GREATER BEVERLY YMCA

  SUMMER CAMPS 

PARENT HANDBOOK 

DOWNLOAD YOUR 2018 CAMPER ENROLLMENT PACKET ONLINE AT ​WWW.NORTHSHOREYMCA.ORG We are so glad that your child will be joining us this summer! This handbook is to provide you with everything you need to know about camp including camp rules, policies and procedures to ensure that you and your child are ready for your first day of camp. If, after reading this handbook, you have any questions, please call us at 978-927-6855!

Merri-Lynn Lathrop Director of Operations

Lorigan Sudak Senior Director of School Age Education

ABOUT THE GREATER BEVERLY YMCA SUMMER CAMPS Goals The goal of the Greater Beverly YMCA Summer Camps is to help mold young people into tomorrow’s leaders. Our camps provide children with a positive, safe, fun, and creative summer experience incorporating the YMCA of the USA character values of caring, honesty, respect and responsibility. While having fun at camp, your child will have opportunities to practice these values so they can include them in their everyday life. Through innovative activities delivered by qualified staff and counselors, your child can grow to their full potential. Safety is our highest priority. All Greater Beverly YMCA Camps must comply with regulations of the Massachusetts Department of Public Health and be licensed by the local Board of Health. Our lead staff have years of camping experience and are over the age of 21. All are trained in site specific Emergency Action Plans and are certified in First Aid and CPR. Your child’s safety is our top priority! Camp Staff Our Greater Beverly YMCA Camps are directed by full time, year round recreational professionals. You can contact us at any time to get all of your questions answered. Summer Literacy - Lorigan Sudak Sterling Woods - Kelci Smith Teen Camp - Jon Keefe Sports Camp - Eric Joyner Adventure Camp - Janelle Brink Ocean Adventure Camp - Mariana McCarthy Gymnastics Camp - Brendon Graffum Arts Camp - Nicole Heena Camp STAR - Jerry Justice

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Hiring and Training Camp Staff All YMCA of the North Shore Employees and Volunteers (Camp and Non-Camp) are required to complete a background check consisting of a CORI and SORI. Each staff person and volunteer shall have a background free of conduct that bears adversely upon his or her ability to provide safety and well-being of campers. Camp staff complete a rigorous training program including North Shore YMCA Camp Training, Greater Beverly YMCA Camp Training, First Aid, CPR, Emergency Action Plan and Child Abuse & Neglect Prevention Training which focuses on recognizing the signs of abuse and/or neglect, as well as the process of reporting such. Any employee of the YMCA of the North Shore is a mandated reporter and obligated to let their director/supervisor know of any signs of abuse and/or neglect. The director/supervisor is then obligated to inform the Executive Director of their YMCA branch of the case, who then informs our Director of Child Care Resources, who contacts the Department of Children and Families. Parents have the right to request copies of background check, health care, discipline policies and grievance procedures upon request. Camper/Counselor Ratios YMCA Camps follow the ratios set by the Massachusetts Department of Public Health Day Camps 1:10 ratio for campers over the age of six 1:5 ratio for camper ages six and under Travel Camps 1:10 ratio, with at least two counselors at all times STAR Camps 1:4 or 1:2 depending on the camper’s individual needs

REGISTRATION, PAYMENTS & PAPERWORK Registration We try to make registration as simple as possible. Register online and download the full Enrollment Packet at www.northshoreymca.org​ or register in person at the YMCA. Registration closes every Friday at noon for the following week’s session at which time all required information must be completed and received. Per the Massachusetts Department of Public Health, all registration paperwork, proof of physical and immunizations must be on file before the first day of camp. Any child with incomplete paperwork will not be admitted to camp. Payment To reserve your space at camp, payment is required. Pay in full at time of registration or pay $25 per week non-refundable deposit at time of registration and use our convenient E-pay system. E-pay will automatically draft a credit card 8 days prior to the start of your camp session. Any child/family that has an outstanding balance with the YMCA’s summer camp, child care, or other programs, will not be allowed to enroll in our summer camp until the prior balance is paid in full. Any payment received will go toward an outstanding balance. Financial Assistance: The YMCA does not turn anyone away from its membership, services and programs. Financial assistance is available for those who apply and are eligible, based on a sliding income scale. Apply on-line at ​www.northshoreymca.org​ or in person at the YMCA. Please allow three weeks processing time and keep in mind that financial assistance is not retroactive. Registration Changes Keep in mind, all $25.00 deposits are non-refundable. Change requests must be made by Friday at noon for the following week’s session and fees may apply. Cancellations must be made 7 days prior to the start of the camp week in question. Please remember that your fee pays for direct operating costs, such as staff, materials, and supplies. All of these must be available for your child. When you enroll, you are reserving the time, space, staffing, and provisions for your child whether the child attends or not. Camp Registrar Our Camp Registrar is here to help you every step of the way. Call 978-927-6855 or e-mail us at [email protected]​ to get your questions answered.

