FUN. FRIENDSHIP. FOREVER.

Transcription

FUN. FRIENDSHIP. FOREVER.
FUN. FRIENDSHIP. FOREVER.
HOCKOMOCK AREA YMCA SUMMER 2016
JOIN US FOR
CAMP INFO DAYS
» Saturday, March 26
9:00am–11:30am
» Sunday, April 10
9:00am–11:30am
WELCOME!
DON’T MISS OUR
CAMP OPEN HOUSE
Sunday, May 8
10:00am–1:00pm
» North Attleboro Branch
» Invensys Foxboro Branch
» Bernon Family Branch
WHEN IS CAMP?
2016 Summer Camp Dates
Week 1 ....................... 6/20 – 6/24
(No Busing, All Branches)
Week 2 ....................... 6/27 – 7/1
Week 3 ....................... 7/5 – 7/8
Week 4 ....................... 7/11 – 7/15
Week 5 ....................... 7/18 – 7/22
Week 6 ....................... 7/25 – 7/29
Week 7 ....................... 8/1 – 8/5
Week 8 ....................... 8/8 – 8/12
Week 9 ....................... 8/15 – 8/19
Week 10 .................... 8/22 – 8/26
Week 11 .................... 8/29 – 9/2
(No Busing, All Branches)
Thank you for partnering with us to give your child the Best Summer Ever! We are excited to welcome you at all of our summer camps in the communities
of Bellingham, Foxboro, Franklin, Mansfield, and North Attleboro. We provide a
place for youth and teens to belong, try new things, and make lifelong friends.
Your child will also find fulfillment through hands-on learning, and discover
more about who they are and what they want to achieve during the summer
and beyond.
Our days at camp will be invigorating! We will play, laugh, and learn through
field games, arts and crafts, water games, swim lessons, archery, and
specialties like theatre, dance, sports, ropes team building, and gymnastics.
As trained staff role models, we pledge to reinforce confidence, healthy habits,
and our Y’s core founding values of caring, honesty, respect, and responsibility
every day through our words and actions. We will help your children learn and
grow and we look forward to sharing amazing new adventures with you and
your children this summer!
Sincerely,
Your Hockomock Area YMCA Camp Staff
MEET OUR CAMP LEADERSHIP STAFF
North Attleboro
Branch Camps
Bernon Family
Branch Camps
Invensys Foxboro
Branch Camps
Pages 4 – 15
Pages 17 – 27
Pages 29 – 38
North Attleboro Branch Camp & Sports
Director Kerrie Francis could not be more
excited to start another summer camp
season. “Camp people have this saying,”
Kerrie shares, “we live ten months just for
two. That’s how special camp is to us.” Kerrie,
pictured with Assistant Camp Director Robby
Lawrence, has participated in camp every
year since she was 16 years old, making this
her 24th camp summer. She brings a wealth
of experience and talent. A graduate of
Bridgewater State University, she holds a B.S.
in Education. Her work experience includes
a wide spectrum of summer camps, from
religious residential to outdoor day camps,
from economically disadvantaged to private
affluent camps. “Camp is camp” explains
Kerrie, “a world where kids can discover
themselves, make lifelong friendships, and
develop into the people they were meant to
be.” This type of environment suits Kerrie
well, since she is a natural people person.
Kerrie loves sports, camping, hiking, and
anything outdoors. She thrives on cultivating
this same passion for a healthy, active,
outdoor lifestyle in each of her campers. “My
experiences with camp have been incredible.”
exclaims Kerrie, “My goal is to give each of my
campers the same wonderful experience.”
Meet Jeff Moore, Camp & Sports Director at
our Bernon Family Branch. Jeff is responsible
for the safe operations, instruction, and
fun of all day camp activities and the
development of high quality youth and adult
sport programs at the Bernon Family Branch.
A former resident of Norton, Jeff is a Sports
Management graduate of the University
of Massachusetts-Amherst and earned a
Master’s Degree in Athletic Administration
from Endicott College. Jeff was a Dean’s
list student and recipient of the Abigail
Adams Scholarship. Previously Jeff was
employed at Amherst College as an assistant
football coach and physical education class
instructor. Jeff also worked at Stonehill
College’s Summer Sports Camps where he
helped direct operations for 11 camps, 9
NCAA head coaches, and 1,000+ campers.
Jeff grew up playing basketball at the Y and
loves adventure and fun. He is an avid white
water rafter and enjoys outdoor challenges
including sky diving. “My goal is to continue
bringing enthusiasm and camaraderie to our
campers and staff here at the Franklin Y,”
emphasizes Jeff. “I look forward to another
great summer!”
Known for her friendly smile and fun spirit,
Camp & Family Experience Director Ashli Phillips is entering her 7th year at
our Invensys Foxboro Branch. Pictured
with her son, Cam, Ashli oversees the Child
Watch Center and manages all aspects of
arts and enrichment and camp programming
within the Invensys Foxboro Branch.
Previously, Ashli was employed at the Metro
Atlanta YMCA as Senior Director of Sports,
Gymnastics, and Camp. A native of Foxboro
for the first 12 years of her life, Ashli then
moved to Falmouth where she graduated
from high school and then continued her
education at York College in Pennsylvania.
Ashli earned her B.A. in Behavioral Science
while competing as a varsity athlete in
both soccer and softball. When asked what
her favorite thing is about her job, Ashli
explains, “I love camp! The staff are so full
of life; the kids are energized, enthusiastic,
and so much fun. Our days are spent acting
crazy and laughing, on field trips and
with friends, enjoying the beautiful days
of summer. I could not ask for a better
summer experience every year!”
LET'S CONNECT!
LET'S CONNECT!
LET'S CONNECT!
Facebook.com/
NorthAttleboroBranchYMCACamps
@HockomockYMCA
Facebook.com/
BernonFamilyBranchYMCACamps
@HockomockYMCA
Facebook.com/
InvensysFoxboroBranchYMCACamps
@HockomockYMCA
Outdoor Adventure Programs
Page 22
Mansfield Arts & Education Center Theatre Camps
Page 33
ALL CAMPS ARE FULL DAY 9:00AM–4:00PM UNLESS SPECIFICALLY NOTED. PRE AND POST CAMP AVAILABLE, SEE PAGE 8.
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NORTH ATTLEBORO BRANCH
TRADITIONAL CAMPS
NOW INCLUDES
STEM
Science, Technology,
Engineering, & Math
ALL LEADERSHIP STAFF ARE 21+
CAMP ELMWOOD is our traditional day camp for children to learn, grow, and have fun! Our camp day
excites and energizes campers to learn new things, exercise their minds and bodies, and build friendships in the great
outdoors. To ensure a fun, safe environment, our role model to camper ratio will never exceed 1:10. Campers' days
are filled with swimming, sports, field trips, water and active play, arts and crafts, drama, nature, games, archery, and
more. Exciting field trips will take place for second and third graders on Wednesdays and for fourth through sixth
graders on Tuesdays and Thursdays. Trips may include hikes through Purgatory Chasm, Paw Sox games, aquariums,
Silver Lake, corn mazes, and so much more. On Wednesdays special guests will come and visit with the first graders.
Some of those visitors may be petting zoos, frisbee catching dogs, magicians, and slippery reptiles.
JUNIOR CAMP ELMWOOD is a branch of Camp Elmwood designed for the pre-school age child.
First time campers make new friends and are introduced to enriching camp activities including swim, sports, active
games, arts and crafts, nature, archery, and more. To provide a fun, safe environment, our role model to camper ratio
will be 1:5. On Wednesdays, special guests will come and visit with our junior campers. Some of those visitors may be
petting zoos, frisbee catching dogs, magicians and slippery reptiles.
NEW HORIZONS CAMP ELMWOOD
is a branch of Camp Elmwood providing increased
support for campers with special needs. To provide a fun, safe environment, our role model to camper ratio will be
1:3. We help each child create positive relationships, build social skills, and encourage full inclusion. Half day
options are available for this camp. New Horizons is also available for Junior Elmwood full and half day options.
A meeting with our integration coordinator is required as part of the registration process. REGISTRATION DEADLINE:
July 1, 2016.
CAMP ELMWOOD – GRADES 1–6
JUNIOR CAMP ELMWOOD – AGES 3–5
NEW HORIZONS CAMP ELMWOOD
Weeks 1–11 » June 20–September 2
Full Day: 9:00am–4:00pm
Weeks 1–11 » June 20–September 2
Weeks 2–10 » June 27–August 26
Full Day: 9:00am–4:00pm
Cost: 5-Day: $244 Member / $341 Non-Member
4-Day: $209 Member / $302 Non-Member
3-Day: $174 Member / $252 Non-Member
Cost: 5-Day: $213 Member / $270 Non-Member 4-Day: $191 Member / $246 Non-Member 3-Day: $164 Member / $205 Non-Member
Weeks 1–11 » June 20–September 2
Half Day: 9:00am–1:00pm
Cost: 5-Day: $165 Member / $247 Non-Member
4-Day: $143 Member / $207 Non-Member 3-Day: $121 Member / $174 Non-Member
4hockymca.org
HOCKOMOCK AREA YMCA SUMMER 2016 CAMP GUIDE
SUPER SPORTS ADD-ON TO TRACK & FIELD
CAMP – GRADES 3–8
Campers who participate in the 1/2-day Track and Field
camp can spend the remainder of the camp day at the 1/2-day Super Sports camp.
Week 8 » August 8–12
Half Day 1:00pm–4:00pm
Cost: 5-Day: $113 Member / $149 Non-Member
LACROSSE CAMP – GRADES 4–8
This camp is designed for boys and girls who are interested
in learning the sport of lacrosse. The camp will focus on
skill development and understanding. Drills and games will
be used to simulate game situations and play. The camp will
be instructed by experienced coaches and players.
Week 9 » August 15–19
Cost: 5-Day: $244 Member / $341 Non-Member
NORTH ATTLEBORO BRANCH
SPORTS CAMPS
SUPER SPORTS CAMP – GRADES 1–6
Campers will enjoy soccer, basketball, flag football,
wiffle ball, kickball, dodgeball, and more. Campers
will cool off daily in our swimming pool and learn
each sport’s skills with friends while having fun.
Weeks 2–11 » June 27–September 2
Cost: 5-Day: $232 Member / $318 Non-Member
4-Day: $207 Member / $290 Non-Member
3-Day: $175 Member / $242 Non-Member
FLAG FOOTBALL CAMP – GRADES 1–7
Flag football campers will learn skills, drills, and have
fun in a quarterback challenge, receiver and defensive
back challenge, kick and punt challenge, and flag football
tournament. If schedule permits, campers will visit a New
England Pats practice session! Camp may be held at an
offsite location with transportation provided by the YMCA.
GRADES 1–3: NCAA: Week 6 » July 25–29
GRADES 4–7: NFL: Week 6 » July 25–29
Cost: 5-Day: $244 Member / $341 Non-Member
TRACK & FIELD CAMP – GRADES 3–8
This fun, ½-day camp introduces kids to track and field
and the events of hurdles, long jump, triple jump, sprints,
and relays. Our coach competed at a competitive level and
will share knowledge of sport including proper techniques,
safety, and hold a fun mock meet. Camp may be held at a
local school with transportation provided by the YMCA.
Week 8 » August 8–12
Half Day 9:00am–1:00pm
Cost: 5-Day: $165 Member / $247 Non-Member
ALL CAMPS ARE FULL DAY 9:00AM–4:00PM UNLESS SPECIFICALLY NOTED. PRE AND POST CAMP AVAILABLE, SEE PAGE 8.
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NORTH ATTLEBORO BRANCH
ENRICHMENT CAMPS
MIXED MEDIA WITH POTTERY – GRADES 1–9
Campers will enjoy learning the techniques of slab and
coil. They will also experiment with paper maché, collage,
and sketching. Pottery will be glazed and fired in the kiln.
Campers will show off their pottery creations at week’s end.
GRADES 1–4: Week 6 » July 25–29
GRADES 5–9: Week 10 » August 22–26
Cost: 5-Day: $250 Member / $370 Non-Member
COOKING CAMP – GRADES 1–9
Campers will make delicious and healthy recipes by learning
to prepare and cook snacks, meals, and desserts. Campers
will bring home delicious treats each day as well as gain the
knowledge and confidence to show off how they’re made.
GRADES 1–4: Week 4 » July 11–15
GRADES 5–9: Week 7 » August 1–5
Cost: 5-Day: $357 Member / $473 Non-Member
BAKING CAMP – GRADES 1–8
Campers will make a variety of baked goods including cakes,
cookies, and breads in a fun setting using ingredients that
are healthy and low fat. Campers will hold a bake sale to
benefit a charity of their choice at the end of the week.
GRADES 5–8: Week 5 » July 18–22
GRADES 1–4: Week 8 » August 8–12
Cost: 5-Day: $357 Member / $473 Non-Member
REDESIGN YOUR ROOM
& MIXED MEDIA – GRADES 5–9
Create all new accents for your bedroom using a variety of
materials and experiment with paper maché, collage, and
sketching. Wall hooks, bulletin board, lamp shades, and
pillows are some of the choices to decorate and accent
your room.
Week 9 » August 15–19
Cost: 5-Day: $250 Member / $370 Non-Member
FOR THEATRE CAMPS
SEE PAGE 33
6hockymca.org
HOCKOMOCK AREA YMCA SUMMER 2016 CAMP GUIDE
PRINCESS DANCE CAMP – AGES 4–7
Little campers experience the world of dance with
princesses. Campers will learn dance techniques to their
favorite songs. Swim and crafts included for full day camp.
Week 10 » August 22–26
Full Day: 9:00am-4:00pm
Half Day: 9:00am–1:00pm
Cost:
5-Day Full Day: $244 Member / $341 Non-Member
5-Day Half Day:$165 Member / $247 Non-Member
CHEERLEADING DANCE CAMP – GRADES 2–5
GYMNASTICS
CAMPS
Week 6 » July 25–29
PRE-SCHOOL CO-ED GYMNASTICS CAMP
AGES 3–5
Campers will learn cheerleading cheers, chants, jumps,
techniques, and routines using basic jazz, ballet, and hip hop moves along to fun music. Swim and crafts
included. Campers will end their week with a special Friday performance.
Cost: 5-Day: $244 Member / $341 Non-Member
NORTH ATTLEBORO BRANCH
DANCE CAMPS
Campers split by age will participate in flexibility and
strength training, dance, swimming, and crafts. After
lunch, campers will spend the afternoon doing gymnastics.
Campers will end their week with a special Friday
performance.
Week 2: June 27–July 1
Week 5: July 18–22
Week 8: August 8–12
Cost: 5-Day: $244 Member / $341 Non-Member
YOUTH CO-ED GYMNASTICS CAMP
GRADES 1–8
Campers split by age will participate in flexibility and
strength training, dance, swimming, and crafts. After
lunch, campers will spend the afternoon doing gymnastics.
Campers will end their week with a special Friday
performance.
