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Page 1: GENERAL INFORMATION CAMP PAYMENT SCHEDULE€¦ · 3 June 15 - June 19 Mad Scientists 3 LEGOLAND 4 June 22 - June 26 Exploration 4 Wonder Works Museum 5 June 29 – July 3 The Great
Page 2: GENERAL INFORMATION CAMP PAYMENT SCHEDULE€¦ · 3 June 15 - June 19 Mad Scientists 3 LEGOLAND 4 June 22 - June 26 Exploration 4 Wonder Works Museum 5 June 29 – July 3 The Great

GENERAL INFORMATION WELCOME TO CAMPANELLI YMCA SUMMER DAY CAMP!

3 WAYS TO REGISTER!

Walk-In: Processed in real-time at Campanelli YMCA 300 W. Wise Rd. Schaumburg, IL. A receipt will be printed at the time of registration. Mail: Mail registration forms and payment to Campanelli YMCA. Fax: Fax registration forms with complete credit card information to 847.891.8901.

NO REGISTRATIONS TAKEN BY PHONE.

CAMP FEE PAYMENTS

⇒ Make checks payable to Campanelli YMCA or complete credit card information. All weekly camp deposits must be enclosed with registration

($25 per week non-refundable). ⇒ Camp fees are due 2 weeks in

advance of each registered week. Please see last page of this brochure for scheduled due dates.

⇒ Automatic Payments are required for weekly fees. Refer to page 8 for details. ⇒ REGISTRATION CHANGES will incur a

$15 administrative fee (per occurrence). A 14 day written notice IS REQUIRED to change any camp days/or camp sessions in order to receive a credit or refund. (NO CREDITS OR REFUNDS will be issued for changes requested less than 14 days in advance).

Y CAMP DIRECTORS Sheila Turek, Director of Youth Development & Campanelli Day Camp

P: 847.891.9622 ext. 106 E: [email protected]

Sally Camposagrado, M. Ed. Director of School Age Programs & KASPER Camp

P: 847.891.9622 ext. 105 E: [email protected]

YMCA CAMP FINANCIAL ASSISTANCE AVAILABLE

For those who qualify, financial assistance is available to provide children in need the opportunity to experience YMCA summer camp. Applicants must complete a YMCA Financial Assistance Application and provide the required documentation. Call the Campanelli Y at 847.891.9622 for further information. Financial assistance applications are due by May 4, 2020. Limited funds available.

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CONSIDER the BENEFITS of Attending YMCA SUMMER CAMPS

The YMCA became known throughout America for operating Summer Camp back in 1885 to provide children with positive developmental experiences. Today, our goal remains the same….

Physical activity and exercise; 1. Build skills not taught in most schools;

Develop increased sense of independence & confidence as a result of time spent away from home;

Prevent summer learning loss;

and, enhanced socialization as kids have the opportunity to make new friends at summer camp!

YMCA T-shirts are provided to all full-day campers to wear on field trips!

2. 3.

4. 5.

CAMP PAYMENT SCHEDULE

Camp Session/Dates Due Date

Week 1: 6/01/2020

5/18/2020

Week 2: 6/08/2020

5/25/2020

Week 3: 6/15/2020

6/01/2020

Week 4: 6/22/2020

6/08/2020

Week 5: 6/29/2020

6/15/2020

Week 6: 7/06/2020

6/22/2020

Week 7: 7/13/2020

6/29/2020

Week 8: 7/20/2020

7/06/2020

Week 9: 7/27/2020

7/13/2020

Week 10: 8/03/2020

7/20/2020

Week 11: 8/10/2020

7/27/2020

Payments not received by the due date will be charged a $20 late fee in addition to current balance due. The YMCA holds the right to suspend services if payment is not received prior to the start of your camper’s week. Please abide by the due dates listed above. For hassle-free billing and payment, the YMCA will automatically debit your account or charge card on the appropriate payment due date. Sign-up for this service at the YMCA Front Desk. The Automatic Payment Form is included in this brochure.