CAMPER SCHEDULES Drop Off & Pick Up Procedures Safety is a priority at the YMCA. Each child must be signed in and out by an adult. To ensure your child’s safety, we require written notification if anyone other than a person on your authorized pick up is coming to get your child from camp. All parents/guardians must present a valid picture ID at pick-up. Written notification is also required if there is a change as to how your child will leave the camp property. If you desire to have your child walk home from camp, a signed note is required giving your child permission to sign themselves out at the end of the camp day. Drop Off and Pick Up Locations Sterling Woods Sterling YMCA Camp STAR Sterling YMCA Teen Camp Douglas Stephens Teen Center Sports Camp Douglas Stephens Teen Center Adventure Camp Douglas Stephens Teen Center Ocean Adventure Camp Douglas Stephens Teen Center Gymnastics Camp Douglas Stephens Teen Center Arts Camp Hamilton Wenham Community House Summer Literacy Sterling YMCA Hannah School

254 Essex Street, Beverly 254 Essex Street, Beverly 254 Essex Street, Beverly 254 Essex Street, Beverly 254 Essex Street, Beverly 254 Essex Street, Beverly 254 Essex Street, Beverly 284 Bay Road, Hamilton 254 Essex, Street, Beverly 41 Brimbal Ave, Beverly

Early Pick-Up If for some reason you need to pick up your child early from camp, please provide a written note at drop-off stating what time you plan to get your child. The staff will make sure that your child is waiting for you. Early pick-up may not be an option on field trip days. Late Drop Off Late campers sign in at the Camp Office. If you know your child will arrive late, please let the Camp Director know in advance. This will limit the waiting time prior to placement in your camp group. Late drop off may not be an option on field trip days.

Late Pick Ups The camp day ends at 4:00pm, with extended hours available until 6:00pm at an additional cost. If you are not able to pick up at your designated time, please contact the camp office to notify the staff. If you pick up your child after your registered time you will be charged a late pick-up fee. It is not the YMCA’s intention to make money from these fees; however money collected will defray the cost incurred by keeping the program open. Payment for late pick up will be due at the time of pick up. The late fees are: $5 for the first 15 minutes, additional $10 for the next 10 minutes and $2 each additional minute after that. Our camp staff will attempt to contact parent/authorized emergency contacts 10 minutes after the closing of the program. If staff cannot contact any individuals on the authorized release list and​ ​the parent has not contacted the program to notify of their tardiness, after one hour of the closing of the program, the YMCA will contact the Department of Children and Families (DCF) Child at Risk Hotline to report the situation. Absences If your child can’t make it camp, please call the designated number prior to the start of camp to let your Camp Director know. If a phone call is not received, a phone call will be made to inquire on their absence. Refunds and credits are not issued for absences. Extended Day Schedule Options For your convenience, many of our camps offer extended care. Register in advance for Before Care (7:00 AM to 9:00 AM) and/or After Care (4:00 PM to 6:00 PM) to extend your day.

