The York Center Park District continually strives to reduce such
risks and insists that all participants follow safety rules and instructions that are designed to protect the
participants' safety. However, participants and parents/guardians of minors registering for the below listed
programs/activities must recognize that there is an inherent risk of injury when choosing to participate in
recreational activities/programs.
You are solely responsible for determining if you or your minor child/ward are physically fit and/or skilled for the
activities contemplated by this agreement. It is always advisable, especially if the participant is pregnant, disabled
in any way or recently suffered an illness, injury or impairment, to consult a physician before undertaking any
physical activity.
WARNING OF RISK
Recreational activities are intended to challenge and engage the physical, mental and emotional resources of each
participant. Despite careful and proper preparation, instruction, medical advice, conditioning and equipment, there
is still a risk of serious injury when participating in any recreational activity. Understandably, not all hazards and
dangers can be foreseen. Depending on the particular activity, participants must understand that certain risks,
dangers and injuries due to inclement weather, slip and falls, poor skill level or conditioning, carelessness,
horseplay, unsportsmanlike conduct, premises defects, inadequate or defective equipment, inadequate
supervision, instruction or officiating, and all other circumstances inherent to indoor and outdoor recreational
activities exist. In this regard, it must be recognized that it is impossible for the York Center Park District to
guarantee absolute safety.
WAIVER AND RELEASE OF ALL CLAIMS AND ASSUMPTION OF RISK
Please read this form carefully and be aware that in signing up and participating in the programs listed below, you
will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or
loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected
with and associated with these programs (including transportation services and vehicle operations, when
provided).
I recognize and acknowledge that there are certain risks of physical injury to participants in these programs, and I
voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that my
minor child/ward or I may sustain as a result of said participation. I further agree to waive and relinquish all claims I
or my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in these programs
against the York Center Park District, including its officials, agents, volunteers and employees.
I have read and fully understand the above important information, warning of risk, assumption of risk and
waiver and release of all claims. If registering on-line or via fax, my on-line or facsimile signature shall substitute
for and have the same legal effect as an original form signature.
PLEASE PRINT
Participant's Name ____________________________
Participant's Signature _________________________
(18 years or older or Parent/Guardian)
Date ____________________________
PARTICIPATION WILL BE DENIED
If the signature of adult participant or parent/ guardian and date are not on this waiver.
8
Discipline Policy Form
York Center Park District
Your child is enrolled in the Teens on the Go program. Please be aware that our program strives to give each
participant a positive and fun summer camp experience. In order to ensure the quality of this program, each
participant must follow the program rules.
General Teens on the Go Rules:
1. Disrespectful attitudes and actions to counselors, other participants, or staff members at fieldtrip locations
will not be tolerated.
2. Fighting, hitting, swearing, bullying, stealing, etc., will not be tolerated.
3. Any other behavior deemed inappropriate by the counselors will result in warnings and/or disciplinary
actions.
4. Repeated inappropriate behavior will also result in disciplinary action.
Given the nature of the behavior, appropriate disciplinary action will be taken. The Teen Camp Coordinator and
counselors will keep a written record of rule-breaking. Parents will be notified of such occurrences. After three
warnings, the occurrence of any of the above behaviors will result in a participant's "day off' from Teen Camp.
Please refer to the Disciplinary Record enclosed in your packet.
If problems persist, your teen may be withdrawn from the program. Three "day off' offenses will result in an
automatic dismissal from Teens on the Go for the remainder of the summer. Please discuss these rules and
consequences with your child; sign, date, and return this form.
PLEASE NOTE: NO REFUNDS WILL BE GIVEN FOR "DAYS OFF" OR A DISSM1ssAL FROM THE
PROGRAM.
I have discussed the rules/consequences of the Teens on the Go with my teen.
Teen's Name (please print)
Date
Parent/Guardian Signature
1) Offense One: Written warning, Parent signs form. First offense, one day off.
2) Offense Two: Written warning, parent signs form, conference with Teen Camp Supervisor; two days off.
3) Offense Three: Dismissed from Program. No Refunds Given!
I have discussed the Discipline Policy with my teen and they understand what is expected from them in camp.
Parent's Signature
Child's Signature
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Counselor
Disciplinary Record
DAY OFF #1
Date
Participant's Name
Description of Incident
Parent/Guardian Signature
Childs Initials
Counselor's Signature
DAY OFF #2
Date
Participant's Name
Description of Incident
Parent/Guardian Signature Counselor's Signature
Coordinator's Signature
DAY OFF #3 - CAN NO LONGER BE IN PROGRAM
Date
Participant's Name
Description of Incident
Parent/Guardian Signature Coordinator's Signature
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Director's Signature
Extreme Teens On The Go
SIGN IN/OUT PERMISSION FORM
1
give
permission to sign in/out themselves
while attending the Teens on the Go progam at the York Center Park District. The York Center Park District will not
be held responsible for
after he/she signs themselves out.
Field Trip Change Permission Form
The York Center Park District will change a planned trip for any reason that we feel may be necessary. We will not be
contacting every parent to let you know about the change but your teen will be encouraged to let you know about
any changes through the use of their or our phone.
1
understand the change in field trip procedure.
14
Daily Activities
We will be alternating trips to Six Flags and Hurricane Harbor Water Park Every Tuesday.
Six Flags
-More than 10 roller coasters, tons of rides and fun! Don't forget your season pass.
www.sixflags.com/parks/greatamerica
Hurricane Harbor
-A massive water park with tons of slides, a wave pool, and water roller coasters
https://www.sixflags.com/greatamerica/attractions/water-park-rides
June
Top Golf
-Fun and interactive point scoring indoor golf games. Teens will receive a lunch.
http://topgolf.com/chicago/
Vertical Endeavors
-A great facility for rock climbing. Instruction and professional supervision are included.