SESSION CHANGES REGISTRATION CHANGES will incur a $15 administrative fee (per occurrence). A 14 day notice IS REQUIRED to change any camp days/or camp sessions in order to receive a credit or refund. (NO CREDITS OR REFUNDS will be issued for changes requested less than 14 days in advance).

CAMPANELLI YMCA EXECUTIVE DIRECTOR

Judi Nealey, MPA

P: 847.891.9622 ext. 111 E: [email protected]

Camp Fees are due two weeks in advance of each registered session

Page 3: GENERAL INFORMATION CAMP PAYMENT SCHEDULE€¦ · 3 June 15 - June 19 Mad Scientists 3 LEGOLAND 4 June 22 - June 26 Exploration 4 Wonder Works Museum 5 June 29 – July 3 The Great

NEW! SUNRISE

MORNINGS! 6:30 am drop-off

1st - 9th grades

SUMMER CAMP 1st through 9th grades | 9:00 AM to 4:00 PM

VOYAGERS Camp Grades: Entering 3rd - 4th Voyagers will enjoy a variety of activities that are challenging and fun. Campers will engage in team work activities and will be encouraged to express their individual creativity through many activities during the day. Our goal in this age level is to provide each child with the experiences that will help them grow individually in order to work well with others.

NAVIGATORS Camp Grades: Entering 5th - 6th Navigators are our pre-teen campers, and will lead many of their group’s activities. Navigators will focus on being a good role model for the younger campers through weekly interactions. This age level will begin the process of planning activities such as sports, or crafts, that they will be engaging in during their camp day. Our main goal is to provide activities and experiences that are relevant and challenging for pre-teens.

TEEN Camp Grades: Entering 7th - 9th Teen Leaders Camp is designed for junior high students to engage in a variety of team building and leadership activities. The Teen Leaders Camp structure includes four key components: social responsibility, peer mentoring, leadership, and teamwork. In addition to swimming and weekly field trips, teen leaders will participate in several community service learning projects to establish the habit of making a difference in the lives of others. PLEASE NOTE: “Dog Days of Summer” week #11 is not offered for TEEN CAMP.

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• Towel, swimsuit, and flip-flops/sandals

• Water bottle labeled with child’s name

• Gym shoes

• 2 healthy snacks

• Sack lunch and drink labeled with child’s name

• 50 SPF Sunscreen (SPRAY bottle preferred). Please label bottle with your child’s name. Child must apply their own

sunscreen, or parent may apply before camp.

DAILY CAMPER SUPPLIES Campers should bring a backpack

each day with the following supplies:

2020 DAY CAMP REGISTRATION PLEASE PRINT CLEARLY

Child’s Name

Grade as of 9/2020 Age as of 6/2020

DOB Gender Camp Shirt Size

Child’s Home Address

City State Zip

Mother’s/Guardian’s Name | Home Phone

Mother’s/Guardian’s Address City State Zip

Work Phone Cell Phone Email

Father’s/Guardian’s Name | Home Phone

Father’s/Guardian’s Address City State Zip

Work Phone Cell Phone Email

CAMP FEES: REGISTRATION FEES: $45/per child | $75/per family (non-refundable)

CAMP SESSION DEPOSITS: $25 per week (non-refundable)

EXTENDED CARE OPTIONS: Sunrise (6:30-9AM): $40 Member / $50 General Public per week Onsite - 1st - 9th Grades Only

AM Care (7-9AM): $30 Member / $40 General Public per week

PM Care (4-6PM): $45 Member / $55 General Public per week TOTAL PAYMENT: $_______________

Check Enclosed: #________________

Please charge my credit card:

VISA Master Card Discover American Express

Account Number Expiration Date CVV#

Signature Date

EFT and CAD option also available. Please see Automatic Payment Form to set up your automatic payments.

Please select all camp sessions your child will attend.