Weeks 2–11 (except weeks 6 & 9)
June 27–September 2 (except week of July 25 &
August 15)
Cost: 5-Day: $244 Member / $341 Non-Member
Cost: (Week 3): $209 Member / $302 Non-Member
BOYS & GIRLS PRE-TEAM GYMNASTICS CAMP
GRADES 1+
(Only pre-team members may register for this camp.)
Team members will spend their mornings working on
flexibility, strength, and dance for the gymnast workshops.
Team members will work on compulsory routines and skills
during their afternoon gymnastics training.
Week 10 » August 22–26
Cost: 5-Day: $244 Member / $341 Non-Member
ALL CAMPS ARE FULL DAY 9:00AM–4:00PM UNLESS SPECIFICALLY NOTED. PRE AND POST CAMP AVAILABLE, SEE PAGE 8.
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NORTH ATTLEBORO BRANCH
TEAM
GYMNASTICS
CAMPS
OPTIONAL LEVELS 6 & UP GYMNASTICS
CAMP – GRADES 1+
(Only team members may register for this camp.)
Team members will spend the day learning, improving, and
perfecting skills on all 4 events. Stretching, conditioning,
and dance instruction will also be provided. The gymnasts
will have the opportunity to participate in team building
and traditional camp activities including swimming
throughout the week.
Week 6 » July 25–29
Cost: $244 Member / $341 Non-Member
COMPULSORY LEVELS 3–5 GYMNASTICS
CAMP – GRADES 1+
(Only team members may register for this camp.)
Team members will spend the day learning, improving, and
perfecting skills on all 4 events. Stretching, conditioning,
and dance instruction will also be provided. The gymnasts
will have the opportunity to participate in team building
and traditional camp activities including swimming
throughout the week.
Week 9 » August 15–19
Cost: 5-Day: $244 Member / $341 Non-Member
SWIM CAMPS
HALF DAY STROKE CLINIC – GRADES 2+
(Campers must be at a minnow swim level or higher for
this camp.)
This swim clinic is run by our Aquatics Director and lead
instructors. Each day will include a 2-hour workout in the
water. Emphasis will be on building endurance using the
stroke techniques and skills needed to become a solid
all-around swimmer. Competitive swim experience is not required.
Week 8 » August 8–12
Half Day: 12:00pm-4:00pm
Cost: 5-Day: $139 Member / $208 Non-Member
HAY LIGHTNING BOOTCAMP – GRADES 3+
(Campers must have 1-year of competitive swim
experience.)
This swim camp is run by HAY Lightning swim coaches. Each
day will include two 2-hour water workouts. Mornings will
focus on drills and stroke mechanics. Afternoons will focus
on endurance-based workouts utilizing the morning’s skills.
Week 9 » August 15–19
Cost: 5-Day: $276 Member / $348 Non-Member
PRE & POST CAMP
PRE CAMP
POST CAMP
Weeks 1–11 » June 20–September 2
7:00am–9:00am
Weeks 1–11 » June 20–September 2
4:00pm–6:00pm
Pre Camp is available to all full-day campers whose parents
need childcare options before the 9:00am start of camp.
Campers will enjoy a fun activity each morning and then be
escorted to their respective camps for 9:00am.
SEE PAGE
40 FOR
BUSING
Member Cost:
5-Day: $23
4-Day: $19
3-Day: $15
2-Day: $11
1-Day: $5
8hockymca.org
Non-Member Cost:
5-Day: $28
4-Day: $24
3-Day: $18
2-Day: $13
1-Day: $6
Post Camp is available to all full-day campers whose parents
need childcare options after the 4:00pm end of camp.
Campers will be escorted from their respective camps to Post
Camp and will enjoy afternoon activities. Snack included.
Member Cost: 5-Day: $28
4-Day: $23
3-Day: $18
2-Day: $12
1-Day: $6
Non-Member Cost:
5-Day: $34
4-Day: $29
3-Day: $21
2-Day: $15
1-Day: $7
HOCKOMOCK AREA YMCA SUMMER 2016 CAMP GUIDE
VOYAGERS (TEEN TRAVEL CAMP) JUNIOR VOYAGERS – GRADES 6–7 SENIOR VOYAGERS – GRADES 8–9
Voyagers Camp is for those entering grades 6 through
9 who are looking for fun opportunities throughout the
summer. Campers will participate in one service initiative
per week. Some of the trips/activities planned throughout
the summer include: Ropes Team Building, Purgatory Chasm,
Pinz Bowling, Nantasket Beach, Lazer Gate, Kayaking, Spring Lake, Borderland State Park, United Skates of
America, Biking the Cape Cod Canal, and so much more!
Below are the weeks with the theme and highlighted trip.
Week 2: 6/27–7/1
Adventure Week – Tree Top Walk
Week 3: 7/5–7/8
Outdoor Experience Week – Rock Climbing
Week 4: 7/11–7/15
Water Week – Water Wiz
Week 5: 7/18–7/22
Adventure Week – Field of Fire Park
Week 6: 7/25–7/29
Sports Fanatics Week – Paw Sox Game
Week 7: 8/1–8/5
Walk on Water Week – Kayaking/Canoeing
Week 8: 8/8–8/12
Bounce Around Week – Trampoline Park
Week 9: 8/15–8/19
Patriot Week – Training Camp/Boston
Week 10:8/22–8/26
You're an Animal Week – Zoo
CIT: COUNSELOR-IN-TRAINING
GRADES 9–10
(CIT application and interview required to enroll.)
The CIT program is for teens interested in working in a fun
camp setting. CITs will participate in courses teaching camp
traditions in exciting ways and develop leadership skills to
become a future YMCA camp counselor. Completion of the
CIT program does not guarantee future employment. CITs
must commit to a minimum of 6 weeks. If interested, fill
out a CIT application available at our Member Service Desk.
Weeks 2–11 » June 27–September 2
Weeks 2–10 » June 27–August 26
Cost: $323 Member / $428 Non-Member
Cost: $244 Member / $341 Non-Member
Cost: (Week 3): $209 Member / $302 Non-Member
NEW HORIZONS TEEN VILLAGE – GRADES 7+
LIT: LEADER-IN-TRAINING – GRADES 7–8
(LIT application and interview required to enroll.)
LITs will learn positive values and leadership traits through
service learning, team building, and adventure programming
alongside their peers. CPR and first aid included. LITs will
plan fun events for younger campers. This program works
in collaboration with our New Horizons program in the
afternoons. If interested, fill out an LIT application available
at our Member Service Desk. Registration limited to 1
session per participant.
Session 1: Weeks 2–4 » June 27–July 15
Cost: $346 Member / $436 Non-Member
Session 2: Weeks 5–7 » July 18–August 5
Cost: $370 Member / $490 Non-Member
Session 3: Weeks 8–10 » August 8–26
NORTH ATTLEBORO BRANCH
TEEN CAMPS
(Half-day afternoon camp for teens with special
needs.)
Campers will travel in a co-ed group from activity to activity
throughout the afternoon. This inclusive camp pairs New
Horizons campers with peer mentors for traditional camp
experiences and provides opportunities for appropriate
social interaction. Focus is on having fun through activities,
games, and swim while building friendships and increasing
social skills. New Horizons Teen Village has a 3:1 camper:
role model ratio for increased support. A meeting with
our integration coordinator is required as part of the
registration process. Interested in being a peer mentor?
Ask our integration coordinator about Inclusion Corps.
Weeks 2–10 » June 27–August 26
(Mon/Tue/Wed/Thur) 12:00pm–4:00pm
Cost: $143 Member / $207 Non-Member
Cost: (Week 3): $121 Member / $174 Non-Member
Cost: $370 Member / $490 Non-Member
OUTDOOR ADVENTURE PROGRAMS for teens – PAGE 22
These travel camps start and end at our Bernon Family Branch in Franklin.
ALL CAMPS ARE FULL DAY 9:00AM–4:00PM UNLESS SPECIFICALLY NOTED. PRE AND POST CAMP AVAILABLE.
9
NORTH ATTLEBORO BRANCH
CAMP CONTACTS
HOCKOMOCK AREA YMCA
North Attleboro Branch
300 Elmwood Street
North Attleboro, MA 02760
Camp Director: Kerrie Francis
508.643.5215, kerrief@hockymca.org
For questions or comments regarding:
»» Camp Elmwood
»» Junior Camp Elmwood
»» Sports Camps
»» Pre & Post Camp
»» Transportation
Sr. Program Director: Joe Halus
508.643.5223, joeh@hockymca.org
For questions regarding:
»» Overall Camp Experience
»» Aquatics & Swim Camps
Camp Office
508.643.5241
Call to report your child’s:
»» Tardiness
»» Absences
»» Early Dismissal, etc.
Sr. Member Experience Director: Katie Fisher
508.643.5265, katief@hockymca.org
For questions or comments regarding:
»» Arts & Enrichment Camps
»» Cooking & Baking Camps
»» Dance
Camp Health Care Supervisor
508.643.5294
For questions or comments regarding:
»» Medical Information
»» Medical Documentation (medications, medical forms, and administer medication forms)
Gymnastics Camp Director: Debbie Moore
508.643.5254, debbiemo@hockymca.org
Camp Billing Administrator: Monica Schmidt
508.643.5255, monicas@hockymca.org
For questions or comments regarding:
»» Camp Registrations & Changes
»» Billing
»» Balance Information
»» EZ-Pay Information
Integration Coordinator:
Amy Turner
508.643.5266, amyt@hockymca.org
Contact for questions & concerns regarding:
»» Special Needs Programming
»» New Horizon Camps
Teen Camp Director: Dawn DaCosta
508.643.5270, dawnd@hockymca.org
For questions or comments regarding:
»» Voyagers Camp
»» LIT: Leader-in-Training
»» CIT: Counselor in Training
Association Scholarship Department
Lynette Testa 508.643.5217
Lori Halben 508.643.5293
nascholarship@hockymca.org
For questions regarding:
»» How to apply for a scholarship
»» Status of scholarship in process, etc.
»» Typical turnaround is 2–3 weeks for processing. Please note, months leading up to and during camp are the busiest time of year. Process can take longer.
Facebook.com/NorthAttleboroBranchYMCACamps
10hockymca.org
@HockomockYMCA
HOCKOMOCK AREA YMCA SUMMER 2016 CAMP GUIDE
Date Received ______________________________________________________
Date Entered ________________________________________________________
Entered By ___________________________________________________________
CAMPER INFORMATION
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Birth Date________________________________________________________________________
Primary Phone___________________________________________________________________
Gender____________________________________________________________________________
Entering Grade for Fall 2016________________________________________________
Address___________________________________________________________________________
City________________________________________________________________________________
State_______________________________________________________________________________
ZIP_________________________________________________________________________________
PARENT/GUARDIAN INFORMATION
PARENT/GUARDIAN INFORMATION
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Address___________________________________________________________________________
City________________________________________________________________________________
State_______________________________________________________________________________
Zip_________________________________________________________________________________
Email_______________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Address___________________________________________________________________________
City________________________________________________________________________________
State_______________________________________________________________________________
Zip_________________________________________________________________________________
Email_______________________________________________________________________________
Relationship to Child___________________________________________________________
NORTH ATTLEBORO BRANCH REGISTRATION COVER SHEET
FOR OFFICE USE ONLY
I understand that if I list a parent or guardian, they are authorized to pick up my child.
 Yes  No FOR INFORMATION PURPOSES ONLY: Is the camper a descendant of a veteran of the armed forces of the United States.
 Yes  No I currently receive scholarship assistance.
 Yes  No I have applied for scholarship assistance. Date Applied ____________________________
 Yes  No Is the camper a Hockomock Area YMCA School’s Out participant? ____________________________________________________________________________________________________
ADDITIONAL ADULTS AUTHORIZED TO PICK UP MY CHILD (Must be 18+ YEARS OF AGE)
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
11
NORTH ATTLEBORO BRANCH REGISTRATION COVER SHEET
PHOTOGRAPHIC AND VIDEO MARKETING AUTHORIZATION
Unless otherwise noted, by participating in the camp program and affixing my signature below I understand that the Hockomock Area Y may use
photographs and video footage of my child(ren) for promotional purposes (i.e. brochures, newspaper, Reach Out for Youth and Families video, camp
slideshow, etc.).
AUTHORIZATION TO ADMINISTER BUG SPRAY AND SUNSCREEN
Unless otherwise noted, by participating in this program and affixing my signature below I give Y staff permission to assist my camper(s) in applying
sunscreen and/or bug spray during the camp day.
FINANCIAL POLICIES
ALL CAMPS REQUIRE A $10 DEPOSIT PER CAMP SESSION AT REGISTRATION. REGISTRATIONS RECEIVED
WITHOUT A DEPOSIT WILL NOT BE PROCESSED.
1. The camper’s membership must be valid and in good standing and all overdue balances paid up for any Y programs at the time of registration and for
the duration of their camp session(s). If the membership should lapse, the account will be adjusted to reflect the non-member rate and the parent
will be responsible for the payment difference.
2. The balance for each session is due two weeks prior to the start of that session.
3. Deadline for registrations is Wednesday prior to the start of the camp week depending on availability. Any registrations received after the close of business on Wednesday of the week prior will incur a $20 late registration fee. All camp registrations require 48 hours for processing.
4. Camp fees will be refunded in full only in cases where the Y cancels a session.
5. Withdrawal or cancellation thirty (30) days prior to the start of camp for any reason will result in a refund of camp fees less the $10 deposit per
camp. (REQUEST MUST BE MADE IN WRITING).
6. Withdrawal or cancellation two weeks prior to the start of camp for any reason will result in a 50% refund. (REQUEST MUST BE MADE IN WRITING).
7. No credits or refunds will be issued less than two weeks prior to the start of the registered camp session.
8. Payment is required for all registered days, whether or not the camper attends on those days.
9. Returned check fee is $20.
10. Registrations must be mailed to the appropriate branch or dropped off at the appropriate Member Service Desk.
11. IF PAYMENT IS NOT MADE IN FULL AT TIME OF REGISTRATION, A VALID CREDIT CARD ON FILE IS REQUIRED. NO EXCEPTIONS.
Credit Card on file will be charged on the Monday two weeks prior to the start of the camp week for balances not paid on due date.
If the camper has an outstanding balance, they will not be allowed to attend camp.
permission and waiver
I have read and I understand all camp financial policies and information listed above. For more information, please contact Billing Administrator.
By signing this form, I give permission for my child to:
• attend any Hockomock Area YMCA summer camp field trips scheduled during their sessions of attendance at camp.
• take part in the Adventures in Respect Ropes Challenge Course.
On my behalf and that of my child(ren), I hereby release, waive, discharge, and covenant not to sue the Hockomock Area YMCA and all branches thereof,
its officers, employees, and agents from all liability to the undersigned and my child/children, and any claims or demands therefore on account of injury
of death to my child(ren) or damage to property, whether caused by the negligence of this Hockomock Area YMCA employee or otherwise, regardless of
the location of such accident, incident, or act giving rise to such injury, death, or damage.
I have read, understand, and voluntarily signed this release and waiver of liability and further agree that no oral representations, statements, or
inducement apart from the foregoing written agreement have been made.