Waiver needed.
http://www.verticalendeavors.com/vewarrenville/index.html
Barefoot Bay
-Four bodies of water, body slides, body flumes, water rock climbing wall, lazy river, and diving well.
http://www.mundeleinparks.org/Swim-Aquatics/Barefoot-Bay.asp
Lincoln Park Zoo
-Zoo in downtown Chicago. Kids will walk around all day and enjoy the animals, as well as the view of the
city skyline www.lpzoo.org
Cantigny
-A 500-acre park that features museums, tanks, and gardens to explore. We will provide a variety of
games to play in the picnic area as well as snacks. http://www.cantigny.org
The Hub
-Batting Cages and an 18 hole miniature golf course. http://www.epd.org/facilities/hub-berens-park
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Hollywood Park
-Teens will have play card for the arcade games, unlimited bumper cars, and rock wall climbs. A pizza
lunch will be served as well. http://www.hollywoodfunpark.com/
Pelican Harbor
-This is an indoor/outdoor pool that has slides, a zero depth section, a lazy river, and beach
volleyball.
http://www.bolingbrookparks.org/en/facilities/pelican-harbor/
Starved Rock
-A fun trip, hiking and checking out awesome canyons! http://www.starvedrockstatepark.org
Hall Quarry
-Sandy beach and swimming with slides and islands and picnic area
White Sox Game
-See the Chicago White Sox play against the Minnesota Twins! chicago.whitesox.mlb.com
July
Westmont Yards
-An action packed sports facility where teens will get to a bunch of games such as dodge ball, flag football.
The facility uses inflatable obstacles as well. http://westmontyard.com
Painted Penguin
-Teens will pick out and paint a ceramic figurine. It will be glossed there and taken home.
http://www.thepaintedpenguin.com/
Centennial Beach - Naperville
-Man-made
beach
with
sandy
http://www.centennialbeach.org/visitorsguide
shores,
slides,
and
diving
boards.
Bulls/Sox Academy
-Kids get an opportunity to play basketball, baseball, and see many fun training techniques that the pros
use http://www.bullssoxacademy.com/
Blackwell Forest Preserve
- Teens will get a chance to go kayaking and explore Blackwell Forest Preserve
http://dupageforest.org/Conservation/Forest_Preserves/Blackwell.aspx
Rockin Jump
-This huge facility is filled with trampolines and a massive foam pit! http://carolstream.rockinjump.com/
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Cypress Cove
-3 Body Slides, 1 Tube Slide, 1 Drop Slide, Lazy River, Diving Board and Plunge Pool
www.woodridgeparks.org/cypresscove
Scitech Museum
Over 150 interactive STEMs (science, technology, engineering, mathematics) exhibits which help our
Teens be inspired education and imagination. http://scitechmuseum.org/
Woodfield Mall
-
Over hundreds of stores for our teens to shop and explore. Also a food court filled with endless
options. Bring money.
http://www.simon.com/mall/woodfield-mall
NIU Foodbank
-
It's a field trip that will give back to others. Help box food packages to feed hungry families in Illinois.
You must wear gym shoes! Waiver needed. http://solvehungertoday.org/GetInvoIvedNolunteer.aspx
Main Event
-We will be going bowling, going on a high ropes course. Pizza is included in the trip.
http://www.mainevent.com/
Rainbow Falls
-Features several slides, diving board, frog leap, and reptile river.
http://www.elkgroveparks.org/Rainbow_Falls/Attractions/ Nickel City
-A huge selection of arcade games all for a nickel. Teens will be provided with nickels for their games.
http://nickelcitygames.com/
Bartlett Nature Center
-Participate in this nature center's edition of Fear Factor. The program will test your knowledge
and guts. Don't chicken out! http://bartlettparks.org/naturecenter/
Paradise Bay
-Lombard's largest outdoor water park with numerous slides, sprays, a lap pool, sandbox, and a whirlpool.
Basement of the Dead
Laser Tag- iCombat Aurora -An extremely exciting to play
tactical laser tag! http://42fear.com/icombat-aurora/
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August
Diamond Lake
-Enjoy this sandy beach and pristine lake. Take a dip in the lake or work on your tan.
http://www.mundeleinparks.org/Swim-Aquatics/Diamond-Lake-Beach.asp
Odyssey Fun World
-Arcades,
rides
and
www.odysseyfunworld.com
pizza.
Sports Zone
-Teens will get go-kart ,play miniature golf, and hit the batting cages http://www.sportzonepark.com
Funway
-Kids will go bowling and roller blading as well as have access to hundreds of arcade games and
concessions. http://funway.com/
Phillips Park Zoo
-This zoo has a variety of mammals, birds, and a reptile house. Additionally, there is a great picnic area.
http://www.phillipsparkaurora.com/Zoo_08232c233a0060bc.htmI
Bensenville Theater and Ice Cream Shop
-Movie theater with an attached ice cream shop. Participants will get a hot dog a drink popcorn and a movie, then
after the movie we will stop in the ice cream shop for some soft serve.
Gymnasti
-State-of-the-art gymnastics training center. Teens will be twisting, tumbling, playing relay games, and bouncing
on the trampolines. http://www.gymnasti.com/
Raging Waves
-Awesome water park featuring a large wave pool, many slides, a lazy river, and more www.ragingwaves.com
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