YMCA OF GREATER SEATTLE – West Seattle / Fauntleroy YMCA
Summer Camps serving the Central, South and West Seattle area
Summer Registration Paperwork Packet
PROGRAM OFFERINGS







Outdoor Day Camp
Discovery Camp
Sports Camp
Trek-NEW!
Horse Camp at Flying Horseshoe Ranch
Summer Fun Bunch
Jump Rope Specialty Camp
PAPERWORK INCLUDED IN PACKET

To be returned to the Fauntleroy YMCA location on the Monday 2 weeks prior to
the first session your child will be attending:
o Youth Program Registration From
o Immunization Form (if exemption is needed, please request from Y Staff)
o Policies for Summer Programs
o Statement of Understanding Form

To keep for parent reference:
o Summer Family Handbook
 Containing all policies, procedures, philosophy, Medical Emergencies,
Disaster Preparedness Plan, Pesticide Policy, Statement for Prevention of
Abuse and the Creating a Child Safe Environment brochure.
YMCA OF GREATER SEATTLE
Youth Program Registration Form
YOUTH INFORMATION
Legal First Name
M
Legal Last Nameast
Home Address
Apt
Preferred Name
Date of Birth
Gender
City
State
Zip Code
Ethnicity
SPECIFIC MEDICAL, BEHAVIORAL OR DEVELOPMENTAL NEEDS
Date of Last Physical
Date of Last Dental Exam
Date of Last Tetanus
Depending upon your child’s need, additional paperwork and a meeting with a YMCA Director may be required prior to your child’s start to ensure your
child can best be accommodated. Failure to share information that identifies your child’s special care, accommodations or supervision needs may
jeopardize the placement of or continued participation by your child in the program. Write “none” if none.
Dietary Modifications/Allergy
Chronic/Recurring Illness
Current Medications (medication authorization may be required)
Operations/Serious Injury
Physical Disability
Behavioral Disorder
Developmental Delays
List any activities from which your child should be exempted for health reasons:
EMERGENCY & INSURANCE INFORMATION
Child’s Physician
Address
Phone Number
Child’s Dentist
Address
Phone Number
Out of Area Emergency Contact
Phone Number
Local Emergency Contact (other than parent or Dr.)
Phone Number
It is the responsibility of every individual, their parent or legal guardian, to provide for their own accident and health coverage while participating in all YMCA activities. The
YMCA of Greater Seattle does not provide any accident or health coverage for its participants.
Medical Insurance Company
Policy Number
PARENT OR GUARDIAN
Legal First Name
M
Legal Last Name
Home Address (if different than child)
Phone Number
Apt
Cell Phone
Preferred Name
Date of Birth
Gender
City
State
Zip
Work Phone
Ethnicity
Does Child Live With You?
Primary Email
Employer Name
PARENT OR GUARDIAN
Legal First Name
M
Legal Last Name
Home Address (if different than child)
Phone Number
Primary Email
Employer Name
Apt
Cell Phone
Preferred Name
Date of Birth
Gender
City
State
Zip
Work Phone
Does Child Live With You?
Ethnicity
PICK UP AUTHORIZATIONS
Legal First Name
M
Legal Last Name
Address
Legal First Name
Apt
M
Legal Last Name
Address
Legal First Name
M
Legal Last Name
Address
St
Zip
City
St
Zip
St
Zip
St
Zip
Phone Number
Apt
M
City
Phone Number
Apt
Address
Legal First Name
Phone Number
Legal Last Name
City
Phone Number
Apt
City
YMCA POLICIES
Everyone is Welcome: The YMCA is a membership organization open to all people.
Financial Assistance: If you cannot afford the full cost of a program or membership, please ask for a confidential scholarship application.
Financial assistance, to the extent possible, is available to those in need.
Personal Safety Discussions: Our staff will engage children in discussions to help them understand how they can set their own personal safety
and touching limits. These discussions will emphasize respect, set the ground rules for appropriate behavior, and encourage children to tell if
someone touches them in a way that makes them feel uncomfortable. The YMCA of Greater Seattle respects the diversity and rights of the
individuals it serves.
AUTHORIZATIONS
Participation
I give permission for my child to participate in all activities, including field trips, climbing wall, overnights, and swimming and to be transported as
authorized by the YMCA. I give permission for the YMCA to use any pictures of my child for future promotional purposes.
Medical Treatment
I hereby give permission for my child to be given cardiopulmonary resuscitation (CPR) and first aid treatment by a qualified staff member of the
YMCA. In the event I cannot be contacted, I also give permission for my child to be transported by ambulance or aid car to an emergency center for
treatment. I further consent to the disclosure of health information and to the medical, surgical and hospital care treatment and procedures
(including, but not limited to, administration of necessary anesthetics, tests, x-ray examinations, transfusions, injections, drugs) to be performed for
my child by a licensed physician or hospital selected by the YMCA director when deemed immediately necessary or advisable by the physician to
safeguard my child’s health.
Release from Liability
Recognizing that the YMCA will do its best to ensure a safe experience, I understand that accidents may occur both from my child’s participation in
program activities and from transportation to and from the program. I agree to assume these risks. By signing below, I release the YMCA of Greater
Seattle, its employees, volunteers, independent contractors, directors and agents from all liability based on any damage, loss or injury whether it is
the result of ordinary negligence or otherwise, caused to my child or to me from participation in YMCA programs.
Photo Release:
The applicant hereby gives permission for the YMCA (local, national and international) to use, without limitation or obligation, photographs or other
media that may include the members’ image or voice to promote or interpret YMCA programs.
I have read and understand the above and have completed this form to the best of my ability.
Signature of parent or legal guardian: ________________________________________________________________ Date: ______________
Certificate of Immunization Status (CIS)
DOH 348-013 January 2010
Please print. See back for instructions on how to fill out this form or get it printed from the Immunization Registry.
Child’s Last Name:
First Name:
Middle Initial:
Birthdate (mm/dd/yyyy): Sex:
Symbols below:
Vaccine
 Required for School and Child Care/Preschool
 Required for Child Care/Preschool Only
Dose
Date
Month
Day
Vaccine
Year
 Hepatitis B (Hep B)
Hep B
1
Hep B
2
Hep B
3
Hep B
4
or Hep B - 2 dose alternate schedule for teens
Hep B
1
Hep B
2
Rotavirus (RV1, RV5)
RV5
1
2
3
 Diphtheria, Tetanus, Pertussis (DTaP, DTP, DT)
DT
1
DT
2
DT
3
DT
4
DT
5
 Tetanus, Diphtheria, Pertussis (Tdap, Td)
Td
1
Td
2
Td
3
 Haemophilus influenzae type b (Hib)
Hib
1
Hib
2
Hib
3
Hib
4
 Pneumococcal (PCV, PPSV)
PPSV
1
PPSV
2
PPSV
3
PPSV
4
RV5
RV5
Office Use Only:
Reviewed by:
Date:
Signed Cert. of Exemption on file?  Yes  No
I certify that the information provided on
this form is correct and verifiable.