PARENT/GUARDIAN:
Printed Name _______________________________________________________________
Signature____________________________________________________________
Date ________________________
PAYMENT METHOD (Visa/MasterCard/Discover/American Express, Check, or Money Order ONLY)
IF PAYMENT IN FULL IS NOT MADE AT TIME OF REGISTRATION, A CREDIT CARD ON FILE IS REQUIRED. NO EXCEPTIONS.




Payment in full
Deposit by check or money order
Deposit by credit card
Check, money order or online payment will be paid two weeks prior to the start of camp (you do not have to be a member to pay online) If payment is not received the credit card on file will be charged.
To make your payments online: Visit our website www.hockymca.org and follow these instructions:
1. Select “Register for Programs” button. 2. S
elect LOGIN.
3. Enter your USERNAME and PASSWORD. If you do not know your USERNAME and PASSWORD, select “Forgot your login?” and an email will
be sent with your login information. If you are unsuccessful, please contact Billing Administrator or the Member Service Desk. You can pay
balances online whether or not you are a member of the Hockomock YMCA.
4. Select “You have a balance”
 Use credit card for balance two weeks prior to start of camp
CREDIT CARD PAYMENT:  VISA  MC  DISC  AMEX
Credit Card # ___________________________________________________________________________________ CID # __________________________ Name on Card_________________________________________________________________________________ Signature___________________________________________________________________________
Exp. Date___________________________________
Please submit completed registration form(s) to:
Hockomock Area YMCA – North Attleboro Branch, Attention: Billing Administrator, 300 Elmwood Street, North Attleboro, MA 02760
12
FINANCIAL ASSISTANCE: Did you know that the Y is a not-for-profit charitable organization? Inquire at any Y to find out more.
1
Please mark selection(s):
Darkened Box
2
3
4
5
6
7
8
9
10
11
7/25–
7/29
8/1–
8/5
8/8–
8/12
8/15–
8/19
8/22–
8/26
8/29–
9/2
= Camp NOT offered!
6/20– 6/27–
6/24
7/1
CAMPS
WEEKS
CAMP ELMWOOD – Grades 1–6
WEEKLY SESSIONS (ONLY cross off each
full week your camper will attend)
DAILY OPTION
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
7/5–
7/8
7/11– 7/18–
7/15 7/22
pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due
6/6
6/13
6/20
6/27
7/5
7/11
7/18
7/25
8/1
8/8
8/15
1
2
3
4
5
6
7
8
9
10
11
If weekly sessions are not what you need, you may select a 4 or 3 day option by
crossing off the specific dates you require BELOW.
6/20 6/27
7/11 7/18 7/25
8/1
8/8
8/15
8/22 8/29
6/21 6/28
7/5
7/12 7/19 7/26
8/2
8/9
8/16
8/23 8/30
6/22 6/29
7/6
7/13 7/20 7/27
8/3
8/10 8/17
8/24
8/31
6/23 6/30
7/7
7/14 7/21 7/28
8/4
8/11 8/18
8/25
9/1
6/24
7/1
7/8
7/15 7/22 7/29
8/5
8/12 8/19
8/26
9/2
 FULL DAY
 HALF DAY
NEW HORIZONS CAMP ELMWOOD
WEEKLY SESSIONS (ONLY cross off each
full week your camper will attend)
DAILY OPTION
MONDAY
2
3
4
5
6
7
8
9
10
TUESDAY
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
WEDNESDAY
THURSDAY
6/29
6/30
7/6
7/7
7/13
7/14
7/20
7/21
7/27
7/28
8/3
8/4
8/10
8/11
8/17
8/18
8/24
8/25
FRIDAY
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
 FULL DAY Ages 3–5 (Must be potty-trained)
 HALF DAY Ages 3–5 (Must be potty-trained)
JUNIOR CAMP ELMWOOD
WEEKLY SESSIONS – Full Day (Ages 3-5)
or Half-Day (Ages 3–5) (ONLY Cross off
each full week your camper will attend
DAILY OPTION– Full Day (Ages 3-5)
or Half-Day (Ages 3–5)
11
If weekly sessions are not what you need, you may select a 4 or 3 day option by
crossing off the specific dates you require BELOW.
6/27
7/11 7/18 7/25
8/1
8/8
8/15
8/22
1
2
3
4
5
6
8
9
10
11
If weekly sessions are not what you need, you may select a 4 or 3 day option by
crossing off the specific dates you require BELOW.
MONDAY 6/20
6/27
7/11
7/18
7/25
8/1
8/8
8/15
8/22
8/29
TUESDAY 6/21
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
8/30
WEDNESDAY 6/22
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
8/31
THURSDAY 6/23
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
9/1
FRIDAY 6/24
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
9/2
SPORTS CAMPS (continued on page 14)
Super Sports Camp (Grades 1–6)
DAILY OPTION
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
$213
$270
FEE
FEE
4-Day Option
$191
$246
3-Day Option
$164
$205
FULL DAY / FULL DAY /
HALF DAY HALF DAY
FEE
FEE
$213 FD
$270 FD
$165 HD
$247 HD
FEE
FEE
4-Day Option
$191 FD
$246 FD
$143 HD
$207 HD
3-Day Option
NEW HORIZONS
 FULL DAY  HALF DAY
7
MEMBER
FEE
SUMMER
MEMBER
& NONMEMBER
FEE
NORTH ATTLEBORO BRANCH REGISTRATION FORM
ONE REGISTRATION FORM PER CAMPER
2
3
4
5
6
7
8
9
10
11
If weekly sessions are not what you need, you may select a 4 or 3 day option by
crossing off the specific dates you require BELOW.
6/27
7/11 7/18 7/25
8/1
8/8
8/15
8/22 8/29
6/28
7/5
7/12 7/19 7/26
8/2
8/9
8/16
8/23 8/30
6/29
7/6
7/13 7/20 7/27
8/3
8/10 8/17
8/24
8/31
6/30
7/7
7/14 7/21 7/28
8/4
8/11 8/18
8/25
9/1
7/1
7/8
7/15 7/22 7/29
8/5
8/12 8/19
8/26
9/2
$164 FD
$121 HD
FULL DAY /
HALF DAY
FEE
$205 FD
$174 HD
FULL DAY /
HALF DAY
FEE
$244 FD
$165 HD
$341 FD
$247 HD
FEE
FEE
4-Day Option
$209 FD
$143 HD
$302 FD
$207 HD
3-Day Option
$174 FD
$121 HD
$252 FD
$174 HD
FEE
FEE
$232
$318
FEE
FEE
4-Day Option
$207
$290
3-Day Option
$175
$242
13
NORTH ATTLEBORO BRANCH REGISTRATION FORM
1
2
3
6/20–
6/24
6/27–
7/1
7/5–
7/8
Please mark selection(s):
Darkened Box
= Camp NOT offered!
CAMPS
WEEKS
4
5
6
7/11– 7/18– 7/25–
7/15 7/22 7/29
7
8
9
10
11
8/1–
8/5
8/8–
8/12
8/15–
8/19
8/22–
8/26
8/29–
9/2
pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due
6/6
6/13
6/20
6/27
7/5
7/11
7/18
7/25
8/1
8/8
8/15
SPORTS CAMPS (continued)
MEMBER
SUMMER
MEMBER
& NONMEMBER
FEE
FEE
Flag Football Camp NCAA (Grades 1–3)
6
$244
$341
Flag Football Camp NFL (Grades 4–7)
6
$244
$341
Track and Field – Half-Day (Grades 3–8)
8
$165
$247
Super Sports Add-On to Track and Field
8
$113
$149
$244
$341
FEE
FEE
$250
$370
$250
$370
$357
$473
$357
$473
$357
$473
$357
$473
$250
$370
FEE
FEE
$244 FD
$165 HD
$341 FD
$247 HD
$244
$341
FEE
FEE
$244
$341
Lacrosse Camp (Grades 4–8)
9
ENRICHMENT CAMPS
Mixed Media with Pottery (Grades 1–4)
6
Mixed Media with Pottery (Grades 5–9)
10
Cooking Camp (Grades 1–4)
4
Cooking Camp (Grades 5–9)
7
Baking Camp (Grades 1–4)
8
Baking Camp (Grades 5–8)
5
Redesign Your Room and Mixed Media
(Grades 5–9)
9
Please use the Invensys Foxboro and Mansfield Branch Registration Form to register for Theatre Camps.
DANCE CAMPS
Elsa and Friends Dance Camp (Ages 4–7)
 Full Day  Half-Day
10
Cheerleading Dance Camp (Grades 2–5)
6
GYMNASTICS CAMPS
Pre-School Co-ed Gymnastics Camp
(Ages 3–5)
2
Youth Co-ed Gymnastics Camp (Grades 1–8)
2
5
4
Youth Co-ed Gymnastics Camp (Grades 1–8)
8
5
7
8
10
11
3
Pre-team Gymnastics Camp (Grades 1+)
10
Optional Team Levels 6+ Gymnastics Camp
(Grades 1+)
Compulsory Levels 3-5 Gymnastics Camp
(Grades 1+)
6
9
SWIM CAMPS
$244
$341
$209
$302
$244
$341
$244
$341
$244
$341
FEE
FEE
$139
$208
$276
$348
FEE
FEE
$244
$341
3
$209
$302
2–4
$346
$436
$370
$490
$323
$428
FEE
FEE
$143
$207
$121
$174
Half Day Stroke Clinic (Grades 2+)
8
Competitive Swimming Camp (Grades 3+)
9
TEEN LEADERSHIP CAMPS
Please use the Bernon Family Branch Registration Form to register for Outdoor Adventure Programs.
Adventure Programs depart from the Bernon Family Branch.
PLEASE SELECT YOUR CAMP:
 Junior Voyagers
 Junior Voyagers (Grades 6–7)
 Senior Voyagers (Grades 8–9)
 Junior Voyagers (Grades 6–7)
 Senior Voyagers (Grades 8–9)
 Senior Voyagers
2
LIT: Leader in Training (Grades 7–8)
4
5
LIT: Leader in Training (Grades 7–8)
CIT: Counselors-In-Training (Grades 9–10)
6
7
8
5–7
9
10
8–10
Contact the Teen Camp Director for registration information for the CIT Program.
NEW HORIZONS TEEN VILLAGE (3 Day Camp)
Half Day Camp (Grades 7+) – M/T/W/TH
12:00–4:00PM
Half Day Camp (Grades 7+) – T/W/TH
12:00–4:00PM
14
2
4
3
5
6
7
8
9
10
Darkened Box
= Camp NOT offered!
CAMPS
WEEKS
2
6/20– 6/27–
6/24
7/1
3
7/5–
7/8
4
5
6
7/11– 7/18– 7/25–
7/15 7/22 7/29
7
8
9
8/1–
8/5
8/8–
8/12
8/15–
8/19
10
11
8/22– 8/29–
8/26
9/2
pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due
6/6
6/13
6/20
6/27
7/5
7/11
7/18
7/25
8/1
8/8
8/15
MEMBER
SUMMER
MEMBER
& NONMEMBER
FEE
FEE
BUS TRANSPORTATION (Please note that transportation is subject to change based on the school calendar.)
WEEKS
AM Bus Stop
(write in bus stop number)
PM Bus Stop
(write in bus stop number)
2
MONDAY
6/27
3
4
5
6
7
8
9
10
7/11
7/18
7/25
8/1
8/8
8/15
8/22
TUESDAY
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
WEDNESDAY
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
THURSDAY
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
FRIDAY
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
WEEKS
2
3
4
5
6
7
8
9
10
7/11
7/18
7/25
8/1
8/8
8/15
8/22
MONDAY
6/27
$15 per week
TUESDAY
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
WEDNESDAY
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
THURSDAY
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
FRIDAY
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
2
3
4
5
6
7
8
9
10
11
7/11
7/18
7/25
8/1
8/8
8/15
8/22
8/29
$15 per week
PRE CAMP
WEEKS
Pre Camp
1
MONDAY 6/20
6/27
TUESDAY 6/21
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
8/30
WEDNESDAY 6/22
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
8/31
THURSDAY 6/23
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
9/1
FRIDAY 6/24
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
9/2
2
3
4
5
6
7
8
9
10
11
7/11
7/18
7/25
8/1
8/8
8/15
8/22
8/29
FEE
5-Day Option
$23
$28
4-Day Option
$19
$24
3-Day Option
$15
$18
2-Day Option
$11
$13
1-Day Option
$5
$6
POST CAMP
WEEKS
Post Camp
1
MONDAY 6/20
6/27
TUESDAY 6/21
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
8/30
WEDNESDAY 6/22
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
8/31
THURSDAY 6/23
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
9/1
FRIDAY 6/24
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
9/2
FEE
FEE
NORTH ATTLEBORO BRANCH REGISTRATION FORM
1
Please mark selection(s):
FEE
5-Day Option
$28
$34
4-Day Option
$23
$29
3-Day Option
$18
$21
2-Day Option
$12
$15
1-Day Option
$6
$7
$
$
Facebook.com/NorthAttleboroBranchYMCACamps
SEE PAGE
40 FOR
BUSING
"LIKE US"
TO RECEIVE DAILY CAMP UPDATES!
15
BEST SUMMER EVER
TRADITIONAL CAMPS
NOW INCLUDES
ALL LEADERSHIP
STAFF ARE 21+
STEM
Science, Technology,
Engineering, & Math
CAMP WIGGI is our traditional day camp for children to learn, grow, and have fun! Our camp day excites
and energizes campers to learn new things, exercise their minds and bodies, and build friendships in the great
outdoors. To ensure a fun, safe environment, our role model to camper ratio will never exceed 1:10. Camper days
are filled with swimming, sports, field trips, water and active play including our new Rockland Trust Splash Park, arts
and crafts, drama, nature, games, archery, and more. Exciting field trips will take place for second and third graders
on Wednesdays and for fourth through sixth graders on Tuesdays and Thursdays. Trips may include hikes through
Purgatory Chasm, Paw Sox games, aquariums, Silver Lake, corn mazes, and so much more. On Wednesdays, special
guests will come and visit with the first graders. Some of those visitors may be petting zoos, Frisbee catching dogs,
magicians, and slippery reptiles.
BERNON FAMILY BRANCH
ROCKLAND TRUST SPLASH PARK
COMING SPRING 2016!
JUNIOR CAMP WIGGI
is a branch of Camp Wiggi designed for the pre-school age child. First time
campers make new friends and are introduced to enriching camp activities including swim, sports, water and active
play including our new Rockland Trust Splash Park, arts and crafts, nature, archery, and more. To provide a fun, safe
environment, our role model to camper ratio will be 1:5. On Wednesdays, special guests will come and visit with our
junior campers. Some of those visitors may be petting zoos, Frisbee catching dogs, magicians, and slippery reptiles.