WHAT TO BRING Pack for the weather! Camp is hosted outdoors, even on rainy days, unless it becomes unsafe for the campers. Sneakers, an extra set of clothing, sweatshirt, rain gear, swimming attire and plenty to eat/drink make for a fun day at camp! Pack for Camp​ ​Be sure to label items with your child’s name! Sturdy, light backpack Sneakers Lunch and 2 snacks T-Shirt/Shorts Refillable water bottle Pants/Sweatshirt Rain gear Gymnastics Activewear Towel (Leotard not required)

Sunscreen Bug Spray Flip flops/Water Shoes One piece bathing suit

Camp staff are not authorized to apply bug spray or sunscreen without written parental consent in the enrollment packet. Campers may not share products. When making food choices, please remember all of Greater Beverly YMCA Summer Camps are nut sensitive. We have campers with life threatening allergies to nut products and ask that you help us keep all of the campers in our care safe. Healthy food choices are encouraged and proper methods for storing meals from home should be followed including cold packs in lunches. All campers and staff have adequate and centralized drinking water available. Leave at Home Sandals, slides Technology - iPods, video games, etc. Stuffed animals/lovey blankets Radios or Music Speakers Bikini or mid-drift baring swimsuit

Pokemon and/or similar trading cards Action Figures and toys Glass food and/or drink containers Cosmetics Cell Phones

Camp is a social environment where campers are encouraged to interact. Phones and cameras are prohibited as well as taking photos for camper cyber safety. Please do not ask Camp Staff to be responsible for these items, we request they are left at home. A Lost and Found is kept at each camp. Labeled items are much easier to locate and return. ​The YMCA is not responsible for any missing items.

CAMP ACTIVITIES Activity Schedules Camp is a wonderful opportunity for children to meet new people and to safely step outside their comfort zone. Generally speaking, campers are placed in groups by age. Activity schedules are posted and available to parents/guardians upon request. Feel free to ask camp staff specific questions if you have them in regards to your child’s daily schedule. Swimming Both the indoor and outdoor pool located at the Sterling YMCA will host campers for swimming. Camps offer swim two to five times per week. Certified lifeguards are on duty at all times that the pool is open. Campers are swim tested upon their first time entering the pool and designated as Swimmers or Non-Swimmers. Campers who choose not to swim test are considered non-swimmers. All Non-Swimmers are given a properly fitted USCG approved PFD to wear. Parents may provide a PFD from home, all such PFDs must be Type I,II or III and clearly marked with the campers name. Bring a swimsuit and towel every day to make the most of the water fun! Field Trips Each YMCA camp will provide parents/guardians with a written transportation plan for their field trip made available up to, but not limited to, three days prior to the trip. Staff will bring camper files and first aid supplies with them in case of emergency care needed. For camps traveling to waterfronts, a YMCA lifeguard(s) travel with the camp. All campers will be fitted and equipped with USCG approved PFDs and required to wear them while participating in watercraft activities. Challenge Course Elements Qualified, experienced staff lead Archery and High Ropes activities during camper Adventure time. Participation is encouraged with varying levels of difficulty, but not required. No personal bows, weapons or rifles are allowed on Y property.

INCLEMENT WEATHER / DISASTER PLAN Inclement Weather Most YMCA Day Camps are held outside and on rainy days the children may get wet. Activities will be conducted outdoors as scheduled until dangerous inclement weather arrives (ie: hard rain, rain for an extended amount of time, thunder and/or lightning). At that time, campers will be moved inside. With thunder and lightning, all campers will be brought inside and will not return outside until 30 minutes after the thunder and lightning has stopped. Heat Depending on the temperature outside, our camps may add extra swim time or water activities to their schedules. On the occasion that the temperature is severely hot or scheduled for an extended amount of days, indoor activities can be scheduled.

ILLNESS & MEDICATIONS Illness If your child is feeling ill the morning of camp or has a temperature over 99 degrees, we ask that they are kept home until the symptoms clear for 24 hours. If the Camp Director and/or Health Supervisor deems a child ill, parents will be required to have their child picked up within 60 minutes of notification. If your child is ill and unable to attend camp, please notify the camp office no later than 9:00 am. If your child is unable to attend camp, a refund will not be granted unless a physician’s note is signed. First Aid The Greater Beverly YMCA Day Camps have a physician on call, in addition to key staff trained in emergency care and first aid. Trained Y staff will handle minor injuries or illnesses. In the event of a minor accident, injury, or illness (i.e. bloody nose, cut, or scrapes), the camp staff will contact the parent/guardian or the emergency contact person by phone or a report home. In the case of serious illness or accident, the YMCA camp staff will utilize appropriate police, fire department or ambulance transportation. If this action is taken, the camper will be taken to Beverly Hospital or the nearest medical facility when on field trips. Parents will be notified in all cases. Medication Parents whose children need medication during the camp day are required by the Massachusetts Department of Public Health to provide the medication in the original prescription container with the original prescription label attached. Please pre-cut any pills if needed. A Medication Consent Form must be completed prior to any medications being dispensed, this form is included in your Enrollment Packet. Non-prescription medication must be accompanied by a physician’s note. All medications should be given immediately to the Camp Director and will be stored in a secured cabinet affixed to the infirmary wall or if necessary in the refrigerator at a temperature of 38 to 42 degrees F. Medications not given to the Camp Director or in accordance with the above