Parent/Guardian Name (please print):
Parent/Guardian Signature Required
Dose
Date
Month
Day
Year
1) 
Chickenpox disease verified by printout
from CHILD Profile Immunization Registry
Must be marked by printout (not by hand) to be valid.
2) 
Chickenpox disease verified by Health
Care Provider (HCP)
If you choose this box, mark 2A OR 2B below.
2A)  Signed note from HCP attached OR
2B)  HCP signed here and print name below:
Flu
Flu
 Measles, Mumps, Rubella (MMR)
MMR
1
MMR
2
MMR
3
MMR
4
 Varicella (chickenpox) or verify disease 1-4 
Varicella
1
Varicella
2
Hepatitis A (Hep A)
Hep A
1
Hep A
2
Meningococcal (MCV, MPSV)
MPSV
1
Human Papillomavirus (HPV)
HPV
1
HPV
2
HPV
3
Office Use Only: Immunization information updated
and verified with parent/guardian permission:
Date
Printed Staff Name
If the child named on this CIS had chickenpox disease
(and not the vaccine), disease history must be verified.
Mark option 1, 2, 3, OR 4 below – see, back #5.
 Polio (IPV, OPV)
1
OPV
2
OPV
3
OPV
4
OPV
5
Influenza (flu, most recent)
OPV
Printed Staff Name
Date
Date
Licensed health care provider (HCP) Signature
Date
(MD, DO, ND, PA, ARNP)
HCP Printed Name: _______________________________
3) 
Chickenpox disease verified by school
staff from CHILD Profile Immunization Registry
If you choose this box, staff must initial that parent or
guardian approves: __________(initial) _________(date)
4)  Chickenpox disease verified by parent*
If you choose this box, fill in the date or child’s age
when he or she had the disease:
Age/Date of disease:_______________________
*Can ONLY verify for some grades, see back #5 (4).
If the child can show immunity by blood test (titer) and
hasn’t had the vaccine, ask your HCP to fill in this box.
Documentation of Disease Immunity
I certify that the child named on this CIS has laboratory
evidence of immunity (titer) to the diseases marked.
Signed lab report(s) MUST also be attached.





Diphtheria
Hepatitis A
Hepatitis B
Hib
Measles





Mumps
Polio
Rubella
Tetanus
Varicella

Other:
_______________
_______________
Licensed health care provider (HCP) Signature
Date
(MD, DO, ND, PA, ARNP)
Printed Staff Name
Date
Printed Staff Name
Date
HCP Printed Name: _______________________________
Instructions for completing the Certificate of Immunization Status (CIS): printing it from the Immunization Registry or filling it in by hand.
#1 To print with info filled in: First, ask if your health care provider’s office puts vaccination history into the CHILD Profile Immunization
Registry (Washington’s statewide database). If they do, ask them to print the CIS from CHILD Profile and your child’s information will fill in automatically.
Be sure to review all the information, sign and date the CIS in the upper right hand box, and return it to school or child care. If your provider’s office does
not use CHILD Profile, ask for a copy of your child’s vaccine record so you can fill it in by hand using steps #2-7 (below):
EXAMPLE
#2 To fill in by hand: Print your child’s name, birthdate, sex, and your own name in the top box.
#3 Write each vaccine your child received under the correct disease. Write the vaccine type under the
Vaccine
Date
Dose
Month
Day
Year
 Diphtheria, Tetanus, Pertussis (DTaP, DTP, DT)
DTaP
01
12
2011
1
DTaP
03
20
2011
2
DTaP
06
01
2011
3
“Vaccine” column and the date each dose was received in the “Month,” “Day,” and “Year” columns (as
mm/dd/yyyy). For example, if DTaP was received Jan 12, March 20, June 1, ’11, fill in as shown here 
#4 If your child receives a combination vaccine (one shot that protects against several diseases), use the
Reference Guide below to record each vaccine correctly. For example, record Pediarix under Diphtheria,
Tetanus, Pertussis as DTaP, Hepatitis B as Hep B, and Polio as IPV.
#5 If your child has had chickenpox (varicella) disease and not the vaccine, use only one of these four options to record this on the CIS:
1)  If your child’s CIS is printed directly from the CHILD Profile Immunization Registry (by your health care provider or school system), and disease
verification is found, box 1 is automatically marked. To be valid, this box must be marked by the Immunization Registry printout (not by hand).
2)  If your health care provider (HCP) can verify that your child has had chickenpox, mark box 2. Then mark either 2A to attach a signed note from your
HCP, or 2B if your HCP signs and dates in the space provided. Be sure your HCP’s full name is also printed.
3)  If school staff access the CHILD Profile Immunization Registry and see verification that your child has had chickenpox, they will mark box 3. Then,
they must initial and date that they got parent or guardian approval to mark this box (i.e. make this change) to the CIS.
4)  If your child started kindergarten in the 2008-2009 school year or later, you CANNOT use this box. If your child started kindergarten before the 08-09
school year, mark this box if you know he or she has had chickenpox. If you mark box 4, you must also write the approximate age or date your child
had chickenpox. To find out which grades require chickenpox vaccine (or history), visit: http://www.doh.wa.gov/cfh/immunize/schools/vaccine.htm
#6 Documentation of Disease Immunity: If your child can show immunity by blood test (titer) and has not had the vaccine, have your health care provider
(HCP) fill in this box. Ask your HCP to mark the disease(s), sign, date, print his or her name in the space provided, and attach signed lab reports.
#7 Be sure to sign and date the CIS in the upper right hand box, and return to school or child care.
#8 If a school or child care makes a change to your CIS, staff will print their name in the middle bottom box and date to show that you gave approval.