CAMP WIGGI NEW HORIZONS
is a branch of Camp Wiggi providing increased support for
campers with special needs. To provide a fun, safe environment, our role model to camper ratio will be 1:3. We help
each child create positive relationships, build social skills, and encourage full inclusion. Half day options are available
for this camp. New Horizons is also available for Junior Camp Wiggi full and half day options. A meeting with our
integration coordinator is required as part of the registration process. REGISTRATION DEADLINE: July 1, 2016.
CAMP WIGGI – GRADES 1–6
JUNIOR CAMP WIGGI – AGES 3–5
NEW HORIZONS CAMP WIGGI
Weeks 1–11 » June 20-September 2
Full Day: 9:00am–4:00pm
Full Day: 9:00am–4:00pm
Cost: 5-Day: $244 Member / $341 Non-Member
4-Day: $209 Member / $302 Non-Member
3-Day: $174 Member / $252 Non-Member
Cost: 5-Day: $213 Member / $270 Non-Member 4-Day: $191 Member / $246 Non-Member 3-Day: $164 Member / $205 Non-Member
Weeks 1–11 » June 20-September 2
Half Day: 9:00am–1:00pm
Weeks 1–11 » June 20-September 2
Weeks 2–10 » June 27–August 26
Cost: 5-Day: $165 Member / $247 Non-Member
4-Day: $143 Member / $207 Non-Member 3-Day: $121 Member / $174 Non-Member
ALL CAMPS ARE FULL DAY 9:00AM–4:00PM UNLESS SPECIFICALLY NOTED. PRE AND POST CAMP AVAILABLE, SEE PAGE 20.
17
BERNON FAMILY BRANCH
CAMP SILVER LAKE
CANOEING, STAND-UP PADDLE BOARDS,
SANDY BEACH, PLAYGROUND,
& SHADED LUNCH AREA
ALL
LEADERSHIP
STAFF ARE 21+
Camp Silver Lake is situated at the beautiful Silver Lake Park in Bellingham and
is a Hockomock Area YMCA camp established in collaboration with the Town
of Bellingham. This exciting camp gives school-age campers the opportunity
to enjoy traditional camp activities such as sports, games, arts and crafts,
water games, swimming, nature, boating, and other special electives. Our
role model to camper ratio will never exceed 1:10 to ensure a fun, safe
environment. Transportation provided to and from the Bernon Family Branch.
CAMP SILVER LAKE – GRADES 1–6
Weeks 2–10 » June 27–August 26
Cost: 5-Day: $208 Member / $265 Non-Member
4-Day: $186 Member / $240 Non-Member
3-Day: $159 Member / $200 Non-Member
18hockymca.org
HOCKOMOCK AREA YMCA SUMMER 2016 CAMP GUIDE
SPORTS CAMPS
Campers will enjoy soccer, basketball, flag football, wiffle
ball, kickball, dodgeball, and more. Campers will cool off
daily in our swimming pool and learn each sport’s skills with
friends while having fun.
Weeks 2-11 » June 27–September 2
Cost: 5-Day: $232 Member / $318 Non-Member
4-Day: $207 Member / $290 Non-Member
3-Day: $175 Member / $242 Non-Member
SPORTS FIELD TRIP CAMP – GRADES 2–7
Campers will go on 5 sports trips, 1 each day Monday
through Friday. Past trips have included: Fenway Park tour,
the Basketball Hall of Fame, a Paw Sox game, and Gillette
Stadium visit!
Week 5 » July 18–22
Cost: 5-Day: $319 Member / $379 Non-Member
ENRICHMENT
CAMPS
WIGGI WACKY ARTIST CAMP – GRADES 2–6
Campers will enjoy experimenting in various art mediums
such as painting, sculpting, and drawing. Artists will be
broken up by age to keep activities challenging and fun for
all. Campers will cool off daily in our swimming pool.
BERNON FAMILY BRANCH
SUPER SPORTS CAMP – GRADES 1–7
Week 4 » July 11-15
GYMNASTICS
CAMPS
YOUTH CO-ED GYMNASTICS CAMP
GRADES 1–8
Campers split by age will participate in flexibility, strength
training, dance, recreational swimming, and crafts in the
morning. After lunch, campers will focus on gymnastics.
Parents are invited to a special show on Friday.
Weeks 6–11 » July 25–September 2
(Not Available Week 10)
Cost: 5-Day: $244 Member / $341 Non-Member
Week 8 » August 8-12
Cost: 5-Day: $250 Member / $370 Non-Member
CENTER STAGE AT WIGGI CAMP – GRADES 2–6
Dabble in the world of performing arts by putting together
a production from start to finish. Parents are invited to a
special performance at the end of the week. Campers will
cool off daily in our swimming pool.
Week 6 » July 25–29
Cost: 5-Day: $250 Member / $370 Non-Member
DANCE AT WIGGI CAMP – GRADES 2–6
Would you like your child to learn ballet, tap, jazz, lyrical hip
hop, creative movement in 1 week? With quality instructors
who love to teach, they will make sure your child has lots
of fun while learning. Campers will swim Monday through
Thursday and perform in a big show on Friday for familly
and friends.
BOYS & GIRLS PRE-TEAM GYMNASTICS CAMP
– GRADES 1+
Week 4 » July 11–15
Team members will spend their mornings working on
flexibility, strength, and dance for the gymnast workshops.
Team members will work on compulsory routines and skills
during their afternoon gymnastics training.
SWIM CAMPS
Week 10 » August 22–26
WIGGI WATERWORLD SWIM CAMP
GRADES 2–5
(Only pre-team members may register for this camp)
Cost: 5-Day: $244 Member / $341 Non-Member
FOR THEATRE CAMPS
SEE PAGE 33
Cost: 5-Day: $244 Member / $341 Non-Member
Campers who enjoy swimming and are already comfortable
in the water are ready to join Wiggi’s Waterworld. Focus will
be on stroke development and safety as well as fun aquatic
activities including water polo, relay races, and our new
Rockland Trust Splash Park!
Week 9 » August 15–19
Cost: 5-Day: $276 Member / $348 Non-Member
ALL CAMPS ARE FULL DAY 9:00AM–4:00PM UNLESS SPECIFICALLY NOTED. PRE AND POST CAMP AVAILABLE, SEE PAGE 20.
19
BERNON FAMILY BRANCH
TEEN CAMPS
VOYAGERS (TEEN TRAVEL CAMP)
JUNIOR VOYAGERS – GRADES 7–8
SENIOR VOYAGERS – GRADES 9–10
CIT: COUNSELOR-IN-TRAINING – GRADES 9–10
(CIT application and interview required to enroll.)
Voyagers Camp is for those entering grades seven through
ten and looking for fun opportunities throughout the
summer. Campers will participate in one service initiative
per week. Some of the trips/activities throughout the
summer include: Team Building, Newport Beach and Cliff Walk, Castle Island, Southwick Zoo, Purgatory Chasm,
Pinz Bowling, Breezy Acres, Starland, and so much more!
The CIT program is for teens interested in working in a fun
camp setting. CITs will participate in courses teaching camp
traditions in exciting ways and develop leadership skills to
become a future YMCA camp counselor. Completion of the
CIT program does not guarantee future employment. CITs
must commit to a minimum of 6 weeks. If interested, fill
out a CIT application available at our Member Service Desk.
Weeks 2–11 » June 27–September 2
Weeks 2-11 » June 27–September 2
Cost: $244 Member / $341 Non-Member
Cost (Week 3): $209 Member / $302 Non-Member
Cost: $323 Member / $428 Non-Member
LIT: LEADER-IN-TRAINING – GRADES 7–8
(LIT application and interview required to enroll.)
LITs will learn positive values and leadership traits through
service learning, team building, and adventure programming
alongside their peers. CPR and first aid included. LITs will
plan fun events for younger campers. If interested, fill out
an LIT application available at our Member Service Desk.
Registration limited to 1 session per participant.
Session 1: Weeks 2–4 » June 27–July 15
Cost: $346 Member / $436 Non-Member
Session 2: Weeks 5–7 » July 18–August 5
Cost: $370 Member / $490 Non-Member
Session 3: Weeks 8–10 » August 8–26
Cost: $370 Member / $490 Non-Member
NEW HORIZONS TEEN VILLAGE – GRADES 7+
(Half-day afternoon camp for teens with special
needs.)
Campers will travel in a co-ed group from activity to activity
throughout the afternoon. This inclusive camp pairs New
Horizons campers with peer mentors for traditional camp
experiences and provides opportunities for appropriate
social interaction. Focus is on having fun through activities,
games, and swim while building friendships and increasing
social skills. New Horizons Teen Village has a 3:1 camper:
role model ratio for increased support. A meeting with
our integration coordinator is required as part of the
registration process. Interested in being a peer mentor?
Ask integration coordinator about Inclusion Corps.
Weeks 2–10 » June 27–August 26
(Mon/Tue/Wed/Thur) 12:00pm–4:00pm
Cost: $143 Member / $207 Non-Member
Cost (Week 3): $121 Member / $174 Non-Member
OUTDOOR ADVENTURE PROGRAMS for teens – PAGE 22
These travel camps start and end at our Bernon Family Branch in Franklin.
PRE & POST CAMP
PRE CAMP
POST CAMP
Weeks 1–11 » June 20–September 2
7:00am–9:00am
Weeks 1–11 » June 20–September 2
4:00pm–6:00pm
Pre Camp is available to all full-day campers whose parents
need childcare options before the 9:00am start of camp.
Campers will enjoy a fun activity each morning and then be
escorted to their respective camps for 9:00am.
SEE PAGE
40 FOR
BUSING
Member Cost:
5-Day: $23
4-Day: $19
3-Day: $15
2-Day: $11
1-Day: $5
20hockymca.org
Non-Member Cost:
5-Day: $28
4-Day: $24
3-Day: $18
2-Day: $13
1-Day: $6
Post Camp is available to all full-day campers whose parents
need childcare options after the 4:00pm end of camp.
Campers will be escorted from their respective camps to Post
Camp and will enjoy afternoon activities. Snack included.
Member Cost: 5-Day: $28
4-Day: $23
3-Day: $18
2-Day: $12
1-Day: $6
Non-Member Cost:
5-Day: $34
4-Day: $29
3-Day: $21
2-Day: $15
1-Day: $7
HOCKOMOCK AREA YMCA SUMMER 2016 CAMP GUIDE
CAMP CONTACTS
BERNON FAMILY BRANCH
HOCKOMOCK AREA YMCA
Bernon Family Branch
45 Forge Hill Road
Franklin, MA 02038
Camp & Sports Director: Jeff Moore
774.235.2720, jeffm@hockymca.org
For questions or comments regarding:
»» Camp Wiggi
»» Junior Camp Wiggi
»» Wiggi Wacky Artist Camp
»» Center Stage at Wiggi Camp
»» Camp Silver Lake
»» CIT, LIT, & Voyagers Camp
»» Pre & Post Camp
»» Transportation
Sr. Program Director: Tim Shaw
774.235.2746, tims@hockymca.org
For questions or comments regarding:
»» Overall Camp Experience
»» Aquatics & Wiggi Waterworld Swim Camp
Gymnastics & Dance Camp Director: Amy Tucker
774.235.2764, amytr@hockymca.org
For questions or comments regarding:
»» Youth Co-ed Gymnastics Camp
»» Pre-Team Gymnastics Camp
Integration Coordinator: Amy Turner
774.235.2722, amyt@hockymca.org
For questions or comments regarding:
»» Special Needs Programming
»» New Horizons Camps
Sports Camp Coordinator: Kendra Drake
774.235.2720, kendrad@hockymca.org
For questions or comments regarding:
»» Super Sports Camp
»» Sports Field Trip Camp
Outdoor Adventure Program Director: Cody Albright
774.235.2744, codya@hockymca.org
For questions or comments regarding:
»» Outdoor Adventure Programs for Teens
Camp Office
774.235.2760
Call to report your child’s:
»» Tardiness
»» Absences
»» Early Dismissal, etc.
Camp Health Care Supervisor
508.235.2760
For questions or comments regarding:
»» Medical Information
»» Medical Documentation (medications, medical forms, and administer medication forms)
Camp Billing Administrator: Monica Schmidt
508.643.5255, monicas@hockymca.org
For questions or comments regarding:
»» Camp Registrations & Changes
»» Billing
»» Balance Information
»» EZ-Pay Information
Association Scholarship Department
Lynette Testa 508.643.5217
Lori Halben 508.643.5293
frscholarship@hockymca.org
For questions regarding:
»» How to apply for a scholarship
»» Status of scholarship in process, etc.
»» Typical turnaround is 2–3 weeks for processing. Please note, months leading up to and during camp are the busiest time of year. Process may take longer.
Facebook.com/BernonFamilyBranchYMCACamps
@HockomockYMCA
ALL CAMPS ARE FULL DAY 9:00AM–4:00PM UNLESS SPECIFICALLY NOTED. PRE AND POST CAMP AVAILABLE, SEE PAGE 20.
21
OUTDOOR ADVENTURE PROGRAMS
ADVENTURE CAMPS
ADVENTURE SAMPLER – GRADES 3–6
Sample many of the outdoor delights Massachusetts has to
offer. Campers will experience entry level rock climbing routes
and techniques, canoe at a local waterway, hike the Blue Hills
Reservation, and enjoy the view of the summit. Campers will
also learn how to set up their own tents, cook dinner, and make
s’mores over an open fire on an overnight excursion at Myles
Standish State Forest.
Week 6 » July 25–29 (12 campers max)
Week 9 » August 15–19 (12 campers max)
Cost: $425 Member / $635 Non-Member
WHITE WATER RAFTING – GRADES 7–11
Challenge the mighty Kennebec, one of New England's best white
water rivers, with skilled guides at Adventure Bound in Caratunk,
ME. Campers will explore the natural beauty and solitude that
Maine provides. Nights will be spent in cabins and tents at a
lakeside private campground. Days will be spent rafting, hiking to
waterfalls, and swimming in pristine mountain lakes.
Week 5 » July 18–22 (16 campers max)
Week 8 » August 8–12 (16 campers max)
Cost: $550 Member / $825 Non-Member
OVERNIGHT ADVENTURE – (GRADES 3–6)
New for 2016! Campers will travel to a local state forest for a
day of light hiking, programming, and swimming in glacial formed
lakes. Campers will enjoy this overnight campout under the stars
as they cook s’mores on the campfire and create memories to
last a lifetime.
End of Week 3 » July 7–8 (16 campers max)
End of Week 7 » August 4–5 (16 campers max)
Cost: $175 Member / $265 Non-Member
MANDATORY PARENT MEETINGS
Parents and campers must attend one of these meetings at our Bernon Family Branch:
Sunday, June 26, 4:30pm or Monday, July 11, 7:00pm
SIGN UP EARLY! SPACES ARE LIMITED!
These travel camps start and end at our
Bernon Family Branch in Franklin.
Our Outdoor Adventure Program Director Cody Albright is a graduate of Louisiana State University where he
earned a Bachelor’s degree in Cultural Anthropology. With over 12 years experience in camping and outdoor
adventure programming, Cody brings a southern flair to our Outdoor Adventure Camps. In his free time Cody
enjoys downhill skiing, backpacking, reading, exploring in the White Mountains, and competing in the sport of
powerlifting to keep his competitive spirit alive. He looks forward to sharing his love of the outdoors by providing
once in a lifetime adventure-based trips for Y campers this summer.