regulations will not be distributed and your child will not be allowed to attend camp. Medications will be dispensed by authorized YMCA personnel only. The Greater Beverly YMCA Health Care Consultant is Dr. William Medwid. Our Health Care Policy has been agreed upon by Dr. Medwid and is available in full upon request.

EMERGENCIES Each YMCA camp trains all staff and bus drivers in emergency procedures to prevent, recognize and handle emergencies. The staff on duty will not release your child to unauthorized people. Staff are trained that throughout the day they are to do frequent head counts, name roll calls, buddy checks, and monitor attendance to ensure each child is safe. Fire / Evacuation Drills Each camp will perform a fire/evacuation drill signaled by 2 long air horn blasts within 24 hours of the start of the camp week to ensure all YMCA staff and children are knowledgeable of the fire/evacuation plan. Camp specific plans are available upon request and maps are posted within Sterling YMCA. Lost Camper/Swimmer In the event it is determined that your child is missing, all available staff will work to locate your child. If a camper is assumed to be missing, camp staff will report to the camp office and notify the Camp Director. An air horn will sound with for five long blasts, indicating that a camper is missing. Upon which time, all groups will meet at their designated location and attendance will be taken for all groups. Staff will report to their assigned location and search until the camper is found. Staff will be assigned to report to all egresses to ensure that the missing person does not leave the YMCA facility while additional YMCA staff search the facility. Should it be determined that a camper is missing at an off-site location, one YMCA staff will remain with the entire group, while the second YMCA staff searches the area. The first YMCA staff will contact the director via cell phone to inform them of the situation and exact location of the group. Off Site Transportation In the event it is determined that campers must relocate to an offsite location, YMCA staff will escort campers to YMCA of the North Shore vehicles, sitting two campers per seat, three if needed. A head count will be performed by the lead staff of that vehicle, as well as a name roll call to ensure all campers are present. Only YMCA of the North Shore 7D licensed staff are allowed to operate vehicles used. When transported to the emergency location, another head count and name roll call will be made. Traffic Control In the event it is determined that emergency pick up is needed, parents/guardians will be notified through email and/or phone. Pick up locations will remain the same as their child’s specific camp pick up location. If this changes in any way, the parent/guardian will be notified of such through email and/or phone. In all situations, the Camp Director will notify authorities after a designated time. A parent/guardian will be called to inform them of the situation. All camp leaders have telephones readily available and a two way radio communication system in case of emergency.

CAMP CHILD GUIDANCE PLAN The YMCA Summer Camp Child Guidance Plan is based on the safety and respect for others and ourselves, both personal and property. Positive reinforcement and guidance will be consistent and based on the understanding of the individual needs and development of the camper. Rules are constantly explained and reviewed with the campers. Campers are encouraged to work out minor disputes by themselves, according to their abilities. YMCA staff will intervene as quickly as possible when there is potential for major disruptions. Diversion techniques are used as well as mediation between all parties concerned. Our YMCA will focus on positive discipline, using group incentives, based on the YMCA’s four core Character Development values of caring, honesty, respect, and responsibility. Repeated infringement of the rules or disruptions of the group by a camper may result in a short time-out. This will be followed by a talk with the camp counselor about better ways to handle difficult situations. If the child is uncontrollable and creates a problem for the safety of other campers, him/herself, or disruption of the activity for others, the camper will be escorted to the Camp Director or other designated YMCA staff. Strategies to be implemented by YMCA staff (depending on situation): ● Talk through the problem with the camper. Redirection is encouraged to suggest alternative solutions and assist in implementing. A warning may be given to the camper as well as a list of consequences for continuance of their behavior. ●