Vaccine Trade Names in alphabetical order
Trade Name
ActHIB
Adacel
Afluria
Boostrix
Cervarix
Comvax (Cmvx)
Daptacel
Decavac
Vaccine
Hib
Tdap
Flu (TIV)
Tdap
HPV2
Hep B + Hib
DTaP
Td
Vaccine
Trade Name
Vaccine
Trade Name
Vaccine
Trade Name
Vaccine
Engerix-B
Fluarix
FluLaval
FluMist
Fluvirin
Fluzone
Gardasil
Havrix
Hep B
Flu (TIV)
Flu (TIV)
Flu (LAIV)
Flu (TIV)
Flu (TIV)
HPV4
Hep A
Ipol
Infanrix
Kinrix (Knrx)
Menactra
Menomune
Pediarix (Pdrx)
PedvaxHIB
Pentacel (Pntcl)
IPV
DTaP
DTaP + IPV
MCV or MCV4
MPSV or MPSV4
DTaP + Hep B + IPV
Hib
DTaP + Hib + IPV
Pentavalente
Pneumovax
Prevnar
ProQuad (PrQd)
Quadracel (Qdrcl)
Recombivax HB
Rotarix
RotaTeq
DTaP + Hep B + Hib
PPSV or PPV23
PCV or PCV7 or PCV13
MMR + Varicella
DTaP + IPV
Hep B
Rotavirus (RV1)
Rotavirus (RV5)
TriHIBit
Tripedia
Twinrix (Twnrx)
Vaqta
Varivax
DTaP + Hib
DTaP
Hep A + Hep B
Hep A
Varicella
Vaccine Abbreviations in alphabetical order
Abbreviations
Full Vaccine Name
DT
Diphtheria, Tetanus
DTaP
DTP
Flu
(TIV or LAIV)
(For updated lists, visit http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/us-vaccines-508.pdf)
Trade
Name
Diphtheria, Tetanus,
acellular Pertussis
Diphtheria, Tetanus,
Pertussis
Abbreviations
Hep A (HAV)
Hep B (HBV)
Hib
HPV
(For updated lists, visit http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/us-vaccines-508.pdf)
Full Vaccine Name
Hepatitis A
Hepatitis B
Haemophilus influenzae
type b
Abbreviations
Human Papillomavirus
OPV
MPSV or MPSV4
MMR / MMRV
Full Vaccine Name
Meningococcal
Polysaccharide Vaccine
Measles, Mumps, Rubella /
with Varicella
Abbreviations
Rota
(RV1 or RV5)
Full Vaccine Name
Td
Tetanus, Diphtheria
Oral Poliovirus Vccine
Tdap
Tetanus, Diphtheria, acellular
Pertussis
TIG
Tetanus immune globulin
VAR or VZV
Varicella
Inactivated Poliovirus
PCV or PCV7 or
Pneumococcal Conjugate
Vaccine
PCV13
Vaccine
Hepatitis B Immune
Meningococcal
Pneumococcal Polysaccharide
HBIG
MCV or MCV4
PPSV or PPV23
Globulin
Conjugate Vaccine
Vaccine
If you have a disability and need this document in another format, please call 1-800-525-0127 (TDD/TTY 1-800-833-6388).
Influenza
IPV
Rotavirus
DOH 348-013 January 2010
YMCA OF GREATER SEATTLE - Policies for Summer Programs
(Please initial)
I have read and understand the Payment, Credit and Refund Policy, page 9 of the Summer
Programs Handbook, outlined below.
•
•
•
•
•
•
Payment must be received no later than 2 weeks prior to the beginning of each session. If payments
are not received by the due date, your session will be cancelled and deposit will be forfeited.
Cancellations or transfers require written notice two weeks prior to the start of the session.
Deposits are non-refundable but can be transferred and used for other 2013 summer care programs.
A Payment Schedule is located in your Summer Programs Handbook.
A fee of $30 will be assessed for any returned/declined payment transactions.
Refund and credit policy will use guidelines below:
Notice Given Prior To:
Two weeks with written notice
Thursday prior with written notice
After Thursday prior
(Please initial)
Refund
100%
0%
0%
Credit
100%
100% (Less deposit)
0%
Deposit
100% (credit only)
0%
0%
I have read and understand the Sunscreen Policy, page 16 of the Summer Programs Handbook.
Please check one box below:
I wish to have the YMCA Summer Program staff use the following sunscreen on my
child: Rocky Mountain Sunscreen/SPF 45 - Waterproof, Hypoallergenic, PAPA Free, and
Fragrance Free. Active Ingredients: Ethylehexly-P-Methoxycinnamate, 2 Ethylhexyl Salicylate,
Oxybenzone, 2-Ethylhexl-2-Cyano-3-Diphenylacrylate.
I do not wish to have sunscreen on my child.
I will provide sunscreen for my child labeled with my child’s name.
(Please initial)
(Please initial)
I have read and understand the No Tolerance Policy, page 14 of the Summer Programs Handbook.
I have read and understand the Peanut and Nut Policy, page 7 of the Summer Programs
Handbook, outlined below.
To help the YMCA create a safe environment for children with life-threatening nut allergies, you may be
asked to refrain from sending your child with food containing peanut butter or other nuts and/or other
foods manufactured in a plant that processes nuts.
(Please initial)
I have read and understand the Challenge Course Awareness of Risks Statement, page 18 of the
Summer Programs Handbook and agree to the following statement:
In consideration of being allowed to participate, I hereby agree to release the YMCA of Greater Seattle,
its officers, directors, employees, volunteers or other agents from ordinary negligence, including
liability for injury, illness, death, loss or damage resulting from participation in these activities. I
understand if any part of this release from liability is determined to be unlawful in the State of
Washington; the remaining parts will still apply.
Agreement
I have read and initialed the above information and I fully understand all policies of the YMCA’s Summer Programs.
Child’s Full Name: ____________________________________________________________________________________________________________
Parent/Guardian Signature: _______________________________________________________ Date: _______________________________
PARENT/GUARDIAN STATEMENT OF UNDERSTANDING
The following information is important for the safety and protection of your child. Please
read the information and sign this form.
I understand that the adult who signs the child up for the program is responsible for payments to the YMCA.
I understand all financial, attendance, enrollment and other business documents will be provided only to the adult who
signs the child up for the program and is responsible for payment.
I understand that YMCA staff are not allowed to baby-sit or transport children outside of the YMCA program.
I understand children should not receive gifts (video games, jewelry, movie tickets…) that are not part of the YMCA
program from YMCA staff or volunteers, and I should report this to a supervisor if they do.
I understand that I have free access, at all times, to areas of the program used by my child. I also understand that I
will have opportunities to participate in program activities, and that this participation may require me to go through a
screening process. I also understand that if my participation obstructs the program in any way, this privilege will be
revoked.
I understand that I am not to leave my child at the YMCA or program site unless a YMCA staff is there to receive and
supervise my child.
I understand that my child will not be allowed to leave the program with an unauthorized person.
I understand that should a person arrive to pick up my child who appears to be under the influence of drugs or
alcohol, for the child’s safety, staff may have no recourse but to contact the police.
I understand that YMCA staff will engage children in discussions to help them understand how they can set their own
personal safety and touching limits.
I understand that I will be provided information about my child’s progress and/or any issues related to his/her care,
however, both parents/guardians may receive this information upon request.
I understand that staff in licensed child care programs, family and mental health services and specific staff in other
programs are mandated by state law to report any suspected cases of child abuse or neglect to the appropriate
authorities for investigation. I also understand that employees in all YMCA programs follow the same reporting
protocol. Furthermore, our staff are protected from liability for good faith reporting.
I understand that the Health Care Plan is posted and available for my review.
I have read and understand the statements above and I have received a copy of:
_______________ Family Handbook (Containing all policies, procedures, philosophy, Medical Procedures, Disaster
Preparedness Plan, Pesticide Policy, Statement for Prevention of Abuse and the Creating a Child Safe
Environment brochure)
____________________________________________________________________
Child’s Full Name
_________________________________________________
Parent/Guardian Signature
__________________
Date
COPY OF STATEMENT WILL BE FILED WITH CHILD’S RECORDS.
