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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 wouldlike 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.Please do NOT communicate with me by: ¨ Email ¨ Phone

Authorized for Pick-up: Name: Name:

TRADITIONAL CAMPLocation: Huff Kid’s PlaceProgram/Dates (choose one or more):December 23–27¨ Individual Days: $55/$65* (daily)

¨ December 23¨ December 24 (Camp ends at 1:30 pm)¨ December 26¨ December 27

¨ Full 4 Days: $184/$234* (week)

December 30 – January 3¨ Individual Days: $55/$65* (daily)¨ December 30¨ December 31 (Camp ends at 1:30 pm)¨ January 2¨ January 3

¨ Full 4 Days: $184/$234* (week)

HOLIDAY BAKING & CRAFTSLocation: Almond Kid’s PlaceProgram/Dates:¨ December 23–27: $208/$248* (week)

CLONE WARSLocation: Almond Kid’s Place

Program/Dates:¨ December 30 – January 3: $208/$248* (week)

CREATINGEXTRAORDINAREXPERIENCESHoliday CampEL CAMINO 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 ¨ DiscoverName on Card:¨ Financial assistance application enclosed

Signature

EL CAMINO YMCA

Holiday Camp Registration Form(One form per child)

How: Parent/Guardian must complete attached Health HistoryForm and Liability Waiver, before child attends Holiday Camp ifchild has not attended camp or child care in the last year. Formsare also available at YMCA Branch Membership Desk.

Refund Policy: If you cancel your registration in writing nolater than two weeks before the start of the session, a refundwill be made by check or credit card. Otherwise, fees arenon-refundable.

Mail or drop off at: El Camino YMCA2400 Grant RoadMountain View, CA 94040

Or fax to: 650 969 1053

*A current $45 program membership fee per year is requiredfor registration.

Special Holiday HoursDecember 24 & 31 • 7:30 am – 1:30 pm (half day)

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WHO WE AREThe Y is the nation’s leading nonpro t committed tostrengthening communities through youth development,healthy living and social responsibility.

HOW WE DO ITWe integrate our four core values of caring, honesty,respect and responsibility in everything we do. We createextraordinary memories through providing opportunitiesto engage in new, fun and enriching experiences. At the Y,we help kids develop new skills and interests, interact inpositive ways, and engage in healthy lifestyles while beingmentored by adult role models.

OUR IMPACTThe Y is, and always will be, dedicated to building healthy,con dent, connected and secure children, adults, familiesand communities. Every day our impact is felt when anindividual makes a healthy choice, when a mentor inspires

a child, and when a community comes together for thecommon good.

SCHOOL BREAK CAMPSTraditional CampKids enjoy awesome arts and crafts projects, weekly eldtrips, outdoor games and cooking projects. Holiday BreakCamp helps your child stay physically active, developfriendships, and engage in a variety of activities thatpromote character development.

Fieldtrip: Christmas in the Park

Holiday Baking & CraftsCampers can explore their creativity through basic Holidayartwork and baking designing skills. Discover the art ofmeasuring, sifting, whisking, grating, and rolling, as youryoung chef prepares holiday muf ns, scones, biscuits,and pies. Your child will learn baking, decorating, drawing,painting, and enjoy traditional camp activities such asholiday games and songs

Fieldtrip: Christmas in the Park

Clone Wars

Explore through the highs and lows of the completeStar Wars Saga. Come as a Padawan, and leave a JediKnight. In this camp, advanced Jedi mental and physicalchallenges will develop the force within you. Then useyour knowledge of the Clone Wars to develop and star ina movie.

Fieldtrip: Tech museum to visit the Star Wars exhibit.

CAMPS HOURSProgram: 9:00 am – 4:00 pmExtended Care: 7:30–9:00 am & 4:00–6:00 pm

Special Hours: December 24 & 317:30 am – 1:30 pm (half day)

DROP-OFF AND PICK UPA parent or guardian must personally sign-in each childbetween 7:30–9:00 am, and sign-out each child between4:30–6:00 pm each day. On Field trip days, all childrenmust be at the center before 9:00 am and you may pickthem up after 4:30 pm. There is a $1.00 a minute chargefor any one picked up after 6:00 pm. An additionalHealthy History form will need to be completed on the

rst day of camp.

TRADITIONAL CAMPDates: December 23–27

December 30 – January 3Grades: K–5Location: Huff Kid’s Place

253 Martens AvenueMountain View, CA 94040

Fee: Facility Members: $55/dayProgram Members: $65/day*

- OR - Facility Members: $184/week

Program Members: $234/week*

HOLIDAY BAKING & CRAFTSDates: December 23–27Grades: K–5Location: Almond Kid’s Place

550 Almond AvenueLos Altos, CA 94022

Fee: Facility Members: $208/weekProgram Members: $248/week*

CLONE WARSDates: December 30 – January 3Grades: K–5Location: Almond Kid’s Place

550 Almond AvenueLos Altos, CA 94022

Fee: Facility Members: $208/weekProgram Members: $248/week*

DEDICATED TO TODAY’S YOUTHFOCUSING ON HEALTHY LIVINGDRIVING SOCIAL RESPONSIBILITY

Online registration available for allschool break camps at El Camino YMCA

For Youth Development

Swim, Sports & Play