Horizon (M-F) 1 2 3 4 5 6 7 8 9 10 11

Horizon (M/W/F) 1 2 3 4 5 6 7 8 9 10 11

Horizon (T/TH) 1 2 3 4 5 6 7 8 9 10 11

Adventure (M-F) 1 2 3 4 5 6 7 8 9 10 11

Adventure (M/W/F) 1 2 3 4 5 6 7 8 9 10 11

Adventure (T/TH) 1 2 3 4 5 6 7 8 9 10 11

Rookie Sports (M-F) 1 2 3 4 5 6 7 8 9 10 11

Rookie Sports (M/W/F) 1 2 3 4 5 6 7 8 9 10 11

Rookie Sports (T/TH) 1 2 3 4 5 6 7 8 9 10 11

Veteran Sports (M-F) 1 2 3 4 5 6 7 8 9 10 11

Veteran Sports (M/W/F) 1 2 3 4 5 6 7 8 9 10 11

Veteran Sports (T/TH) 1 2 3 4 5 6 7 8 9 10 11

Discovery (M-F) 1 2 3 4 5 6 7 8 9 10 11

Discovery (M/W/F) 1 2 3 4 5 6 7 8 9 10 11

Discovery (T/TH) 1 2 3 4 5 6 7 8 9 10 11

Explorers (M-F) 1 2 3 4 5 6 7 8 9 10 11

Explorers (M/W/F) 1 2 3 4 5 6 7 8 9 10 11

Explorers (T/TH) 1 2 3 4 5 6 7 8 9 10 11

Pathfinders (M-F) 1 2 3 4 5 6 7 8 9 10 11

Pathfinders (M/W/F) 1 2 3 4 5 6 7 8 9 10 11

Pathfinders (T/TH) 1 2 3 4 5 6 7 8 9 10 11

Voyagers (M-F) 1 2 3 4 5 6 7 8 9 10 11

Voyagers (M/W/F) 1 2 3 4 5 6 7 8 9 10 11

Voyagers (T/TH) 1 2 3 4 5 6 7 8 9 10 11

Navigators (M-F) 1 2 3 4 5 6 7 8 9 10 11

Navigators (M/W/F) 1 2 3 4 5 6 7 8 9 10 11

Navigators (T/TH) 1 2 3 4 5 6 7 8 9 10 11

Teen (M-F) 1 2 3 4 5 6 7 8 9 10

Teen (M/W/F) 1 2 3 4 5 6 7 8 9 10

Teen (T/TH) 1 2 3 4 5 6 7 8 9 10

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Extended AM Care (7-9AM) 1 2 3 4 5 6 7 8 9 10 11/DD

Register your kids for the “Dog Days of Summer” child care right before school starts! Kids will have a great time playing outdoors, making new friends, and playing group games. Please send your child with a sack lunch every day.

Fee: $185M/$195GP Ext. AM Care (7-9AM): $30M/$40GP Ext. PM Care (4-6PM): $45M/$55GP Location: Campanelli YMCA

“Dog Days of Summer” Week for Kids in Preschool - 6th Grades

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LOCATION: Campanelli Y Campus | 300 W. Wise Rd, Schaumburg

NEW! Camp Sunrise Early Care: 6:30 AM - 9 AM | $40 Members / $50 General Public per week

EXTENDED CARE: AM Care: 7 AM - 9 AM | $30 Members / $40 General Public per week PM Care: 4 PM - 6 PM | $45 Members / $55 General Public per week

PATHFINDERS Camp Grades: Entering 1st - 2nd Pathfinders will enjoy traditional camp activities such as arts & crafts, nature projects, games, field trips, swimming, and sports. Activities are age-appropriate and meet the social, emotional, cognitive, and physical needs of younger campers. Our goal is to provide each child with an experience that will leave them wanting to come back to camp year after year!

Extended PM Care (4-6PM) 1 2 3 4 5 6 7 8 9 10 11/DD

(LIMITED SPACE!)

Sunrise AM (6:30-9AM) 1 2 3 4 5 6 7 8 9 10 11/DD

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DISCOVERY CAMP Ages: 3 - 4 Discovery Camp incorporates the Illinois Early Learning Standards into the curriculum to include physical, cognitive, social, and emotional development. Our enriching environment offers children the opportunity to actively participate in cooperative groups, gain self-esteem, develop valuable problem solving skills, and form interpersonal relationships with one another. Campers will also enjoy the outdoors, swimming, and age appropriate field trips.