22hockymca.org
HOCKOMOCK AREA YMCA SUMMER 2016 CAMP GUIDE
Date Received ______________________________________________________
Date Entered ________________________________________________________
Entered By ___________________________________________________________
CAMPER INFORMATION
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Birth Date________________________________________________________________________
Primary Phone___________________________________________________________________
Gender____________________________________________________________________________
Entering Grade for Fall 2016________________________________________________
Address___________________________________________________________________________
City________________________________________________________________________________
State_______________________________________________________________________________
ZIP_________________________________________________________________________________
PARENT/GUARDIAN INFORMATION
PARENT/GUARDIAN INFORMATION
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Address___________________________________________________________________________
City________________________________________________________________________________
State_______________________________________________________________________________
Zip_________________________________________________________________________________
Email_______________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Address___________________________________________________________________________
City________________________________________________________________________________
State_______________________________________________________________________________
Zip_________________________________________________________________________________
Email_______________________________________________________________________________
Relationship to Child___________________________________________________________
I understand that if I list a parent or guardian, they are authorized to pick up my child.
 Yes  No FOR INFORMATION PURPOSES ONLY: Is the camper a descendant of a veteran of the armed forces of the United States.
 Yes  No I currently receive scholarship assistance.
 Yes  No I have applied for scholarship assistance. Date Applied ____________________________
 Yes  No Is the camper a Hockomock Area YMCA School’s Out participant? ____________________________________________________________________________________________________
ADDITIONAL ADULTS AUTHORIZED TO PICK UP MY CHILD (Must be 18+ YEARS OF AGE)
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
BERNON FAMILY BRANCH AND OUTDOOR ADVENTURE REGISTRATION COVER SHEET
FOR OFFICE USE ONLY
23
BERNON FAMILY BRANCH AND OUTDOOR ADVENTURE REGISTRATION COVER SHEET
PHOTOGRAPHIC AND VIDEO MARKETING AUTHORIZATION
Unless otherwise noted, by participating in the camp program and affixing my signature below I understand that the Hockomock Area Y may use
photographs and video footage of my child(ren) for promotional purposes (i.e. brochures, newspaper, Reach Out for Youth and Families video, camp
slideshow, etc.).
AUTHORIZATION TO ADMINISTER BUG SPRAY AND SUNSCREEN
Unless otherwise noted, by participating in this program and affixing my signature below I give Y staff permission to assist my camper(s) in applying
sunscreen and/or bug spray during the camp day.
FINANCIAL POLICIES
ALL CAMPS REQUIRE A $10 DEPOSIT PER CAMP SESSION AT REGISTRATION. REGISTRATIONS RECEIVED
WITHOUT A DEPOSIT WILL NOT BE PROCESSED.
1. The camper’s membership must be valid and in good standing and all overdue balances paid up for any Y programs at the time of registration and for
the duration of their camp session(s). If the membership should lapse, the account will be adjusted to reflect the non-member rate and the parent
will be responsible for the payment difference.
2. The balance for each session is due two weeks prior to the start of that session.
3. Deadline for registrations is Wednesday prior to the start of the camp week depending on availability. Any registrations received after the close of business on Wednesday of the week prior will incur a $20 late registration fee. All camp registrations require 48 hours for processing.
4. Camp fees will be refunded in full only in cases where the Y cancels a session.
5. Withdrawal or cancellation thirty (30) days prior to the start of camp for any reason will result in a refund of camp fees less the $10 deposit per
camp. (REQUEST MUST BE MADE IN WRITING).
6. Withdrawal or cancellation two weeks prior to the start of camp for any reason will result in a 50% refund. (REQUEST MUST BE MADE IN WRITING).
7. No credits or refunds will be issued less than two weeks prior to the start of the registered camp session.
8. Payment is required for all registered days, whether or not the camper attends on those days.
9. Returned check fee is $20.
10. Registrations must be mailed to the appropriate branch or dropped off at the appropriate Member Service Desk.
11. IF PAYMENT IS NOT MADE IN FULL AT TIME OF REGISTRATION, A VALID CREDIT CARD ON FILE IS REQUIRED. NO EXCEPTIONS.
Credit Card on file will be charged on the Monday two weeks prior to the start of the camp week for balances not paid on due date.
If the camper has an outstanding balance, they will not be allowed to attend camp.
permission and waiver
I have read and I understand all camp financial policies and information listed above. For more information, please contact Billing Administrator.
By signing this form, I give permission for my child to:
• attend any Hockomock Area YMCA summer camp field trips scheduled during their sessions of attendance at camp.
• take part in the Adventures in Respect Ropes Challenge Course.
On my behalf and that of my child(ren), I hereby release, waive, discharge, and covenant not to sue the Hockomock Area YMCA and all branches thereof,
its officers, employees, and agents from all liability to the undersigned and my child/children, and any claims or demands therefore on account of injury
of death to my child(ren) or damage to property, whether caused by the negligence of this Hockomock Area YMCA employee or otherwise, regardless of
the location of such accident, incident, or act giving rise to such injury, death, or damage.
I have read, understand, and voluntarily signed this release and waiver of liability and further agree that no oral representations, statements, or
inducement apart from the foregoing written agreement have been made.
PARENT/GUARDIAN:
Printed Name _______________________________________________________________
Signature____________________________________________________________
Date ________________________
PAYMENT METHOD (Visa/MasterCard/Discover/American Express, Check, or Money Order ONLY)
IF PAYMENT IN FULL IS NOT MADE AT TIME OF REGISTRATION, A CREDIT CARD ON FILE IS REQUIRED. NO EXCEPTIONS.




Payment in full
Deposit by check or money order
Deposit by credit card
Check, money order or online payment will be paid two weeks prior to the start of camp (you do not have to be a member to pay online) If payment is not received the credit card on file will be charged.
To make your payments online: Visit our website www.hockymca.org and follow these instructions:
1. Select “Register for Programs” button. 2. S
elect LOGIN.
3. Enter your USERNAME and PASSWORD. If you do not know your USERNAME and PASSWORD, select “Forgot your login?” and an email will
be sent with your login information. If you are unsuccessful, please contact Billing Administrator or the Member Service Desk. You can pay
balances online whether or not you are a member of the Hockomock YMCA.
4. Select “You have a balance”
 Use credit card for balance two weeks prior to start of camp
CREDIT CARD PAYMENT:  VISA  MC  DISC  AMEX
Credit Card # ___________________________________________________________________________________ CID # __________________________ Name on Card_________________________________________________________________________________ Signature___________________________________________________________________________
Exp. Date___________________________________
Please submit completed registration form(s) to:
Hockomock Area YMCA – Bernon Family Branch, Attention: Billing Administrator, 45 Forge Hill Road, Franklin, MA 02038
24
FINANCIAL ASSISTANCE: Did you know that the Y is a not-for-profit charitable organization? Inquire at any Y to find out more.
1
Please mark selection(s):
Darkened Box
= Camp NOT offered!
CAMPS
WEEKS
CAMP WIGGI (Grades 1–6)
WEEKLY SESSIONS (ONLY cross off each full
week your camper will attend)
DAILY OPTION
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
2
6/20– 6/27–
6/24
7/1
3
7/5–
7/8
4
5
6
7/11– 7/18– 7/25–
7/15 7/22 7/29
7
8
9
8/1–
8/5
8/8–
8/12
8/15–
8/19
10
11
8/22– 8/29–
8/26
9/2
pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due
6/6
6/13
6/20
6/27
7/5
7/11
7/18
7/25
8/1
8/8
8/15
1
2
3
4
5
6
7
8
9
10
11
If weekly sessions are not what you need, you may select a 4 or 3 day option by
crossing off the specific dates you require BELOW.
6/20 6/27
7/11 7/18 7/25
8/1
8/8
8/15 8/22 8/29
6/21 6/28
7/5
7/12 7/19 7/26
8/2
8/9
8/16 8/23 8/30
6/22 6/29
7/6
7/13 7/20 7/27
8/3
8/10 8/17
8/24 8/31
6/23 6/30
7/7
7/14 7/21 7/28
8/4
8/11 8/18 8/25
9/1
6/24
7/1
7/8
7/15 7/22 7/29
8/5
8/12 8/19 8/26
9/2
 FULL DAY
 HALF DAY
NEW HORIZONS CAMP WIGGI
WEEKLY SESSIONS (ONLY cross off each full
week your camper will attend)
DAILY OPTION
2
3
4
5
6
7
8
9
10
If weekly sessions are not what you need, you may select a 4 or 3 day option by
crossing off the specific dates you require BELOW.
MONDAY
6/27
7/11
7/18
7/25
8/1
8/8
8/15
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
WEDNESDAY
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
THURSDAY
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
FRIDAY
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
$213
$270
FEE
FEE
4-Day Option
$191
$246
3-Day Option
$164
$205
FULL DAY / FULL DAY /
HALF DAY HALF DAY
FEE
FEE
$213 FD
$270 FD
$165 HD
$247 HD
FEE
FEE
4-Day Option
8/22
TUESDAY
MEMBER
FEE
SUMMER
MEMBER
& NONMEMBER
FEE
$191 FD
$143 HD
$246 FD
$207 HD
3-Day Option
 FULL DAY Ages 3–5 (Must be potty-trained)
 HALF DAY Ages 3–5 (Must be potty-trained)
JUNIOR CAMP WIGGI
WEEKLY SESSIONS – Full Day (Ages 3-5)
or Half-Day (Ages 3–5) (ONLY Cross off
each full week your camper will attend
DAILY OPTION
1
2
3
4
5
6
NEW HORIZONS
 FULL DAY  HALF DAY
7
8
9
10
11
If weekly sessions are not what you need, you may select a 4 or 3 day option by
crossing off the specific dates you require BELOW.
MONDAY 6/20
6/27
TUESDAY 6/21
6/28
WEDNESDAY 6/22
THURSDAY 6/23
FRIDAY 6/24
7/11
7/18
7/25
8/1
8/8
8/15
8/22
8/29
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
8/30
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
8/31
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
9/1
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
9/2
CAMP SILVER LAKE (Grades 1–6)
WEEKLY SESSIONS (ONLY cross off each full
week your camper will attend)
DAILY OPTION
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
2
3
4
5
6
7
8
9
10
If weekly sessions are not what you need, you may select a 4 or 3 day option by
crossing off the specific dates you require BELOW.
6/27
7/11 7/18 7/25
8/1
8/8
8/15 8/22
8/16 8/23
6/28
7/5
7/12 7/19 7/26
8/2
8/9
6/29
7/6
7/13 7/20 7/27
8/3
8/10 8/17
8/24
6/30
7/7
7/14 7/21 7/28
8/4
8/11 8/18 8/25
7/1
7/8
7/15 7/22 7/29
8/5
8/12 8/19 8/26
$164 FD
$121 HD
FULL DAY /
HALF DAY
FEE
$205 FD
$174 HD
FULL DAY /
HALF DAY
FEE
$244 FD
$165 HD
$341 FD
$247 HD
FEE
FEE
4-Day Option
$209 FD
$143 HD
$302 FD
$207 HD
3-Day Option
$174 FD
$121 HD
$252 FD
$174 HD
FEE
FEE
$208
$265
FEE
FEE
BERNON FAMILY BRANCH AND OUTDOOR ADVENTURE REGISTRATION COVER SHEET
ONE REGISTRATION FORM PER CAMPER
4-Day Option
$186
$240
3-Day Option
$159
$200
25
BERNON FAMILY BRANCH AND OUTDOOR ADVENTURE REGISTRATION COVER SHEET
1
Please mark selection(s):
Darkened Box
= Camp NOT offered!
CAMPS
WEEKS
2
3
6/20– 6/27–
6/24
7/1
7/5–
7/8
4
5
7/11– 7/18– 7/25–
7/15 7/22 7/29
7
8
8/1–
8/5
8/8–
8/12
9
10
11
8/15– 8/22– 8/29–
8/19 8/26
9/2
pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due
6/6
6/13
6/20
6/27
7/5
7/11
7/18
7/25
8/1
8/8
8/15
SPORTS CAMPS
Super Sports Camp (Grades 1–7)
2
DAILY OPTION
3
4
5
6
7
8
9
10
11
If weekly sessions are not what you need, you may select a 4 or 3 day option by
crossing off the specific dates you require BELOW.
MONDAY
6/27
TUESDAY
6/28
WEDNESDAY
THURSDAY
FRIDAY
7/11
7/18
7/25
8/1
8/8
8/15
8/22
8/29
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
8/30
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
8/31
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
9/1
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
9/2
Sports Field Trip Camp (Grades 2–7)
5
GYMNASTICS CAMPS
Youth Co-ed Gymnastics Camp (Grades 1–8)
6
7
8
9
Pre-Team Gymnastics Camp (Grades 1+)
11
10
ARTS AND ENRICHMENT CAMPS
Wiggi’s Wacky Artist – Art Camp (Grades 2–6)
4
8
Center Stage at Wiggi – Drama Camp
(Grades 2–6)
6
Dance at Wiggi Camp (Grades 2–6)
4
MEMBER
SUMMER
MEMBER
& NONMEMBER
FEE
FEE
$232
$318
FEE
FEE
4-Day Option
$207
$290
3-Day Option
$175
$242
$319
$379
FEE
FEE
$244
$341
$244
$341
FEE
FEE
$250
$370
$250
$370
$244
$341
FEE
FEE
$276
$348
FEE
FEE
$244
$341
$209
$302
Please use the Invensys Foxboro and Mansfield Branch Registration Form to register for Theatre Camps.
SWIM CAMPS
Wiggi’s WaterWorld (Grades 2–5)
9
TEEN LEADERSHIP CAMPS
PLEASE SELECT YOUR CAMP:
 Junior Voyagers (Grades 7–8)
 Senior Voyagers (Grades 9–10)
 Junior Voyagers (Grades 7–8)
 Senior Voyagers (Grades 9–10)
LIT: Leader in Training (Grades 7–8)
 Junior Voyagers
 Senior Voyagers
2
4
5
7
8
9
10
2–4
LIT: Leader in Training (Grades 7–8)
CIT: Counselors-In-Training (Grades 9–10)
6
3
5–7
8–10
Contact the Camp Director for registration information for the CIT Program.
NEW HORIZONS TEEN VILLAGE (3 Day Camp)
Half Day Camp (Grades 7+) – M/T/W/TH
12:00–4:00PM
Half Day Camp (Grades 7+) – T/W/TH
12:00–4:00PM
4
5
6
7
8
9
3
OUTDOOR ADVENTURE CAMPS
Adventures Sampler (Grades 3–6)
6
White Water Rafting (Grades 7–11)
Overnight Adventure (Grades 3–6)
26
6
9
5
3
8
7
10
11
$346
$436
$370
$490
$323
$428
FEE
FEE
$143
$207
$121
$174
FEE
FEE
$425
$635
$550
$825
$175
$265
Darkened Box
= Camp NOT offered!