SUMMER PROGRAMS
HANDBOOK
Page 1
Everyone is welcome. Financial assistance is available. The YMCA of Greater Seattle strengthens communities
in King and south Snohomish counties through youth development, healthy living and social responsibility.
TABLE OF CONTENTS
Welcome
3
Medication Management
10
Locations & Contact Information
4
Medical Emergencies
11
Partnering With You
5
Special Needs
11
YMCA Core Values
5
Behavior Management
12
Philosophy & Purpose
6
Child Safety
12
Nondiscrimination Statement
6
Emergency Procedures
13
Daily Sign-In/Out Procedures
6
Disaster Plan
13
Lunch, Snack and Meal Plans
7
Insurance
13
Peanut and Nut Allergies
7
Code of Conduct
14
What To Bring
7
No Tolerance Policy
14
What Not To Bring
7
Statement for Prevention of Abuse
15
Staff Ratios & Training
8
Inclement Weather
16
Transportation & Trips
8
Sunscreen Policy
16
Lost and Found
8
Pet Policy
16
Custody Issues
8
Pesticide Policy
17
Payment, Credit, & Refund Policy
9
Late Pick-Up Policy
17
Financial Assistance
9
Paperwork Policy
17
Sick Child Procedures
10
Challenge Course Awareness of Risks
18
Page 2
WELCOME
Dear YMCA Summer Program Parent or Guardian,
Welcome to Summer Camp 2013 at the YMCA! We are pleased to offer a wide variety of exciting and enriching programs for
you and your family this summer. We hope you will find a program, which fits your child’s interests, is conveniently located
and provides your child with a lifetime of memories. Each week will be theme-based and offer a diverse and enriching
curriculum for your child.
YMCA summer youth programs are tons of fun but also instructive for life. Our staff provides activities that have a positive,
life-long impact on your child through:
•
Developing self-confidence and independence
•
Communicating core values of respect, responsibility, honesty and caring
•
Creating lasting friendships and lifelong memories
•
Stemming summer learning loss with enrichment activities and literacy-rich programs
•
Encouraging learning and exploration in a supportive environment
•
Infusing fun and good health into activities each day
Positive relationships among campers, staff and parents are critical for each child's healthy development and social growth. A
small ratio of campers to staff enables YMCA leaders to engage in activities and conversations with each camper every day. In
our quality programs, staff is upbeat and interacts with campers using warmth, patience, understanding and fairness. In
addition they:
•
Are responsive to camper's feelings, needs, cultures, abilities and languages
•
Encourage leadership skills in campers by letting them offer ideas to expand or enrich an activity and suggest and
initiate activities
•
Allow campers - as a key part of learning - to make and learn from their own mistakes
We also make sure that there are positive relationships among staff. We know the campers look to camp staff as role models,
watching and learning as they cooperate, communicate and solve problems with each other. We are excited about your
interest in joining us this summer. If we can answer any questions for you, please do not hesitate to call your local YMCA.
We look forward to having you as part of our Y family this summer!
Sincerely,
Courtney K. Whitaker
Child Care Executive
YMCA of Greater Seattle
Page 3
LOCATION AND CONTACT INFORMATION-West Seattle/Fauntleroy YMCA
Summer Camps in Central, South and West Seattle
Camp
Site
Address
Camp
Director
Outdoor Day Camp
Lincoln Park
Concessions Building
8011 Fauntleroy Way SW
Seattle, WA 98136
Stacy LaVielle
206206-930930-2591
Wrap Around Care
Admiral Congregational
Church
4320 SW Hill St
Seattle, WA 98116
Stacy LaVielle
206--930206
930-2591
West Seattle
Elementary
6760 34th Ave SW
Seattle, WA 98126
Stacy LaVielle
206--930206
930-2591
Bailey Gatzert
Elementary
1301 E Yesler St
Seattle, WA 98122
Lawrena King
206--325206
325-1652
Concord Int'l
Elementary
723 S Concord
Seattle, WA 98108
Angie Claiborne
206--768206
768-1164
Thurgood Marshall
Elementary
2401 S Irving St
Seattle, WA 98144
Diane Lesemann
206206-720720-1932
West Seattle
Elementary
6760 34th Ave SW
Seattle, WA 98126
Rosa Webber
206--937206
937-1036
or 206206-510510-8000
Summer Fun Bunch
Lincoln Park
8011 Fauntleroy Way SW
Seattle, WA 98136
Jill Mudge
206--935206
935-6000
Specialty Camp /Jump
Rope
Fauntleroy YMCA Gym
9140 California Ave SW
Seattle, WA 98136
Mary Sanderson
206206-937937-1000
Sports Camp
Lincoln Park
8011 Fauntleroy Way SW
Seattle, WA 98136
Mary Sanderson
206206-937937-1000
Discovery Camp
Page 4
PARTNERING WITH YOU
A great summer program requires a partnership between summer staff and parents. As a partner in your child’s success in our
program, you have free access at all times, to all areas of the camp used by your child. We invite you to become familiar with
the staff and encourage you to visit and to participate in the program as often as possible. If you plan to attend a scheduled
field trip or need to pick-up your child early at camp or at a field trip destination, please make advance arrangements with the
Camp Director.
Parent/Staff Communication
A schedule of activities or newsletter will be provided to you at the beginning of each session to keep you informed of
program plans and special events. Any problems your child may be having at home may affect his/her behavior at camp.
Please keep the Camp Director informed so that we can be sensitive to your child's needs. Any information of a confidential
nature will be shared only with those who need to know.
YMCA CORE VALUES
The YMCA of Greater Seattle is committed to a value-based character development curriculum. The teaching of the following
core values is incorporated into all youth activities:
Respect:
Respect Special regard for others, including assertiveness, consideration, courtesy, gentleness, unity, tolerance, humility.
Responsibility:
Responsibility Moral, legal and mental accountability, including courage, determination, helpfulness, justice, reliability,
loyalty, self-discipline, obedience, cleanliness.
Honesty:
Honesty Fairness of conduct and adherence to facts. Other virtues that relate to this concept include sincerity,
truthfulness, honor, tact, forgiveness, moderation, orderliness.
Caring:
Caring Interest and Concern, including compassion, friendliness, generosity, kindness, love, mercy.
Values Reports
Other behaviors such as being disrespectful to other children or staff, dishonesty, or failing to carry out responsibilities are
also inappropriate at the YMCA. Families will receive written VALUES REPORTS for behaviors such as those mentioned that
need attention as well as for positive behaviors. The Values Reports will be sent home and a copy will be put in your child’s
records. If a child receives one to three (dependent upon the offense) “Needs Attention Values Reports,” the Camp Director,
child and parents will have a formal conference to determine a plan of action.