CREATE & PLAY CAMP CALENDAR & THEMES FIELD TRIPS*

Week Date Theme Week Field Trip Location 1 June 1 - June 5 Welcome Week 1 Get to Know You Games (Onsite) 2 June 8 - June 12 Lil” Artists 2 Art Füzd 3 June 15 - June 19 Mad Scientists 3 LEGOLAND 4 June 22 - June 26 Exploration 4 Wonder Works Museum 5 June 29 – July 3 The Great Outdoors 5 Spring Valley Nature Center 6 July 6 - July 10 Everyday Heros 6 Fire Zone Fire Safety 7 July 13 - July 17 Pirate Treasure Hunter 7 Pirates Cove 8 July 20 - July 24 Fun in the Sun 8 Sunny Hill Sprinkler Park 9 July 27 - July 31 Dinosaurs 9 DuPage Children’s Museum 10 August 3 - August 7 Under the Big Top 10 Carnival (Onsite) 11 August 10 - August 14 Dog Days of Summer 11 Magic Show (Onsite)

*FIELD TRIPS are scheduled on Wednesdays and subject to change due to availability. Swimming at the Y is on Mondays. Week #11 “Dog Days of Summer” will be held at the YMCA (Limited Enrollment).

EXPLORERS CAMP Grades: Entering Kindergarten Explorers Camp is designed for the active 5 year old! We will provide a fun and engaging traditional outdoor summer camp experience. Activities are age appropriate to meet the developmental needs of younger campers. Explorers will enjoy swimming and weekly field trips.

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REGISTRATION: $45 - One Child $75 - All Children in Family

DAY CAMP: 5 Days $185M/$195GP 3 Days $145M/$155GP 2 Days $105M/$115GP

EXTENDED CARE: AM CARE: 7 AM - 9 AM $30M/$40GP PER WEEK

PM CARE: 4 PM - 6 PM $45M/$55GP PER WEEK

M=YMCA Member GP=General Public

• Towel, swimsuit, and

• flip-flops/sandals

• Water bottle labeled with child’s name

• Gym shoes

• 50 SPF Sunscreen (SPRAY bottle preferred). Please label bottle with your child’s name. Child must

apply their own sunscreen, or parent may apply before camp.

DAILY CAMPER SUPPLIES Campers should bring a backpack

each day with the following supplies:

Signature (Parent/Guardian) Date Spouse/Legal Guardian

In the event of an emergency and I cannot be reached, I give my permission for the YMCA to act on my behalf in authorizing any necessary medical treatment. If an emergency vehicle is necessary, I understand that I will be called immediately following the call for appropriate follow-up.

Yes No

1.

AUTHORIZED PICK-UP FORM

Name Relationship DOB

Address City State Zip

Home Phone Cell Phone Work Phone

MEDICAL INFORMATION Allergies - List all known (medication, food, insect bites, etc.):

Will your child be taking any medication while at camp?

Please provide a copy of your child(rens) most recent physical signed by your physician. ((REQUIRED FOR PRE-SCHOOL CAMPERS ONLY)

Doctor’s Name Phone Number Parent/Guardian’s Signature Date

PARENT/GUARDIAN INFORMED CONSENT

If “yes” please list all medications (over the counter or prescription):

1. I understand that my child/children’s participation in YMCA activities, regardless of location, is at my own risk. As such, I as the parent or legal guardian assume full responsibility for bodily injury, death, or property damage arising out of my child/children’s participation in YMCA activities. 2. I understand that, on occasion, photos may be taken for YMCA promotion/publicity. As such, I give my permission for the use of my child/my family’s likeness in such promotion.

Signature (Parent/Guardian of record) Date

I authorize to make changes to this form on my behalf.

2. Name Relationship DOB

Address City State Zip

Home Phone Cell Phone Work Phone

3. Name Relationship DOB

Address City State Zip

Home Phone Cell Phone Work Phone

Please list the names of people who may pick up your child from the YMCA.