CAMPS
WEEKS
2
6/20– 6/27–
6/24
7/1
3
4
7/5–
7/8
7/11–
7/15
5
6
7/18– 7/25–
7/22 7/29
7
8
9
10
11
8/1–
8/5
8/8–
8/12
8/15–
8/19
8/22–
8/26
8/29–
9/2
pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due
6/6
6/13
6/20
6/27
7/5
7/11
7/18
7/25
8/1
8/8
8/15
BUS TRANSPORTATION (Please note that transportation is subject to change based on the school calendar.)
WEEKS
AM Bus Stop
(write in bus stop number)
PM Bus Stop
(write in bus stop number)
2
3
4
5
6
7
8
9
10
7/11
7/18
7/25
8/1
8/8
8/15
8/22
MONDAY
6/27
TUESDAY
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
WEDNESDAY
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
THURSDAY
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
FRIDAY
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
WEEKS
2
3
4
5
6
7
8
9
10
7/11
7/18
7/25
8/1
8/8
8/15
8/22
6/27
TUESDAY
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
WEDNESDAY
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
THURSDAY
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
FRIDAY
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
1
2
3
4
5
6
7
8
9
10
11
MONDAY
6/20
6/27
7/11
7/18
7/25
8/1
8/8
8/15
8/22
8/29
TUESDAY
6/21
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
8/30
WEDNESDAY
6/22
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
8/31
THURSDAY
6/23
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
9/1
FRIDAY
6/24
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
9/2
WEEKS
1
2
3
4
5
6
7
8
9
10
11
MONDAY
6/20
6/27
7/11
7/18
7/25
8/1
8/8
8/15
8/22
8/29
TUESDAY
6/21
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
8/30
WEDNESDAY
6/22
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
8/31
THURSDAY
6/23
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
9/1
FRIDAY
6/24
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
9/2
FEE
FEE
5-Day Option
$23
$28
4-Day Option
$19
$24
3-Day Option
$15
$18
2-Day Option
$11
$13
1-Day Option
$5
$6
POST CAMP
Post Camp
FEE
$15 per week
PRE CAMP
Pre Camp
FEE
$15 per week
MONDAY
WEEKS
MEMBER
SUMMER
MEMBER
& NONMEMBER
FEE
FEE
5-Day Option
$28
$34
4-Day Option
$23
$29
3-Day Option
$18
$21
2-Day Option
$12
$15
1-Day Option
$6
$7
$
BERNON FAMILY BRANCH AND OUTDOOR ADVENTURE REGISTRATION COVER SHEET
1
Please mark selection(s):
$
Facebook.com/BernonFamilyBranchYMCACamps
SEE PAGE
40 FOR
BUSING
"LIKE US"
TO RECEIVE DAILY CAMP UPDATES!
27
BEST SUMMER EVER
ALL
LEADERSHIP
STAFF ARE
21+
NOW INCLUDES
STEM
Science, Technology,
Engineering, & Math
CAMP WAPAWCA
(With A Positive Attitude We Can Achieve) is our traditional day camp for children to
learn, grow, and have fun! Our camp day excites and energizes campers to learn new things, exercise their minds and
bodies, and build friendships in the great outdoors. To ensure a fun, safe environment, our role model to camper ratio will
never exceed 1:10. Our days are filled with swimming, sports, field trips, water and active play, arts and crafts, drama,
nature, games, archery, and more. Exciting field trips will take place for second and third graders on Wednesdays and for
fourth and fifth graders on Tuesdays and Thursdays. Trips may include hikes through Purgatory Chasm, Paw Sox games,
aquariums, Silver Lake, corn mazes, and so much more. On Wednesdays special guests will come and visit with the first
graders. Some of those visitors may be petting zoos, frisbee catching dogs, magicians, and slippery reptiles.
INVENSYS FOXBORO BRANCH
TRADITIONAL CAMPS
JUNIOR CAMP WAPAWCA
is a branch of Camp WAPAWCA designed for the pre-school age child
(children must be potty trained). First time campers make new friends and are introduced to enriching camp activities
including swimming, sports, water and active play, arts and crafts, nature, archery, and more. To provide a fun, safe
environment, our role model to camper ratio will be 1:5. On Wednesdays special guests will come and visit with our
junior campers. Some of those visitors may be petting zoos, frisbee catching dogs, magicians and slippery reptiles.
NEW HORIZONS CAMP WAPAWCA is a branch of Camp WAPAWCA providing increased
support for campers with special needs. To provide a fun, safe environment, our role model to camper ratio will be 1:3.
We help each child create positive relationships, build social skills, and encourage full inclusion. New Horizons is also
available for Junior Camp WAPAWCA full and half day options. A meeting with our integration coordinator is required
as part of the registration process. REGISTRATION DEADLINE: July 1, 2016.
CAMP WAPAWCA – GRADES 1–5
JUNIOR CAMP WAPAWCA – AGES 3–5
NEW HORIZONS CAMP WAPAWCA
Weeks 1–11 » June 20–September 2
Full Day: 9:00am–4:00pm
Full Day: 9:00am–4:00pm
Cost: 5-Day: $251 Member / $352 Non-Member
4-Day: $215 Member / $312 Non-Member
3-Day: $180 Member / $259 Non-Member
Cost: 5-Day: $219 Member / $278 Non-Member 4-Day: $195 Member / $253 Non-Member 3-Day: $166 Member / $208 Non-Member
Weeks 1–11 » June 20–September 2
Half Day: 9:00am–1:00pm
Weeks 1–11 » June 20–September 2
Weeks 2–10 » June 27–August 26
Cost: 5-Day: $168 Member / $254 Non-Member
4-Day: $147 Member / $213 Non-Member 3-Day: $124 Member / $180 Non-Member
ALL CAMPS ARE FULL DAY 9:00AM–4:00PM UNLESS SPECIFICALLY NOTED. PRE AND POST CAMP AVAILABLE, SEE PAGE 31.
29
INVENSYS FOXBORO BRANCH
SPORTS CAMPS
SUPER SPORTS CAMP – GRADES 1–7
Campers will enjoy soccer, basketball, flag football,
wiffle ball, kickball, dodgeball, and more. Campers
will cool off daily in our swimming pool and learn
each sport’s skills with friends while having fun.
Weeks 1–11 » June 20–September 2
Cost: 5-Day: $232 Member / $318 Non-Member
4-Day: $207 Member / $290 Non-Member
3-Day: $175 Member / $242 Non-Member
SPORTS FIELD TRIP CAMP – GRADES 2–7
Campers will go on 5 sports trips, 1 each day Monday
through Friday. Past trips have included: Fenway Park tour,
the Basketball Hall of Fame, a Paw Sox game, and Gillette
Stadium visit!
Week 5 » July 18–22
Week 8 » August 8–12
Cost: 5-Day: $319 Member / $379 Non-Member
FLAG FOOTBALL CAMP – GRADES 1–7
Flag football campers will be split into age appropriate
groups while learning skills, drills, and having fun in a
quarterback challenge, punt, pass, and kick challenge, and
flag football tournament. If schedule permits, campers will
visit a New England Pats practice session! Camp will be held
offsite with transportation provided by the YMCA.
GRADES 1–3: NCAA: Week 7 » August 1–5
GRADES 4–7: NFL: Week 7 » August 1–5
Cost: 5-Day: $244 Member / $341 Non-Member
FOR THEATRE CAMPS
SEE PAGE 33
30hockymca.org
HOCKOMOCK AREA YMCA SUMMER 2016 CAMP GUIDE
VOYAGERS (TEEN TRAVEL CAMP) JUNIOR VOYAGERS – GRADES 6–7
SENIOR VOYAGERS – GRADES 8–9
CIT: COUNSELOR-IN-TRAINING – GRADES 9–10
(CIT application and interview required to enroll.)
Voyagers Camp is for those entering grades six through
nine who are looking for fun opportunities throughout the
summer. Campers will participate in one service initiative
per week. Some of the trips/activities planned throughout
the summer include: Team Building, Newport Beach and Cliff
Walk, Castle Island, Southwick Zoo, Purgatory Chasm, Pinz
Bowling, Breezy Acres, Starland, and so much more!
The CIT program is for teens interested in working in a fun
camp setting. CITs will participate in courses teaching camp
traditions in exciting ways and develop leadership skills to
become a future YMCA camp counselor. Completion of the
CIT program does not guarantee future employment. CITs
must commit to a minimum of 6 weeks. If interested, fill
out a CIT application available at our Member Service Desk.
Weeks 1-11 » June 20–September 2
Weeks 2–11 » June 27–September 2
Cost: $251 Member / $352 Non-Member
Cost (Week 3): $215 Member / $312 Non-Member
Cost: $323 Member / $428 Non-Member
LIT: LEADER-IN-TRAINING – GRADES 7–8
(1/2-day afternoon camp for teens with special
needs.)
(LIT application and interview required to enroll.)
LITs will learn positive values and leadership traits through
service learning, team building, and adventure programming
alongside their peers. CPR and first aid included. LITs will
plan fun events for younger campers. This program works
in collaboration with our New Horizons program in the
afternoons. If interested, fill out an LIT application available
at our Member Service Desk. Registration limited to 1
session per participant.
Session 1: Weeks 2–4 » June 27–July 15
Cost: $346 Member / $436 Non-Member
Session 2: Weeks 5–7 » July 18–August 5
Cost: $370 Member / $490 Non-Member
Session 3: Weeks 8–10 » August 8–26
Cost: $370 Member / $490 Non-Member NEW HORIZONS TEEN VILLAGE – GRADES 6+
Campers will travel in a co-ed group from activity to activity
throughout the afternoon. This inclusive camp pairs New
Horizons campers with peer mentors for traditional camp
experiences and provides opportunities for appropriate social
interaction. Focus is on having fun through activities, games,
and swim while building friendships and increasing social
skills. New Horizons Teen Village has a 3:1 camper: role model
ratio for increased support. A meeting with our integration
coordinator is required as part of the registration process.
Interested in being a peer mentor? Ask our integration
coordinator about Inclusion Corps.
INVENSYS FOXBORO BRANCH
TEEN CAMPS
Weeks 2–10 » June 27–August 26
(Mon/Tue/Wed/Thur) 12:00pm–4:00pm
Cost: $147 Member / $213 Non-Member
Cost (Week 3): $124 Member / $180 Non-Member
OUTDOOR ADVENTURE PROGRAMS for teens – PAGE 22
These travel camps start and end at our Bernon Family Branch in Franklin.
PRE & POST CAMP
PRE CAMP
POST CAMP
Weeks 1–11 » June 20–September 2
7:00am–9:00am
Weeks 1–11 » June 20–September 2
4:00pm–6:00pm
Pre Camp is available to all full-day campers whose parents
need childcare options before the 9:00am start of camp.
Campers will enjoy a fun activity each morning and then be
escorted to their respective camps for 9:00am.
Member Cost:
5-Day: $23
4-Day: $19
3-Day: $15
2-Day: $11
1-Day: $5
Non-Member Cost:
5-Day: $28
4-Day: $24
3-Day: $18
2-Day: $13
1-Day: $6
Post Camp is available to all full-day campers whose parents
need childcare options after the 4:00pm end of camp.
Campers will be escorted from their respective camps to Post
Camp and will enjoy afternoon activities. Snack included.
Member Cost: 5-Day: $28
4-Day: $23
3-Day: $18
2-Day: $12
1-Day: $6
Non-Member Cost:
5-Day: $34
4-Day: $29
3-Day: $21
2-Day: $15
1-Day: $7
ALL CAMPS ARE FULL DAY 9:00AM–4:00PM UNLESS SPECIFICALLY NOTED. PRE AND POST CAMP AVAILABLE.
SEE PAGE
40 FOR
BUSING
31
INVENSYS FOXBORO BRANCH
CAMP CONTACTS
HOCKOMOCK AREA YMCA
Invensys Foxboro Branch
67 Mechanic Street
Foxboro, MA 02035
Camp Director: Ashli Phillips
508.772.1353, ashlip@hockymca.org
For questions or comments regarding:
»» Camp Wapawca
»» Pre & Post Camp
»» Transportation
Sr. Program Director: Erin Brennock
508.772.1306, erinb@hockymca.org
For questions or comments regarding:
»» Overall Camp Experience
»» Aquatics
Integration Coordinator: Barbara Manuelpillai
508.772.1327, barbaram@hockymca.org
For questions or comments regarding:
»» Special Needs Programming
»» New Horizons Teen Camps
Sports Camp Director: Tim LaConte
508.772.1354, timl@hockymca.org
For questions or comments regarding:
»» Sports Camps
Teen Camp Director: Dan DeMars
508.772.1316, danield@hockymca.org
For questions or comments regarding:
»» Voyagers Camp
»» CIT: Counselor in Training
»» LIT: Leaders in Training
Junior Camp Wapawca Director: Nicole Purnell
508.772.1347, nicolep@hockymca.org
For questions or comments regarding:
»» Junior Camp Wapawca
Mansfield Performing Arts Director: Heather Utsler-Smith
614.581.1783, heatheru@hockymca.org
For questions or comments regarding:
»» Theatre Camps
Camp Office
508.772.1353
Call to report your child’s:
»» Tardiness
»» Absences
»» Early Dismissal, etc.
Camp Health Care Supervisor
508.772.1353, campwapawca@gmail.com
For questions or comments regarding:
»» Medical Information
»» Medical Documentation (medications, medical forms, and administer medication forms)
Camp Billing Administrator: Monica Schmidt
508.643.5255, monicas@hockymca.org
For questions or comments regarding:
»» Camp Registrations & Changes
»» Billing
»» Balance Information
»» EZ-Pay Information
Association Scholarship Department
Lynette Testa 508.643.5217
Lori Halben 508.643.5293
fxscholarship@hockymca.org
For questions regarding:
»» How to apply for a scholarship
»» Status of scholarship in process, etc.
»» Typical turnaround is 2–3 weeks for processing. Please note, months leading up to and during camp are the busiest time of year and may take longer to process
Member Service Desk
Phone: 508.543.2523 / Fax: 508.543.5503
For questions or comments regarding:
»» Membership & Classes
Facebook.com/InvensysFoxboroBranchYMCACamps
32hockymca.org
@HockomockYMCA
HOCKOMOCK AREA YMCA SUMMER 2016 CAMP GUIDE
THEATRE CAMPERS begin each day with a warm up and game. Mornings are spent learning
choreography, music, and scenes with a break for snack mid-way. After lunch, campers have free-play outside.
Our camp has weekly themes and each afternoon we enjoy a fun activity relating to that theme. Our day ends with a
rehearsal to review our progress.
“BUGSY MALONE JR." – GRADES 2–8
Campers will sing, dance, and act in this musical based on the hit 1976 film, featuring a catchy, swinging score by
the composer of the Muppet Movie and starring a pre-teen Scott Baio and Jodie Foster! Two gangs in a fictitious city
populated only by children are in a rivalry of Capone-ian standards. Who will win? Dandy Dan’s gang has gotten the
upper hand singing acquiring the “splurge gun” (a weapon that shoots whipped cream!) but Bugsy Malone might give
him a run for his money. Join us to see how it turns out! This production will feature full costumes, lighting, sets, and
sound. Performance dates are Saturday, July 16 and Sunday July 17.
