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.; :1--;:‘ , l amplele Iep IiuIIU111UIa uIIUU uu 1 IMIYIIUIII I UC 1 a•Nrvn uItU II 11 C I PLEASEP Northwest Family Y�AU Huh Adve re 3760 N. ire �� , 155126 . fitillre RINT fPkase only ene th,W per re pshahanl a „ t ,. r r 4 q e s az � � * - - Youlh4Name ` rcl.t ome , �n - 4 WOO } TTa1 1011 � Bnlie - le a' .. ❑ M ale Li „ Femal e ; , 7 ,. 1 _ 3 1 - %.... Vans pick campers up at the stops listed below and return them to same 1 Address r -i� : , a ,* '; I}3 Ory - -1�. h -�, W, � , lesigned for youth 12 -13 stop each afternoon. Campers may also be brought to 7 rthw # rr ZI YMCA at 9 a.m. and pick -up at 3 p.m, or use our exten ours pro 1 Mother Name 4, w Ho P 4.r . "Address - • ” ii iCNy Lp ling activities such as canoeing, SITE PICK -UP DROP -OFF I 4. l r O xi t :::; !ry, climbing and much, much more. Chippewa School 8:15 a.m. 3:15 p.m. ment, team work, grow lrs 4 levelo P P Edgewood School 8:35 a.m. 3:35 p.m. Father s Name ; ; Home Phone � TIP � y %: ' the YMCA's Care Values of caring, Highview Sc 8 on 3:50 p.m. Address = " F lay presents new challenges while 17, Employer Work Phone C Childresideswdh. High Adventure Program look Per3o wig ro i . oa th , - "ty . _ -" c 0- t i the YMCA Hi ;.--7-7.4,-,..,-):.-- 9 0 9 • Develop camp as a community of individuals by practicing interactions of p p y o meeting you. cooperation, non - violence and reseed. Please let the YMCA know if you or your chid has a disabiay requiring an accommodation Yeg; .- rte • Provide the opportunity to learn and develop individual and group skills of responsibility, caring and honest- I00 r s „•,:,, . z ,,., ,+c .� ;:- ys of Operation • Cultivate leadership and service to others. A $2 no n - refundable deposit m ust accompany oath session 888 n c ;� e is d ue one we prior to ,H* start o ndoy - Friday 9 an - 3 p.m, the session. A S5 service fee is charged when a session is cancelled oi - changed after May 1. • Enrich self-esteem and self- worth. ' ' St • Create opportunities for fun and adventure. Please register my chid for the following session(s): CA members: $130 per session • Increase respect and appreciation for the environment we live, work and ID June 1216 0 June 26-30 ❑ July U 21 r ❑July 31 Aug 4 rme Hou 5145 per session play in. ❑ 'June 19 23 - '. 0 - July 10-14 ❑ July , ❑ August 711 ended d Hours: AM or PM 515.00 Each session will include the same activities . _} F . 5 AM and PM $25.00 Extended Rows T ❑ 1 will drop-off and pick -up camper at the YMCA s ',: Extended hours are available from 6:30 -9 a.m. and 3-111. Cam ay be 2. , ❑ I would like to enroll my camper in the extended hours program • dropped off or picked up at the YMCA during these times. n and return it along with a $20.00 non - refundable ❑ A M' O PM." ❑Both wlance is due one week prior to the start of the session. i I 1 would like my camper to take the van before and after camp session is cancelled or changed after May 1. x Name of stop • A FIRST COME -FIRST SERVED BASIS SO REGISTER ' - " -r ' ` I agree to the abovepayment policy 1 will be paying the fee above for the parhapahon of my child m the , . " r High Adventure Program. Failure to comply with the temis of this contrdct will result in dismissal from this ®r Program. must be submitted in writing at least one week prior to - ,- Parent/GuardianSrgnarore Date