LOCATION: Campanelli Y Campus | 300 W. Wise Rd, Schaumburg

EXTENDED CARE: AM Care: 7 AM - 9 AM | $30 Members / $40 General Public per week PM Care: 4 PM - 6 PM | $45 Members / $55 General Public per week FOOD SERVICE: Lunch and two healthy snacks are provided daily.

CREATE & PLAY CAMP FEES

Questions? Contact

Sheila Turek 847.891.9622

Ext. 106

CREATE & PLAY PRESCHOOL DISCOVERY AND EXPLORERS CAMP for 3-5 Year Olds | 9:00 AM to 4:00 PM

Page 5: GENERAL INFORMATION CAMP PAYMENT SCHEDULE€¦ · 3 June 15 - June 19 Mad Scientists 3 LEGOLAND 4 June 22 - June 26 Exploration 4 Wonder Works Museum 5 June 29 – July 3 The Great

Questions? Contact

Sally Camposagrado 847.891.9622

Ext. 105

KASPER CAMP Kindergarten through 6th grades | 9:00 AM to 4:00 PM

KASPER CAMP CALENDAR & THEMES FIELD TRIPS*

Week Date Theme Week Field Trip Location 1 June 1 - June 5 Spirit Week 1 Onsite 2 June 8 - June 12 Wild on Wildlife 2 Reptile Show (Onsite) 3 June 15 - June 19 Super Slimy Science Lab 3 Morton Arboretum 4 June 22 - June 26 Jump into STEM! 4 Urban Air Trampoline Park 5 June 29 – July 3 Tropical Beach Bash 5 Onsite Water Games 6 July 6 - July 10 CSI (Camper Scene Investigations) 6 Challenge Accepted Escape Room 7 July 13 - July 17 Treasure Island 7 Rainbow Falls Water Park 8 July 20- July 24 Roll Out the Red Carpet 8 Elk Grove Movie Theater 9 July 27 - July 31 Super Hero Training Academy 9 Ultimate Ninjas 10 August 3 - August 7*** Pay It Forward Week 10 Carnival (On-site) 11 August 10 - August 14*** Dog Days of Summer 11 Poplar Creek Bowl

*FIELD TRIPS are scheduled on Wednesdays and subject to change due to availability. Camp will swim every Monday at a local water park. ***Week #10 will be held at the YMCA. Week #11 “Dog Days of Summer” will be held at the YMCA (Limited Enrollment).

Our KASPER campers will enjoy weekly field trips, weekly trips to a local water park, arts & crafts, outdoor games and activities, challenging STEM learning projects, and so much more! This camp will explore a variety of elements that will give your child a well-rounded camp experience this summer! KASPER CAMP FEES INCLUDE all bus transportation and field trips.

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KASPER SPORTS CAMP 2nd through 6th grades | 9:00 AM to 4:00 PM

KASPER Sports Camp is perfect for aspiring athletes who love to play a variety of sports and work as a team! Campers will learn basic fundamentals and skills necessary to play a variety of sports, while we emphasize the importance of sportsmanship and teamwork. Sports campers will also have fun with special guest visitors! SPORTS CAMP FEES INCLUDE all bus transportation and field trips.

KASPER SPORTS CAMP CALENDAR & THEMES FIELD TRIPS*

Week Date Theme Week Field Trip Location 1 June 1 - June 5 Sports Sampler 1 Onsite 2 June 8 - June 12 Backyard Sports 2 Reptile Show (Onsite) 3 June 15 - June 19 Go for the (Soccer) Goal! 3 Morton Arboretum 4 June 22 - June 26 Field Day Fun 4 Urban Air Trampoline Park 5 June 29 – July 3 Baseball Academy 5 Onsite Water Games 6 July 6 - July 10 Amazing Adventures 6 Challenge Accepted Escape Room 7 July 13 - July 17 Football Fundamentals 7 Rainbow Falls Water Park 8 July 20 - July 24 Gold Medal Olympics 8 Elk Grove Movie Theater 9 July 27 - July 31 Ninja Boot Camp 9 Ultimate Ninjas 10 August 3 - August 7*** Pay It Forward Week 10 Carnival (On-site) 11 August 10 - August 14*** Dog Days of Summer 11 Poplar Creek Bowl

*FIELD TRIPS are scheduled on Wednesdays and subject to change due to availability. Camp will swim every Monday at a local water park. ***Week #10 will be held at the YMCA. Week #11 “Dog Days of Summer” will be held at the YMCA (Limited Enrollment).