Through our values based programs, we expect all our participants to uphold the YMCA values of respect, responsibility,
caring, and honesty. We are aware that children sometimes copy the behaviors of other children. Therefore, in order for a
child to understand the seriousness of their actions, any child engaging in behavior that is inappropriate at the YMCA, will
receive disciplinary action. This No Tolerance Policy along with the Values Reports will enable us to better communicate with
our families.
Page 5
PHILOSOPHY AND PURPOSE
YMCA OF GREATER SEATTLE MISSION
We’re for youth development, healthy living and social responsibility.
YMCA summer programs will stimulate a child's physical, social, intellectual, and emotional development. We use small group
experiences that are developmentally appropriate.
In YMCA summer programs, your child will:
•
Develop physically, emotionally, and socially through a variety of safe, developmentally appropriate and challenging
experiences.
•
Expand awareness and appreciation for the natural world.
•
Learn and display the four core values of the YMCA: Respect, Responsibility Honesty and Caring
•
Increase appreciation for their own family, friends and surrounding community.
NONDISCRIMINATION STATEMENT
All people are welcome at the YMCA regardless of race, sex, national origin, religion, or abilities. Children and parents who
have limited English language ability can be assisted with the translation of written information or with an interpreter.
Contact the Camp Director to make necessary arrangements. In our efforts to promote an awareness and understanding of
the world around us, lessons about customs and celebrations of other cultures are a part of our curriculum. YMCA Camps will
reflect and respect the diversity in our community. Religious education is not part of our program.
The YMCA of Greater Seattle is committed to providing developmentally and culturally appropriate programming that respect,
reflect, and support children and families; cultivate an understanding among children and staff and incorporate to an anti-bias
approach to curriculum.
DAILY SIGN-IN/OUT PROCEDURES
•
A sign in/out area will be available when you arrive at the site.
•
You must sign your full name on the attendance roster when bringing children to camp and when picking them up.
•
Your child will only be released to the parent/guardian or other authorized adult listed on the Youth Program
Registration Form.
•
Identification may be checked daily. While we know it can be inconvenient to show your ID every day, we appreciate
you supporting our staff to keep your children safe.
•
For the safety of your child, we will not release your child to anyone who appears under the influence of drugs and/or
•
If your child has not arrived by start of the camp day, we will assume he/she will not be attending camp, and we’ll
alcohol, but will assist in making other arrangements for transportation home.
begin our day without him/her.
•
Pick up your child on time each day. If an emergency arises and you are unable to reach the site before closing, call
the staff to inform them of your progress.
•
Page 6
Quest,
Quest, Trek & Lead Participants MAY have the ability to sign themselves in and out of camp
LUNCH, SNACK & MEAL PLANS
Each day you will NEED to provide a nutritious lunch for your child. Lunches provided by parents should strive to meet the
USDA guidelines and contain a dairy product, a protein food, and two or more servings of fruit or vegetables. Please do not
send candy, gum or soda with your child to camp. It is not possible for us to provide refrigeration or a microwave for lunches,
so please do not send foods that
that may spoil such as mayonnaise or require reheating.
Children attending wrap around care will be offered a light morning and afternoon snack daily, with the exception of some
Teen Programs. These snacks are not sufficient to replace breakfast or lunch. If you would like to provide alternate food for
your child during snack time (eg. food from home, extra food from their packed lunch) for dietary, health or other reasons
please ask for a YMCA Parent Meal Plan Agreement (WAC 170-297-7525-Parent or Guardian Provided Food).
PEANUT AND NUT ALLERGIES
To help the YMCA create a safe environment for children with life-threatening nut allergies, you may be asked to refrain from
sending your child with food containing peanut butter or other nuts and/or other foods manufactured in a plant that
processes nuts. If you have any questions please speak with the Camp Director.
WHAT TO BRING
Dress your camper for the weather! Some programs, such as Outdoor Day Camp, are all outdoors. Please send a jacket if it’s
chilly and a poncho if it’s raining! We won’t let a few raindrops or a little dirt stop our summer fun! Wear shoes for running,
playing, and getting dirty!
Following are some items to fill your child’s backpack:
•
Water bottle
•
Sack lunch
•
Swimsuit and towel on swimming day and field trip days
WHAT NOT TO BRING
We ask that you keep these things at home:
•
I-pods
•
Cell Phones
•
Money, gum and candy
•
Trading Cards
•
Weapons of any Kind
•
Drugs, Alcohol & Tobacco Products
•
Any Electronics
•
Any Valuables, including personal sports equipment
Many of these items can be lost, broken or stolen while at camp. If these items accidentally show up at camp, staff will hold
them for the camper and return them at the end of the day.
Page 7
STAFF RATIOS AND TRAINING
Ages 3-5
A staff to child ratio of 1:10 is normally maintained.
Ages 5-15
A staff to child ratio of 1:12 is normally maintained.
Staff-child ratios are adjusted to assure adequate supervision for the age group, ability and physical condition of all the
campers.
All of our staff have had previous experience working with children and have attended and continue to attend regularly
scheduled training events on behavior management, communication skills, and creative activities to do with kids. Staff
maintain current certification in CPR, First Aid, Child Abuse Prevention, and other certification required by the licensor. In
addition, staff and volunteers are thoroughly screened prior to employment and evaluated on a regular basis to ensure
continually high performance.
To make sure your child remains safe outside of the YMCA's supervision and to protect our staff members and volunteers, we
request that you do not ask a YMCA employee or volunteer to baby-sit, host sleepovers, or spend one-on-one time with your
child outside of YMCA programs.
TRANSPORTATION AND TRIPS
Any fees incurred on a field trip will be paid by the YMCA and are included in the weekly camp price. Additionally, upon
signing the Youth Program Registration form, you have already given permission for the YMCA to transport your child in the
following vehicles: YMCA vans, YMCA buses, leased school buses and public transportation. Drivers of all YMCA vehicles are
thoroughly screened and authorized by the YMCA, based on experience and good driving records. Each driver must also have
a Washington State driver's license, be currently certified in First Aid & CPR, and participate in an approved YMCA driver
training program. Our vehicles are regularly maintained and undergo daily inspections before being driven.
LOST AND FOUND
Please label all clothing and items brought to Camp with your child’s First Initial and Last name. A lost and found center will
be located at each Camp. At the end of each Camp week, unclaimed items will be held at the branch for one month and then
donated to Goodwill.
CUSTODY ISSUES
We realize that custody decisions and parenting plans are very important to both parents. However, we are not
not a party to any
custody orders and not in a position to enforce parenting plans.
plans. If both parents are listed on the Youth Programs Registration
Form (or if one parent is listed on the form but that parent has confirmed the identity of the other parent) both parents may
pick up regardless of the custody agreement. Any disagreements must be addressed by the parents away from the site. Please
make sure you have established clear expectations between the parties. We do honor Restraining orders, Anti-Harassment
orders, or other court orders created for the protection of the child. Please provide a copy to the Camp Director.