Weeks 3-4 » July 5-July 15
Cost: 2-Week Session: $515 Member / $641 Non-Member
“SHREK THE MUSICAL" – GRADES 2–8
Everyone’s favorite Ogre will have them rolling in the aisles! Based on the Oscar-winning DreamWorks Animation film,
Shrek the Musical is a Tony Award-winning fairy tale adventure, bringing all the beloved characters you know from the
film to life onstage. Our story begins, as so many do, with “Once Upon a Time,” but throw in a wisecracking Donkey,
a feisty princess, a short tempered bad guy, a cookie with an attitude, and over a dozen other fairy tale misfits,
and you’ve got the recipe for a smash-hit, and an unforgettable camp experience! This production will feature full
costumes, lighting, sets, sound, live musicians, and a dragon! Performance dates are Saturday August 13 and Sunday
August 14.
Weeks 6-8 » July 25-August 12
Cost: 3-Week Session: $730 Member / $788 Non-Member
MANSFIELD ARTS & EDUCATION CENTER
THEATRE CAMPS
HOCKOMOCK AREA YMCA
Mansfield Arts & Education Center
40 Balcom Street
Mansfield, MA 02048
Performing Arts Director: Heather Utsler-Smith
614.581.1783, heatheru@hockymca.org
Camp Office
508.339.3066 / Fax:508.337.8479
Call to report your child’s:
»» Tardiness / Absences Early Dismissal, etc.
Camp Billing Administrator: Monica Schmidt
508.643.5255, monicas@hockymca.org
For questions or comments regarding:
»» Camp Registrations & Billing
Performing Arts Director Heather Utsler-Smith has worked as a teaching artist and director for theatre-based
camps for 12 years. This summer marks her 39th and 40th productions with the Hockomock Area YMCA. She
holds a BA with dual specializations in Acting/ Directing and Youth Theatre/ Puppetry from Bowling Green State
University. She has worked for the Rhode Island Youth Theatre and the Contemporary American Theatre Company
in Columbus, Ohio. Heather looks forward to another great summer of song, dance, and discovery of talent with
the children in her theatre camps.
ALL CAMPS ARE FULL DAY 9:00AM–4:00PM UNLESS SPECIFICALLY NOTED. PRE AND POST CAMP AVAILABLE, SEE PAGE 31.
33
BEST SUMMER EVER
Date Received ______________________________________________________
Date Entered ________________________________________________________
Entered By ___________________________________________________________
CAMPER INFORMATION
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Birth Date________________________________________________________________________
Primary Phone___________________________________________________________________
Gender____________________________________________________________________________
Entering Grade for Fall 2016________________________________________________
Address___________________________________________________________________________
City________________________________________________________________________________
State_______________________________________________________________________________
ZIP_________________________________________________________________________________
PARENT/GUARDIAN INFORMATION
PARENT/GUARDIAN INFORMATION
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Address___________________________________________________________________________
City________________________________________________________________________________
State_______________________________________________________________________________
Zip_________________________________________________________________________________
Email_______________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Address___________________________________________________________________________
City________________________________________________________________________________
State_______________________________________________________________________________
Zip_________________________________________________________________________________
Email_______________________________________________________________________________
Relationship to Child___________________________________________________________
I understand that if I list a parent or guardian, they are authorized to pick up my child.
 Yes  No FOR INFORMATION PURPOSES ONLY: Is the camper a descendant of a veteran of the armed forces of the United States.
 Yes  No I currently receive scholarship assistance.
 Yes  No I have applied for scholarship assistance. Date Applied ____________________________
ADDITIONAL ADULTS AUTHORIZED TO PICK UP MY CHILD (Must be 18+ YEARS OF AGE)
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
First Name_______________________________________________________________________
Last Name________________________________________________________________________
Primary Phone___________________________________________________________________
Work Phone______________________________________________________________________
Cell Phone________________________________________________________________________
Relationship to Child___________________________________________________________
INVENSYS FOXBORO AND MANSFIELD BRANCH REGISTRATION COVER SHEET
FOR OFFICE USE ONLY
35
INVENSYS FOXBORO AND MANSFIELD BRANCH REGISTRATION COVER SHEET
PHOTOGRAPHIC AND VIDEO MARKETING AUTHORIZATION
Unless otherwise noted, by participating in the camp program and affixing my signature below I understand that the Hockomock Area Y may use
photographs and video footage of my child(ren) for promotional purposes (i.e. brochures, newspaper, Reach Out for Youth and Families video, camp
slideshow, etc.).
AUTHORIZATION TO ADMINISTER BUG SPRAY AND SUNSCREEN
Unless otherwise noted, by participating in this program and affixing my signature below I give Y staff permission to assist my camper(s) in applying
sunscreen and/or bug spray during the camp day.
FINANCIAL POLICIES
ALL CAMPS REQUIRE A $10 DEPOSIT PER CAMP SESSION AT REGISTRATION. REGISTRATIONS RECEIVED
WITHOUT A DEPOSIT WILL NOT BE PROCESSED.
1. The camper’s membership must be valid and in good standing and all overdue balances paid up for any Y programs at the time of registration and for
the duration of their camp session(s). If the membership should lapse, the account will be adjusted to reflect the non-member rate and the parent
will be responsible for the payment difference.
2. The balance for each session is due two weeks prior to the start of that session.
3. Deadline for registrations is Wednesday prior to the start of the camp week depending on availability. Any registrations received after the close of business on Wednesday of the week prior will incur a $20 late registration fee. All camp registrations require 48 hours for processing.
4. Camp fees will be refunded in full only in cases where the Y cancels a session.
5. Withdrawal or cancellation thirty (30) days prior to the start of camp for any reason will result in a refund of camp fees less the $10 deposit per
camp. (REQUEST MUST BE MADE IN WRITING).
6. Withdrawal or cancellation two weeks prior to the start of camp for any reason will result in a 50% refund. (REQUEST MUST BE MADE IN WRITING).
7. No credits or refunds will be issued less than two weeks prior to the start of the registered camp session.
8. Payment is required for all registered days, whether or not the camper attends on those days.
9. Returned check fee is $20.
10. Registrations must be mailed to the appropriate branch or dropped off at the appropriate Member Service Desk.
11. IF PAYMENT IS NOT MADE IN FULL AT TIME OF REGISTRATION, A VALID CREDIT CARD ON FILE IS REQUIRED. NO EXCEPTIONS.
Credit Card on file will be charged on the Monday two weeks prior to the start of the camp week for balances not paid on due date.
If the camper has an outstanding balance, they will not be allowed to attend camp.
permission and waiver
I have read and I understand all camp financial policies and information listed above. For more information, please contact Billing Administrator.
By signing this form, I give permission for my child to:
• attend any Hockomock Area YMCA summer camp field trips scheduled during their sessions of attendance at camp.
• take part in the Adventures in Respect Ropes Challenge Course.
On my behalf and that of my child(ren), I hereby release, waive, discharge, and covenant not to sue the Hockomock Area YMCA and all branches thereof,
its officers, employees, and agents from all liability to the undersigned and my child/children, and any claims or demands therefore on account of injury
of death to my child(ren) or damage to property, whether caused by the negligence of this Hockomock Area YMCA employee or otherwise, regardless of
the location of such accident, incident, or act giving rise to such injury, death, or damage.
I have read, understand, and voluntarily signed this release and waiver of liability and further agree that no oral representations, statements, or
inducement apart from the foregoing written agreement have been made.
PARENT/GUARDIAN:
Printed Name _______________________________________________________________
Signature____________________________________________________________
Date ________________________
PAYMENT METHOD (Visa/MasterCard/Discover/American Express, Check, or Money Order ONLY)
IF PAYMENT IN FULL IS NOT MADE AT TIME OF REGISTRATION, A CREDIT CARD ON FILE IS REQUIRED. NO EXCEPTIONS.




Payment in full
Deposit by check or money order
Deposit by credit card
Check, money order or online payment will be paid two weeks prior to the start of camp (you do not have to be a member to pay online) If payment is not received the credit card on file will be charged.
To make your payments online: Visit our website www.hockymca.org and follow these instructions:
1. Select “Register for Programs” button. 2. S
elect LOGIN.
3. Enter your USERNAME and PASSWORD. If you do not know your USERNAME and PASSWORD, select “Forgot your login?” and an email will
be sent with your login information. If you are unsuccessful, please contact Billing Administrator or the Member Service Desk. You can pay
balances online whether or not you are a member of the Hockomock YMCA.
4. Select “You have a balance”
 Use credit card for balance two weeks prior to start of camp
CREDIT CARD PAYMENT:  VISA  MC  DISC  AMEX
Credit Card # ___________________________________________________________________________________ CID # __________________________ Name on Card_________________________________________________________________________________ Signature___________________________________________________________________________
Exp. Date___________________________________
Please submit completed registration form(s) to:
Hockomock Area YMCA – Invensys Foxboro Branch, Attention: Billing Administrator, 67 Mechanic Street, Foxboro, MA 02035
36
FINANCIAL ASSISTANCE: Did you know that the Y is a not-for-profit charitable organization? Inquire at any Y to find out more.
Please mark selection(s):
Darkened Box
1
= Camp NOT offered!
CAMPS
WEEKS
CAMP WAPAWCA (Grades 1–5)
WEEKLY SESSIONS (ONLY cross off each full
week your camper will attend)
DAILY OPTION
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
NEW HORIZONS CAMP WAPAWCA
WEEKLY SESSIONS (ONLY cross off each full
week your camper will attend)
DAILY OPTION
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
2
6/20– 6/27–
6/24
7/1
3
4
5
6
7
8
7/5–
7/8
7/11–
7/15
7/18–
7/22
7/25–
7/29
8/1–
8/5
8/8–
8/12
pmt due pmt due pmt due pmt due pmt due
6/6
6/13
6/20
6/27
7/5
1
2
3
4
5
9
10
11
8/15– 8/22– 8/29–
8/19 8/26
9/2
pmt due pmt due pmt due pmt due pmt due pmt due
7/11
7/18
7/25
8/1
8/8
8/15
6
7
8
9
10
11
If weekly sessions are not what you need, you may select a 4 or 3 day option by
crossing off the specific dates you require BELOW.
6/20 6/27
7/11
7/18
7/25
8/1
8/8
8/15 8/22 8/29
6/21 6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16 8/23 8/30
6/22 6/29
7/6
7/13
7/20
7/27
8/3
8/10 8/17 8/24 8/31
6/23 6/30
7/7
7/14
7/21
7/28
8/4
8/11 8/18 8/25
9/1
6/24
7/1
7/8
7/15
7/22
7/29
8/5
8/12 8/19 8/26
9/2
2
3
4
5
6
7
8
9
10
If weekly sessions are not what you need, you may select a 4 or 3 day option by
crossing off the specific dates you require BELOW.
6/27
7/11
7/18
7/25
8/1
8/8
8/15 8/22
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16 8/23
6/29
7/6
7/13
7/20
7/27
8/3
8/10 8/17 8/24
6/30
7/7
7/14
7/21
7/28
8/4
8/11 8/18 8/25
7/1
7/8
7/15
7/22
7/29
8/5
8/12 8/19 8/26
 FULL DAY Ages 3–5 (Must be potty-trained)
 HALF DAY Ages 3–5 (Must be potty-trained)
JUNIOR CAMP WAPAWCA
WEEKLY SESSIONS – Full Day (Ages 3-5)
or Half-Day (Ages 3–5) (ONLY Cross off
each full week your camper will attend
DAILY OPTION
1
2
3
4
5
6
7
8
9
10
11
If weekly sessions are not what you need, you may select a 4 or 3 day option by
crossing off the specific dates you require BELOW.
MONDAY 6/20
6/27
7/11
7/18
7/25
8/1
8/8
8/15
8/22
8/29
TUESDAY 6/21
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
8/30
WEDNESDAY 6/22
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
8/31
THURSDAY 6/23
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
9/1
FRIDAY 6/24
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
9/2
SPORTS CAMPS
Super Sports Camp (Grades 1–7)
1
2
3
4
5
6
7
8
9
10
11
If weekly sessions are not what you need, you may select a 4 or 3 day option by
crossing off the specific dates you require BELOW.
6/20 6/27
7/11
7/18
7/25
8/1
8/8
8/15 8/22 8/29
6/21 6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16 8/23 8/30
6/22 6/29
7/6
7/13
7/20
7/27
8/3
8/10 8/17 8/24 8/31
6/23 6/30
7/7
7/14
7/21
7/28
8/4
8/11 8/18 8/25
9/1
6/24
7/1
7/8
7/15
7/22
7/29
8/5
8/12 8/19 8/26
9/2
5
8
7
7
DAILY OPTION
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
Sports Field Trip Camp (Grades 2–7)
Flag Football Camp NCAA (Grades 1–3)
Flag Football Camp NFL (Grades 4–7)
TEEN LEADERSHIP CAMPS
Please use the Bernon Family Branch Registration Form to register for Outdoor Adventure Programs.
Adventure Programs depart from the Bernon Family Branch.
PLEASE SELECT YOUR CAMP:
 Junior Voyagers
 Senior Voyagers
 Junior Voyagers (Grades 6–7)
1
2
4
5
6
7
8
9
10
11
 Senior Voyagers (Grades 8–9)
 Junior Voyagers (Grades 6–7)
3
 Senior Voyagers (Grades 8–9)
LIT: Leader in Training (Grades 7–8)
2–4
LIT: Leader in Training (Grades 7–8)
5–7
8–10
CIT: Counselors-In-Training (Grades 9–10)
Contact the Teen Camp Director for registration information for the CIT Program.
MEMBER
FEE
SUMMER
MEMBER
& NONMEMBER
FEE
$219
$278
FEE
FEE
4-Day Option
$195
$253
3-Day Option
$166
$208
FEE
FEE
$219
$278
FEE
FEE
4-Day Option
$195
$253
3-Day Option
$166
$208
FULL DAY / FULL DAY /
HALF DAY HALF DAY
FEE
FEE
$251 FD
$168 HD
$352 FD
$254 HD
FEE
FEE
4-Day Option
$215 FD
$147 HD
$312 FD
$213 HD
3-Day Option
$180 FD
$124 HD
FEE
$232
$259 FD
$180 HD
FEE
$318
FEE
FEE
INVENSYS FOXBORO AND MANSFIELD BRANCH REGISTRATION FORM
ONE REGISTRATION FORM PER CAMPER
4-Day Option
$207
$290
3-Day Option
$175
$242
$319
$379
$244
$341
$244
$341
FEE
FEE
$251
$352
$215
$312
$346
$370
$323
$436
$490
$428
37
INVENSYS FOXBORO AND MANSFIELD BRANCH REGISTRATION FORM
Please mark selection(s):
Darkened Box
1
= Camp NOT offered!