• Towel, swimsuit, and flip-flops/sandals

• Water bottle labeled with child’s name

• Gym shoes

• 2 healthy snacks

• Sack lunch and drink labeled with child’s name

• 50 SPF Sunscreen (SPRAY bottle preferred). Please label bottle with your child’s name. Child must apply their own

sunscreen, or parent may apply before camp.

DAILY CAMPER SUPPLIES Campers should bring a backpack

each day with the following supplies:

Questions? Contact

Sally Camposagrado 847.891.9622

Ext. 105

ROOKIES: Kids entering 2nd – 3rd grades VETERANS: Kids entering 4th - 6th grades

LOCATION: Nerge Elementary | 660 Woodfield Trail, Roselle

EXTENDED CARE: AM Care: 7 AM - 9 AM | $30 Member / $40 General Public per week PM Care: 4 PM - 6 PM | $45 Member / $55 General Public per week

HORIZON: Kids entering Kindergarten – 3rd grades ADVENTURE: Kids entering 4th - 6th grades

LOCATION: Nerge Elementary | 660 Woodfield Trail, Roselle

EXTENDED CARE: AM Care: 7 AM - 9 AM | $30 Member / $40 General Public per week PM Care: 4 PM - 6 PM | $45 Member / $55 General Public per week

• Towel, swimsuit, and flip-flops/sandals

• Water bottle labeled with child’s name

• Gym shoes

• 2 healthy snacks

• Sack lunch and drink labeled with child’s name

• 50 SPF Sunscreen (SPRAY bottle preferred). Please label bottle with your child’s name. Child must apply their own

sunscreen, or parent may apply before camp.

DAILY CAMPER SUPPLIES Campers should bring a backpack

each day with the following supplies:

REGISTRATION: $45 - One Child $75 - All Children in Family

DAY CAMP: 5 Days $185 M / $195 GP 3 Days $145 M / $155 GP 2 Days $105 M / $115 GP

EXTENDED CARE: AM CARE: 7 AM - 9 AM $30M/$40GP PER WEEK

PM CARE: 4 PM - 6 PM $45M/$55GP PER WEEK

M=YMCA Member GP=General Public

KASPER CAMP FEES REGISTRATION:

$45 - One Child $75 - All Children in Family

DAY CAMP: 5 Days $185 M / $195 GP 3 Days $145 M / $155 GP 2 Days $105 M / $115 GP

EXTENDED CARE: AM CARE: 7 AM - 9 AM $30M/$40GP PER WEEK

PM CARE: 4 PM - 6 PM $45M/$55GP PER WEEK

M=YMCA Member GP=General Public

KASPER SPORTS CAMP FEES

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EXPERIENCE YMCA OVERNIGHT CAMP!

SUMMER CAMP 1st through 9th grades | 9:00 AM to 4:00 PM

SUMMER CAMP CALENDAR & THEMES FIELD TRIPS*

Week Date Theme Week Field Trip Location 1 June 1 - June 5 Decades Week 50’s - 80’s 1 Roller Skating Rink 2 June 8 - June 12 Music and Dance 2 Trampoline Park 3 June 15 - June 19 Art You Creative! 3 Art Füzd 4 June 22 - June 26 Mystery Detectives 4 Chicago History Museum 5 June 29 – July 3 Wild About Wildlife 5 Nature Center 6 July 6 - July 10 Farmyard Friends 6 Randall Oaks Farm 7 July 13 - July 17 Olympic Week 7 Congo River Mini Golf 8 July 20 - July 24 Inventors 8 Sci-Tech Museum 9 July 27 - July 31 Performing Arts 9 “Charlie Brown” Live Theater 10 August 3 - August 7 Under the Big Top 10 Carnival (Onsite) 11 August 10 - August 14 Dog Days of Summer 11 Magic Show (Onsite)

*FIELD TRIPS are scheduled on Wednesdays and subject to change due to availability. Swimming at the Y is Tuesday, Thursday, and Friday each week. Week #11 “Dog Days of Summer” will be held at the YMCA (Limited Enrollment).