Page 8
PAYMENT, CREDIT AND REFUND POLICY
Program Payments
Payment must be received to the YMCA no later than two
two weeks prior to the start of each session your child will attend. If
payments are not received by the due date, your session will be cancelled and deposit will be forfeited. A $30 fee will be
assessed for any returned/declined payment transactions. For your convenience, a Payment Schedule is located below.
PAYMENT SCHEDULE
WEEK OF:
PAYMENT DUE DATE:
June 10-14
May 27th
June 17-21
June 3rd
June 24-28
June 10th
July 1-5*
June 17th
July 8-12
June 24th
July 15-19
July 1st
July 22-26
July 8th
July 29 – August 2
July 15th
August 5-9
July 22nd
August 12-16
July 29th
August 19-23
August 5th
August 26-30
August 12th
For cancellations or transfers, we request written notice two weeks prior to the start of the session. Deposits are nonrefundable but can be transferred and applied to other YMCA programs. We will follow the schedule below related to refunds
& credits. *All Camp will be closed July 4th -check your local branch for July 5th as some will be closed that day as well.
CREDIT & REFUND POLICY
Notice
Notice Given Prior To:
Refund
Credit
Deposit
Two weeks with written notice
100%
100%
100% (Credit only)
Thursday prior with written notice
0%
100% (Less deposit)
0%
After Thursday prior
0%
0%
0%
FINANCIAL ASSISTANCE
Financial assistance and flexible payment plans are available through the YMCA for every program we offer. Please call your
local branch for an application. These funds are made possible through our Annual Partners With Youth Campaign and the
United Way.
Page 9
SICK CHILD PROCEDURES
The YMCA cannot accept children for Camp when they are ill. Staff will observe each child upon daily arrival. If your child is
experiencing any of the symptoms listed below, we will ask that other arrangements be made for his/her care.
• Vomiting on 2 or more occasions within the past 24 hours
• Too tired or sick to participate in daily activities
• Fever of 101°F or higher
• Draining Rashes
• Eye Discharge or Pink Eye
• Diarrhea
• Lice or Nits*
*Children must be nit and lice free prior to returning to camp. Lice is highly contagious and can take a while to eliminate from
camp once introduced. Reintroducing children with nits prolongs contamination and prevents kids returning to camp.
If your child develops these symptoms after drop-off, parents will be contacted, and asked to come pick-up their child. We will
separate your child from other children until you can pick them up. Ill staff members will also be sent home. We will report
communicable diseases to the local health department. We will also notify other parents in camp, so that they can take
appropriate action to protect their children.
MEDICATION MANAGEMENT
If it is necessary for your child to take medications while he/she is in our care, please give the medication directly to a staff
member when you sign-in your child. Written parental consent is required for us to administer any medication, and you will be
asked to complete a form when you hand over the medication. Medications are stored in a locked box out of the reach of
children. We maintain a record of administration in the locked box on a medication log. The Camp Director or designee will be
responsible to administer medication per a doctor’s instructions.
All prescription medication must be in its original container properly labeled with your child's full name, date prescription was
filled/or medication's expiration date, and legible instructions for administration such as manufacturer's instructions or
prescription label. Please only send one week’s worth of medication to Camp.
The following non-prescription medications require written parental consent and can be given only at the dosage, duration,
and method of administration specified on the manufacturer’s label for the age and/or weight of your child
•
•
•
•
•
•
•
Antihistamines
Non aspirin fever reducers/pain relievers
Decongestants or non-narcotic cough suppressant
Anti-itching ointments or lotions, intended specifically to relieve itching or dry skin
Sunscreen* (see separate policy on page 16)
Medicated lip balm
Mouthwash
A physician’s written authorization is required for any non-prescription medication that is:
• Not included in the above list
• To be taken differently than indicated on the manufacturer’s label
• Lacks labeled instructions
We cannot give aspirin except with a written authorization from a physician. Any unused medication will be returned to you or
properly disposed of.
*Please note that sunscreen is considered an over-the-counter medication by the Washington State Department of Health and
the Department of Licensing. Written Sunscreen Authorization from parents is required, see page 16 for Sunscreen Policy.
Page 10
MEDICAL EMERGENCIES
The Youth Program Registration Form includes a medical release, giving us permission to seek medical attention for your child
in case of an emergency. Please update this form as necessary with any changes in home, work or medical phone numbers.
In the case of life threatening emergencies, a member of our staff will immediately call 911, administer First Aid and CPR, and
notify you as quickly as possible. If you cannot be reached, your designated emergency contact will be notified. If
transportation to the hospital is needed, a staff member will accompany your child on the ambulance and will stay with
him/her until you arrive.
For minor emergencies and injuries, all of our staff are trained in First Aid and CPR, and we will administer as needed. A staff
member will then contact you to come and care for your child if additional care is needed.
For minor injuries that do not require us to notify you immediately, a verbal or written report will be given to you that day
when you pick up your child, explaining what happened and how the situation was treated. Accident reports are completed for
our records and recorded in our medical log.
We are required to notify the Department of Social & Health Services by phone and in writing of any serious injuries that
require medical treatment, illness that requires hospitalization occurrences of food poisoning, or communicable diseases.
The hospitals used for emergencies are:
Swedish Hospital
747 Broadway
Seattle, WSA 91822
Phone: 206.386.6000
Children’
Children’s Regional Medical Cednter
4800 Sand Point Way NE
Seattle, WA 98105
Phone: 206.987.2000
SPECIAL NEEDS
YMCA staff members are encouraging, patient, and helpful in paving a pathway for children with mild to moderate disabilities
to succeed at YMCA Camps. We are not equipped nor staffed to work with children who need significant assistance with
personal care, constant one-on-one support, or have great difficulty in managing their behavior in a group setting.
If your child has a significant health issue or a special need, please contact the Camp Director to discuss appropriate
accommodations.
Page 11
BEHAVIOR MANAGEMENT
YMCA Camps strive to meet the needs of all children by setting guidelines and boundaries appropriate to each stage of
development. If problems arise, we will use the following sequential procedures:
1. The child will be encouraged to use his/her words to try to solve the situation peacefully.
2. The child will be redirected to a new activity.
3. The child will be removed from the situation until he/she is able to rejoin the group.
4.
Parents are alerted and encouraged to share ideas.
5. Parent & Staff conference will be held with recommendation for an immediate behavior contract or short-term
suspension from Camp.
6. Complete removal of the child from program.
As a partner in your child’s success, we encourage you to share information with us that may affect your child's behavior in
Camp. We are committed to working with you in the best interest of your child and the rest of the children in our care. We do
not use or endorse any form of corporal punishment by anyone (including parents). We do not condone biting, jerking,
shaking, spanking, slapping, hitting, kicking or any other means of inflicting physical pain.