CAMPS
WEEKS
2
6/20– 6/27–
6/24
7/1
3
4
7/5–
7/8
7/11–
7/15
5
6
7/18– 7/25–
7/22 7/29
7
8
9
10
11
8/1–
8/5
8/8–
8/12
8/15–
8/19
8/22–
8/26
8/29–
9/2
pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due pmt due
6/6
6/13
6/20
6/27
7/5
7/11
7/18
7/25
8/1
8/8
8/15
NEW HORIZONS TEEN VILLAGE (3 Day Camp)
Half Day Camp (Grades 6+) – M/T/W/TH
12:00–4:00PM
Half Day Camp (Grades 6+) – T/W/TH
12:00–4:00PM
2
4
5
6
7
8
9
10
3
MANSFIELD BRANCH THEATRE CAMPS
“Bugsy Malone Jr.”
(Grades 2–8)
“Shrek the Musical”
(Grades 2–8)
3–4
6–8
BUS TRANSPORTATION (Please note that transportation is subject to change based on the school calendar.)
WEEKS
AM Bus Stop
(write in bus stop number)
PM Bus Stop
(write in bus stop number)
2
3
4
5
6
7
8
9
10
MONDAY
6/27
7/11
7/18
7/25
8/1
8/8
8/15
8/22
TUESDAY
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
WEDNESDAY
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
THURSDAY
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
FRIDAY
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
WEEKS
2
3
4
5
6
7
8
9
10
7/11
7/18
7/25
8/1
8/8
8/15
8/22
MONDAY
6/27
TUESDAY
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
THURSDAY
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
FRIDAY
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
Pre Camp
(not available in Mansfield)
8/26
2
3
4
5
6
7
8
9
10
11
7/11
7/18
7/25
8/1
8/8
8/15
8/22
8/29
MONDAY 6/20
6/27
TUESDAY 6/21
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
8/30
WEDNESDAY 6/22
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
8/31
THURSDAY 6/23
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
9/1
FRIDAY 6/24
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
9/2
2
3
4
5
6
7
8
9
10
11
7/11
7/18
7/25
8/1
8/8
8/15
8/22
8/29
Post Camp
(not available in Mansfield)
1
$147
$213
$124
$180
FEE
FEE
$515
$641
$730
$788
FEE
FEE
FEE
MONDAY 6/20
6/27
TUESDAY 6/21
6/28
7/5
7/12
7/19
7/26
8/2
8/9
8/16
8/23
8/30
WEDNESDAY 6/22
6/29
7/6
7/13
7/20
7/27
8/3
8/10
8/17
8/24
8/31
THURSDAY 6/23
6/30
7/7
7/14
7/21
7/28
8/4
8/11
8/18
8/25
9/1
FRIDAY 6/24
7/1
7/8
7/15
7/22
7/29
8/5
8/12
8/19
8/26
9/2
FEE
Facebook.com/InvensysFoxboroBranchYMCACamps
38
"LIKE US"
FEE
5-Day Option
$28
$34
4-Day Option
$23
$29
3-Day Option
$18
$21
2-Day Option
$12
$15
1-Day Option
$6
$7
$
SEE PAGE
40 FOR
BUSING
FEE
5-Day Option
$23
$28
4-Day Option
$19
$24
3-Day Option
$15
$18
2-Day Option
$11
$13
1-Day Option
$5
$6
POST CAMP
WEEKS
FEE
$15 per week
PRE CAMP
1
FEE
$15 per week
WEDNESDAY
WEEKS
MEMBER
SUMMER
MEMBER
& NONMEMBER
TO RECEIVE DAILY CAMP UPDATES!
$
The Hockomock Area YMCA
provides bus transportation to
campers at a cost of $15 per
week for morning transportation
and $15 per week for afternoon
transportation. Please see bus
schedule on page 40. Register
for transportation on the camp
registration form.
»» Our camps comply with Massachusetts Department of Public Health regulations and are licensed
by the local board of health.
»» We are proud and respectful of the trust parents place in our YMCA. A safe environment
for children combined with quality programming is part of our focus on youth development,
healthy living, and social responsibility. We place great value on providing the most child-safe
environment possible and creating an atmosphere where youth thrive.
»» Parents have the right to review, on request, our background check policies, healthcare and
discipline policies, and staff code of conduct.
TRANSPORTATION
Stop #
Location
Pick Up
Drop Off
Purple Bus
1
Stone St. parking lot near fire station (Walpole)
7:40am
5:12pm
2
Shaw’s Parking Lot (Sharon)
7:55am
4:52pm
Invensys Foxboro Branch (theatre weeks only)
8:10am
3
Robinson School (Mansfield)
8:25am
4:32pm
4
Mansfield Town Hall
8:28am
4:28pm
5
Foxfield Plaza (Foxboro)
8:36am
4:20pm
6
Invensys Foxboro Branch (drop off & pick up)
8:45am
4:05pm
7
Mansfield Arts & Education Center (drop off only)
9:00am
3:50pm
8
Lindsay St./ Cranberry Rd (North Attleboro)
7:50am
5:00pm
9
Falls School (North Attleboro)
8:00am
4:50pm
10
John Rezza/Remigio Rd (North Attleboro)
8:07am
4:43pm
11
Reservoir St./ Edgewood Dr. (North Attleboro)
8:14am
4:36pm
12
Allen Avenue School (North Attleboro)
8:24am
4:26pm
13
Roosevelt School (North Attleboro)
8:35am
4:15pm
14
Community School (North Attleboro)
8:40am
4:10pm
15
North Attleboro Branch
8:45am
Red Bus
Blue Bus (AND THEATRE BUS SHUTTLE FOR WEEKS 3–4 and 6–8)
16
Horace Mann Shaws Plaza (Franklin)
7:30am
5:25pm
17
Benjamin Franklin Charter School Parking Lot (Franklin)
7:35am
5:20pm
18
Centennial School (Norfolk)
7:45am
5:00pm
19
Veterans Memorial Building (Millis)
8:05am
4:50pm
20
Ocean State Job Lot (Medway)
8:15am
4:35pm
21
Bernon Family Branch A.M. pick up and drop off only for Theatre Camp.
P.M. drop off at Bernon Family Branch for Theatre Camp only.
8:30am
4:15pm
22
CVS on Route 140 (Milford)
8:00am
5:00pm
23
Nona’s Pizza (1 Cape Road, Mendon)
8:15am
4:45pm
24
Bellingham Middle School
8:30am
4:30pm
25
Camp Silver Lake
8:40am
4:25pm
Gray Bus
Bernon Family Branch
NO BUSING
WEEKS
1 and 11
40hockymca.org
HOCKOMOCK AREA YMCA SUMMER 2016 CAMP GUIDE
CAMP HEALTH FORM
Health History and Explanation Form
for Children Attending Camps
Developed by: American Camping Association in
Consultation with
American Academy of Pediatrics
You must attach your child’s health history including immunizations
and health record (available from your physician) or have your physician
complete the BACK OF THIS FORM. ALL CAMPERS MUST HAVE HAD A
PHYSICAL EXAMINATION WITHIN THE PAST TWO YEARS IN ORDER TO
ATTEND CAMP.
NOTE: This form must be completed and returned to the Billing Administrator ONE MONTH prior to camp start date.
PLEASE PRINT LEGIBLY
1.
Camper Name: ___________________________________________________________________________________________________________________________________________________________________
Birth Date: ___________________________________________________________ Sex:  Male  Female Age: _________________________________________________
Parent or Guardian Name: _____________________________________________________________________________________________________________________________________________________
Home Address: _____________________________________________________________________________________________________________________________________________
City:___________________________________________________________________________________________________________ State: ____________________ Zip: __________________________________
Home Phone: ______________________________________________________________________________________ Cell Phone: _______________________________________________________________
Business (Daytime) Phone: _____________________________________________________________
Second Parent or Guardian Name: __________________________________________________________________________________________________________________________________________
Home Address: ___________________________________________________________________________________________________________________________________________________________________
City:___________________________________________________________________________________________________________ State: ____________________ Zip: __________________________________
Home Phone: ______________________________________________________________________________________ Cell Phone: _______________________________________________________________
Business (Daytime) Phone: _____________________________________________________________
2. If not available in an emergency, please notify:
Name: ___________________________________________________________________________________________________ Relationship to Child:____________________________________________
Home Address: ___________________________________________________________________________________________________________________________________________________________________
City:___________________________________________________________________________________________________________ State: ____________________ Zip: __________________________________
Home Phone: ______________________________________________________________________________________ Cell Phone: _______________________________________________________________
Business (Daytime) Phone: _____________________________________________________________
Name of Family Physician: _____________________________________________________________ Phone: _____________________________________________________________________________
Address of Physician: __________________________________________________________________________________________________________________________________________________________
City:___________________________________________________________________________________________________________ State: ____________________ Zip: __________________________________
3. Health History – Please list any known allergies, past surgeries or serious injuries, disabilities and dietary restrictions: ____________________________
_______________________________________________________________________________________________________________________________________________________________________________________
4. Does your child have an IEP or 504 Plan?  Yes  No
If yes, please provide us with this plan in order to support transitions and coordinate services for your child.
5. Is there any information that the director should know that would allow us to provide a better camp experience? ___________________________________
_______________________________________________________________________________________________________________________________________________________________________________________
6. Does your family carry medical/hospital insurance?  Yes  No
If yes, indicate – Carrier: ___________________________________________________________________________ Policy #:________________________________________________________________
IMPORTANT: This section must be completed for attendance.
This health history is correct as far as I know, and the person hereof has permission to engage in all prescribed camp activities except as noted. Authorization for
treatment: I hereby give permission to the medical personnel selected by the camp director to administer prescribed medication from home, order x-rays, routine tests,
treatment and necessary transportation for my child. In the event I cannot be contacted in an emergency, I hereby give permission to the physician selected by the camp
director to conduct and administer treatment, including hospitalization, for my child as named above. This completed form may be photocopied for trips out of camp.
The camper and his/her dependents assume all risks, injuries and property damage incidental to the use of the YMCA facility, including, but not
limited to physical activities in which they are engaged.
Signature of Parent/Guardian: ______________________________________________________________________________________________ Date: _____________________________________________
41
AUthorization to administer
medication to a camper
Please complete if your child is required to take medication during the camp day.
Camper Name _________________________________________________________________________________________________________________ Age _______________________________
Food/Drug Allergy _________________________________________________________________________________________________________________________________________________
1. Name of Medication ___________________________________________________________________________
Expiration Date ____________________________________
Quantity Received __________________________________________ Special Storage Requirements ________________________________________________________
Dose Given at Camp ________________________
Date Ordered ___________________________________________________________________
Specific Directions (ex. on empty stomach/with water) ____________________________________________________________________________________________
Specific Precautions ______________________________________
Frequency ________________________
Route of Administration____________________________________
Duration ______________________________________________________________
Possible Side Effects/Adverse Reactions __________________________________________
2. Name of Medication ___________________________________________________________________________
Expiration Date ____________________________________
Quantity Received __________________________________________ Special Storage Requirements ________________________________________________________
Dose Given at Camp ________________________
Date Ordered ___________________________________________________________________
Specific Directions (ex. on empty stomach/with water) ____________________________________________________________________________________________
Specific Precautions ______________________________________
Frequency ________________________
Route of Administration____________________________________
Duration ______________________________________________________________
Possible Side Effects/Adverse Reactions __________________________________________
105 CMR 430.160(A)
Medication prescribed for campers shall be kept in original containers bearing the pharmacy label, which shows the date of filling, the pharmacy
name and address, the filling pharmacist’s initials, the serial number of the prescription, the name of the patient, the name of the prescribing
practitioner, the name of the prescribed medication, directions for use and cautionary statements, if any, contained in such prescription or
required by law, and if tablets or capsules, the number in the container. All over the counter medications for campers shall be kept in the original
containers containing the original label, which shall include the directions for use.
105 CMR 430.160(C)
Medication shall only be administered by the health supervisor* or by a licensed health care professional authorized to administer prescription
medications. The health care consultant shall acknowledge in writing the list of medications administered at the camp. If the health supervisor is
not a licensed health care professional authorized to administer prescription medications, the administration of medications shall be under the
professional oversight of the health care consultant. Medication prescribed for campers brought from home shall only be administered if it is from
the original container, and there is written permission from the parent/guardian.
105 CMR 430.160(D)
When no longer needed, medications shall be returned to a parent or guardian whenever possible. If the medication cannot be returned, it shall be
destroyed.
*Health Supervisor - A person who is at least 18 years of age, specially trained and certified in at least current American Red Cross First Aid (or
its equivalent) and CPR, has been trained in the administration of medications and is under the professional oversight of a licensed health care
professional authorized to administer prescription medication.
I hereby authorize _____________________________________________________________ to administer, to my child, ________________________________________________
(Name of Camp) (Name of Child)
the medication(s) listed above, in accordance with 105 CMR 430.160.
Parent/Guardian Signature: _______________________________________________________________________________________ Date: _____________________________________
Health Care Consultant Signature: _______________________________________________________________________________ Date: _____________________________________
Doctor Signature: ____________________________________________________________________________________________________ Date: _____________________________________
42
(for non-prescription medication only)
BENEFITS OF CAMP AT THE HOCKOMOCK AREA YCMA
»» Camp offers kids and teens a chance to unplug
»» Camp gives independence to kids and teens
»» Lifelong memories and great friends are made at camp
»» We offer a variety of camp options!
»» Choice of 3, 4, and 5 days per week
»» Camp gives opportunities to learn new skills
»» We offer convenient Pre and Post
Camp
»» At camp, kids and teens learn to work as a team while
having fun
»» Swimming lessons built into
traditional camp every day
»» Camp helps kids and teens develop confidence
»» Field trips and special guest visits
for traditional camps
»» Camp gives kids and teens the opportunity to
appreciate nature and the great outdoors
»» Camps that include kids with special needs model
kindness, tolerance, and respect among all campers
»» Transportation available
»» Financial assistance available
»» Specialty and traditional camp
options
ALL CAMPS ARE FULL DAY 9:00AM–4:00PM UNLESS SPECIFICALLY NOTED. PRE AND POST CAMP AVAILABLE, SEE PAGES 8, 20, OR 31.
43
HOCKOMOCK AREA YMCA
NON-PROFIT
ORGANIZATION
U.S. POSTAGE
Association Offices
300 Elmwood Street
North Attleboro, MA 02760
508.695.7001
PAID
NO. ATTLEBORO, MA
PERMIT NO.131
hockymca.org
BEST SUMMER EVER
SAY HELLO TO SUMMER!
Bernon Family Branch
45 Forge Hill Road
Franklin, MA 02038
508.528.8708
hockymca.org
For the best summer ever, register for camp today.
Invensys Foxboro Branch
67 Mechanic Street
Foxboro, MA 02035
508.543.2523
Mansfield Arts & Education Center
40 Balcom Street
Mansfield, MA 02048
508.339.3066
North Attleboro Branch
300 Elmwood Street
North Attleboro, MA 02760
508.695.7001