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Now more than ever, it is vital for kids to get outdoors. Youth will create and build friendships with peers, which do not involve a keypad or monitor! Camp Edwards can facilitate a memorable summer experience that fits your budget and your needs!

Edwards YMCA CAMP N8901 Army Lake Rd East Troy, WI 53120

262.642.7466 www.gcfymca.org

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Campanelli YMCA Summer Day Camp Program

Refer to camp brochure due dates Please write in amount

AUTOMATIC PAYMENT FORM

The Campanelli YMCA offers two different types of automatic payment plans called Electronic Funds Transfer (EFT) and Charge Account Draft (CAD). Your signature will confirm that you have read and understand the following: • I understand that my child care payment will be automatically withdrawn from my checking account or

charged on my credit card on a weekly basis according to the schedule provided. You will be charged two weeks ahead.

• I understand that I must provide two weeks written notice before my automatic payment can be cancelled

or changed. • I understand that the YMCA automatic payment plans are continuous and will remain in effect until I cancel

my payment preference in writing or until a program ends. • I understand that I am responsible for making funds available for each and every payment while my child/

children are enrolled in YMCA summer camp programs. I also understand that I will incur a $20.00 service charge fee for any payment declined by my bank or credit card provider.

• I understand that the YMCA reserves the right to cancel my summer camp child care after 7 days of

insufficient funds, stopped payments, or declined credit cards.

Print Child’s Name:_________________________________________________________________________________________________________________________

Print Program Name:_______________________________________________________________________________________________________________________

Credit Card #:_____________________________________________________________________________Expiration Date:____________________________________________

Print Name (as it appears on card):_________________________________________________________________________________CVV #:_________________________

Weekly Withdrawal Amount: $__________________________ Withdrawal Start Date:_____________________________________

I hereby authorize the Campanelli YMCA to withdrawal my weekly day camp fees from the designated credit card or account provided with a voided check. This authority is to remain in full force and effective until I provide the YMCA with two weeks written notice of my intention to cancel or change from automatic payment, or at the end of the program.

Please Print Authorized Name:_________________________________________________________________________________________________________________________

Authorized Signature:______________________________________________________________________________________Date:________________________________________

Automatic Payment Form (EFT or CAD)

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Please complete payment option: ________ Electronic Funds Transfer (EFT) - Please attach a voided check to this form.

________ Charge Account Draft (CAD) - Please circle: Visa MasterCard Discover American Express

Contact: Jody Heimos, Executive Director

LOCATION: Campanelli Y Campus | 300 W. Wise Rd, Schaumburg

NEW! Camp Sunrise Early Care: 6:30 AM - 9 AM | $40 Members / $50 General Public per week

EXTENDED CARE: AM Care: 7 AM - 9 AM | $30 Members / $40 General Public per week PM Care: 4 PM - 6 PM | $45 Members / $55 General Public per week

Questions? Contact

Sheila Turek 847.891.9622

Ext. 106

M=YMCA Member GP=General Public

REGISTRATION FEE: $45 - One Child $75 - All Children in Family

DAY CAMP FEE: 5 Days $185 M / $195 GP 3 Days $145 M / $155 GP 2 Days $105 M / $115 GP

SUMMER CAMP FEES EXTENDED CARE: SUNRISE: 6:30 AM - 9 AM

$40M/$50GP PER WEEK AM CARE: 7 AM - 9 AM

$30M/$40GP PER WEEK PM CARE: 4 PM - 6 PM $45M/$55GP PER WEEK