Because there are such a wide variety of behaviors that children display, the YMCA reserves the right to make the decision to
suspend or expel a child based on the physical or emotional safety of the child, other children in the program and the staff. In
such a situation parents may be called to come immediately to pick-up their child, or the child may be separated from the
group for the remainder of the day.
CHILD SAFETY
As a partner in your child’s success, the YMCA of Greater Seattle is committed to providing a safe environment for all participants
and staff. We work hard to create an environment that is both physically and emotionally safe for children. If at any time
throughout the summer you are concerned about the physical or emotional health of your child, please do not hesitate to speak to a
staff member or call the Camp Director.
Personal Safety Talks
As part of our program, staff engages in discussions designed to increase children’s understanding of touching and personal space
limits. YMCA staff will model the use of correct words for body parts and functions, and respond to conversations and questions in
age appropriate ways.
Child Abuse Reporting
YMCA staff are required to report immediately to Child Protective Services (CPS Intake), licensor or police any instance when
there is reason to suspect the occurrence of physical, sexual, or emotional abuse, child neglect or exploitation. We may NOT
notify parents if this occurs except upon the recommendation of Child Protective Services or the Police.
Page 12
EMERGENCY PROCEDURES
All sites practice monthly fire drills and have a posted evacuation plan. The YMCA has written emergency policies for a variety
of issues. A copy may be obtained from your Branch or by contacting the Camp Director.
DISASTER PLAN
Branch: West Seattle and Fauntleroy YMCA
Camp Sites: Bailey Gatzert, Concord Int’l, Thurgood Marshall, West Seattle Elementary Schools, Lincoln Park, Admiral
Congregational Church
Each branch is required by law to develop and implement a disaster plan designed for response to fire, natural disasters, and
other emergencies. The plan must address what you are going to do if there is a disaster and parents/guardians are not able
to get to their children for two or three days. (WAC 170-295-5030)
Q. How will your branch account for all children and staff during and after the emergency?
A. Roll call; staff assigned to groups; specific meeting places; children and staff files move with children.
Q. How will your branch evacuate the premises?
A. Evacuation routes posted at each site, based on the school or site disaster plan.
Q. At what location will you meet after evacuation?
A. See site-specific plan posted at each site on the Family Board.
Q. How will you contact parents/guardians or how will
will parents/guardians be able to contact your child care center?
A. Site cell phone; most staff have cell phones; through emergency workers. Files remain with the children with
emergency contact phone numbers. Each child has been asked to supply an out-of-state contact so that someone can
be notified when in-state numbers are inaccessible.
Q. What kind of transportation method will you use, if necessary?
A. YMCA vans; parents; emergency worker vehicles. Private staff vehicles may be used only as a last option.
INSURANCE
It is the responsibility of every individual, their parent or legal guardian to provide for their own accident and health coverage
while participating in all YMCA activities. The YMCA of Greater Seattle does not provide any accident or health coverage for
its' participants.
Page 13
CODE OF CONDUCT
The YMCA is committed to providing a positive atmosphere that is safe and inclusive to all in our community. Therefore, the
YMCA of Greater Seattle has adopted a code of conduct to govern the actions and behavior of all people while in our facilities
and while participating in YMCA programs.
Individuals are expected to:
•
Uphold the YMCA core values of respect, responsibility, honesty, & caring
•
Provide an atmosphere free of derogatory or unwelcome comments, conduct or actions of a sexual nature, or actions
based on an individual’s sex, race, ethnicity, age, religion, abilities, sexual orientation, or any other legally protected
statues
•
Be respectful and cooperative with YMCA staff and others
The following will NOT be tolerated at YMCA facilities and in YMCA programs:
•
Abusive, harassing, and/or obscene language or gestures
•
Threats of harm, physical aggression, or violent acts
•
Weapons of any kind
•
Smoking
•
Damaging or defacing YMCA property
•
Possession, sale, use, or being under the influence of alcohol or illegal drugs
•
Offensive and unlawful conduct
Individuals who experience or observe inappropriate conduct are encouraged to promptly report their concern to YMCA staff.
Every effort will be made to ensure that reports are investigated and resolved promptly and effectively.
NO TOLERANCE POLICY
We want to make sure all children at the YMCA have a positive atmosphere that is safe and inclusive. We are asking for your
support in maintaining a fun, safe place where children can achieve their potential. Please talk with your children about the
importance of not exhibiting the behaviors described below. Ideally, we want to work with families to prevent these behaviors
from occurring.
No Tolerance Policy
The following will NOT be tolerated in our Camps:
•
•
•
•
•
•
•
Abusive, harassing and/or obscene language or gestures
Threats of harm, physical aggression, violent acts, or bullying
Weapons of any kind
Damaging or defacing YMCA property
Offensive conduct
Purposely leaving the area of supervision without permission
Improper exposure
Failure to follow this code of conduct will result in disciplinary action, which may include a one to three day suspension. A
parent conference will be scheduled to develop a behavior contract in order for your child to remain in the Camp. It may
become necessary for the benefit of the child, as well as for the safety of the other children, to remove a child from our Camp.
Page 14
STATEMENT FOR PREVENTION OF ABUSE
A principal endeavor of the YMCA is to provide a healthy atmosphere for the growth and development of youth and children.
Thus, the mistreatment or neglect of youth or children and the resulting severe effects are of primary concern to the YMCA.
Child abuse is mistreatment or neglect of a child by parents or others resulting in injury or harm. Abuse can lead to severe
emotional, physical, and behavioral problems. Because of its concern for the welfare of children and youth, the YMCA has
developed policies, standards, guidelines, and training to aid in the detection and prevention of child abuse. In addition, all
employees are screened, and background checks are conducted upon hiring or rehiring. Additionally, employees who have
contact with children and youth receive training in recognizing, reporting, and preventing child abuse, which includes training
in recognizing signs that a child is being groomed for abuse. Some of the guidelines employees are expected to follow are:
•
Avoid being alone with a single child where you cannot be observed by other staff or adults
•
You may not relate to children who participate in YMCA programs outside of approved YMCA activities. For example,
baby-sitting weekend trips, foster care etc. are not permitted. An exception must be approved in advance by the
Director of Risk Management and the Branch Executive or SVP/COO
•
Giving personal gifts to program participants or their parents is not allowed
•
Program rules and boundaries must be followed, including appropriate touch guidelines
•
Children or youth should not be singled out for favored attention
•
Dating a program participant under age 18 is not allowed. Some YMCA programs may have additional restrictions
•
Children may not be disciplined by use of physical punishment or by failing to provide the necessities of care.
•
Verbally, physically, sexually, or emotionally abusing or punishing children or youth is not allowed.
•
Children may be informed in a manner that is age appropriate to the group of their right to set their own “touching”
limits for personal safety.
•
Children should only be released to authorized persons in programs with controlled pick-up procedures.
•
Any information regarding abuse or potential abuse should be documented in writing.
•
At the first reasonable cause to believe that any child abuse exists, it should be reported to your supervisor or branch
•
At the first reasonable cause to believe that an employee or volunteer abused a child or youth, even if it was not
executive so that proper reporting can be initiated.
during working hours, his or her conduct should be reported to the program director and the branch executive or
another designated branch representative. Additionally, it is the YMCA’s protocol to make a report to the appropriate
authorities. Appropriate actions will be taken regarding the employee or volunteer, including suspension or
termination from YMCA employment or volunteer status.
Confidentiality of information related to child abuse is crucial and should be limited to the immediate supervisor and/or branch
executive and designated members of the Association office.
Page 15
INCLEMENT WEATHER
Some of our Camp activities will take place outdoors, and campers need to be prepared for whatever the weather will bring!
Most commonly, the rain we experience in the Pacific Northwest is light, and Camp activities will continue in the drizzle. On
days when the rain is heavier, Camp activities will continue as long as they are still safe, and some activities may be moved
indoors at the YMCA branch or other nearby location. On rainy days, campers should wear water repellant rain gear as an
outer layer, and something warm as an inner layer. If we encounter extreme heat, we will try to keep activities in the shade
whenever possible, play lots of water games, and keep kids drinking water.
SUNSCREEN POLICY
During our outside activities and on field trips, children may spend hours in the sun. In order to minimize the effects of this
exposure to the sun, we encourage parents to do one or more of the following:
•
provide your child with a long sleeve cotton shirt to wear in the sun,
•
provide a T-shirt to wear over his or her swimming suit,
•
encourage your child to wear a hat to protect the face,
•
educate your child regarding protecting his or her skin, as well as the early signs of enough sun,
•
purchase and use the early warning sun patches, and
•
use and appropriately apply sunscreen.
The Y will provide sunscreen for all children in our camps. The sunscreen is Rocky Mountain Sunscreen/SPF 45 - Waterproof,
Hypoallergenic, PAPA Free, and Fragrance Free. Active Ingredients
Ingredients:
nts Ethylehexly-P-Methoxycinnamate, 2 Ethylhexyl Salicylate,
Oxybenzone, 2-Ethylhexl-2-Cyano-3-Diphenylacrylate.
Written authorization from parents is required in our paperwork packets. If you wish to supply your own sunscreen for your
camper you may indicate that as well. Y staff will administer sunscreen in the following manner based on the age of your child;
•
Preschool – staff initiated, re-applied at appropriate intervals, staff will assist in application
•
Elementary School Age-staff & child initiated, reminders for re-application by Y staff at appropriate intervals, staff
may assist younger children under 7 with application, most children will be encouraged to rub sunscreen in
themselves
•
Middle School & High School-youth initiated, staff will remind youth at appropriate intervals or based on specific
activities, youth will self-apply sunscreen
PET POLICY
Our Discovery and Fun Bunch Camps may have a pet. This gives children responsibility for feeding and caring for animals. A
designated staff in each camp will be responsible for the pet’s environment and supervision of the learning opportunities.
Reptiles and amphibians will be in a self-contained area except during educational activities. Children five years of age or less
will not physically handle reptiles and amphibians.
List of Possible Pets: Rabbits, Hamsters, Guinea Pigs, Fish, or Insects.
Accommodating arrangements can be made if your child has allergies to any of these pets.
Page 16
PESTICIDE POLICY
You will be notified at least 48 hours in advance of the application of any pesticides, as we receive notification from the
school district or city. This notification will include the product name of the pesticide being used, intended date and time of
application, location where the pesticide will be applied, the pest to be controlled and the name and number of a contact
person at the site. Signs and/or markers will be posted following the application of the pesticide. These will state, “This
landscape has recently been sprayed or treated with pesticides.” They will also state who has treated the landscape and who
to call for more information.
LATE PICK-UP POLICY
Children must be picked up by the time camp closes. If an emergency arises and you are unable to reach the site by close, please
phone us to assure both the staff and your child that you are on the way. State law requires us to notify CPS when children are left
in a program without notification from families and when no contacts can be reached to pick up the child.
Each Camp follows these guidelines in response to a late pick-up:
1.
Staff notifies the family to ensure that someone is on the way to pick up the child. If the family is not reachable, staff
notifies emergency contacts.
2.
If the family and emergency contacts cannot be reached, staff notifies the police.
3.
If your child is picked up late on three occasions, your child’s participation in the program may be terminated.
PAPERWORK POLICY
In addition to your reservation form, additional paperwork is required to ensure the safety of all children participating in our
programs. Paperwork is due no later than 2 weeks prior to the start of your first week of camp.
Please return the following forms to your branch:
1.) Youth Program Registration form (2 pages)
2.) Immunization Certificate (dates filled in on certified state form w/ parent signature, doctor’s records are not accepted in
lieu of certificate)
OR
Immunization Exemption
3.) Policies for Summer Programs
4.) Statement of Understanding
Page 17
CHALLENGE COURSE AWARENESS OF RISKS
YMCA summer programs for its youth may offer the use of various challenge course activities with both low course and high
course elements, including climbing walls and climbing structures, ropes courses, zip lines, giant swings, Odyssey Course and
Alpine Tower. The YMCA takes pride in providing safe environments, equipment and programs, but challenge course activities,
by their nature, are not without risks. We do not want to diminish your enthusiasm for the experience, but we do want all
participants to know in advance what to expect and what some of the potential risks are by participating in this activity.
All of the YMCA’s challenge courses are “Challenge by Choice” activities. Participants need only participate to the extent they
are comfortable, which may include choosing not to participate. Challenge program participants wear helmets, and harnesses
are hooked into belay devices. Participants must follow safety instructions; remain in areas designated by staff, and refrain
from behavior that is harmful to oneself or others.
Although all individuals in average health will be able to comfortably participate, it shall be each individual’s responsibility to
be sure they are in a healthy condition. Challenge courses may require a more strenuous physical activity level than
participants have been accustomed. Because of the height of many of the challenge course elements, the activity can be
stressful and some participants may be fearful. Participants who have heart ailments should understand that this activity
might affect their condition. There are also the usual risks with this activity associated with being outdoors and having
environmental exposures. Other risks associated with this activity include, but are not limited to: broken bones, muscle tears,
sprains, heat exhaustion or heat stroke, allergic reactions, cuts, infections, mental anguish, disabling head or spinal injuries,
paralysis or death. It is important that special health conditions or medical needs are communicated to YMCA staff.
We look forward to having you as part of our Y family this summer!
West Seattle & Fauntleroy YMCA
Summer Camps serving Central, South and West Seattle
West Seattle YMCA
4515 36th Avenue SW
Seattle, WA 98126
206.935.6000
westseattleymca.org
estseattleymca.org
Page 18
Fauntleroy YMCA (Camp Office)
9140 California Avenue SW
Seattle, WA 98136
206.937.1000