A time-out or removal from activity. Staff will safely remove camper from the activity. The YMCA staff will ask the camper to sit down and then help the camper regain control of him/herself. After a time-out (one minute per year of age) or when the

camper is calm, staff will ask why s/he was removed from the group. Campers will be provided an opportunity to resolve the situation by talking with staff and peers. After conversation, the child will be returned to the activity. ●

The camper will be brought to Assistant Camp Director/Camp Director. A parent will be contacted to discuss the camper’s situation. Upon pick up the camp staff and parent will meet to discuss the problem and staff will provide the parent a written report, detailing the situation and efforts made by staff to resolve the situation. ​The camper may receive suspension from the YMCA for up to a week, depending on the circumstances.

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Camp Directors will ​immediately​ contact the parents/guardians when these situations arise: o Physical fighting with another child o Habitual use of swearing/foul language o Hitting and/or kicking a staff member/another child/visitor o Inappropriate physical touching of staff member/another child/visitor o Leaving the camp ground/area o Repeated infringements of camp policies

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If behavior continues, a meeting will be held between child, parent, and Camp Director. All documented prior incidents will be discussed, and the camper will be placed on a behavior plan according to the camper’s developmental needs and level.

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Should future incidents occur, the YMCA Camp Director/other designated YMCA staff may recommend that the camper not return to camp, and give the family a week notice. ​If the camper’s behavior is severe and endangers the safety of the camper, other campers, and YMCA camp staff, the YMCA reserves the right to terminate services immediately.​ ​Any fees paid in advance will be returned on a pro-rated basis. You should feel free to consult the Camp Director regarding any problems in your child’s adjustment to our camp program.

Prohibitions to Guidance Plan ● Corporal punishment, including spanking is prohibited ● No camper shall be subjected to cruel or severe punishment, humiliation, or verbal abuse ● No camper shall be denied food or shelter as a form of punishment ● No child shall be punished for soiling, wetting or not using the toilet

A FUN SUMMER AHEAD Greater Beverly YMCA Summer Camps are designed to help mold young people into the future leaders of our local community. Given opportunities to challenge themselves in new ways, make new friends and learn new skills while enjoying the great outdoors, it is our privilege to partner with you in helping your child grow to their greatest potential. See you at Camp!

       

  Dear YMCA Summer Camp Families​, Thank you for choosing to be a part the Greater Beverly YMCA Camps! We have many exciting activities planned this summer for your camper. Below you will find information to help ensure your registration process goes smoothly. ENROLLMENT PAPERWORK ● Enrollment Packet​ – This packet includes emergency contact information, and permission sign offs that we need on file for camp. Once filling this packet out, please make a copy of your enrollment packet to keep before submitting it to the YMCA. ● Parent Handbook​ – Find information about our various camps including specifics on payments, illness policies and emergency procedures. ● Medical Forms​ – Per the MA Department of Public Health, a copy of your child’s current physical and immunization record must be provided. Children may not attend camp until we have these forms on file. PAYMENT INFORMATION ● Automatic Payments​ - Our E-PAY system is an easy way to manage your child’s camp fees by automatically drafting your payments through a credit or debit card. Find this form towards the end of the enrollment packet. ● Payments by Cash or Check​ – All camp payments are due in full by the Thursday before each weekly camp session begins. Failure to submit payment may result in your slot being forfeited. FINANCIAL ASSISTANCE If you are applying for YMCA financial assistance, ​please allow up to six weeks for your application to process.​ Make sure all information requested in the application is included. Failure to submit such documentation will slow down the approval process. Please note, financial assistance cannot be applied retroactively. READY TO REGISTER! Use the following check-list to ensure you have all your paperwork and information ready. Please return to the Camp Registrar the following items at least 10 business days prior to your child attending their first day of camp: ❑ ❑ ❑ ❑ ❑ ❑

2018 Enrollment Packet 2018 Parent Handbook 2018 Medical Forms/Authorization to Administer Forms (if needed) Current physical record Current immunization record E-Pay form filled out (if needed)

Respectfully,

Merri-Lynn Lathrop Director of Operations

Lorigan Sudak Senior Director of School Age Education

Greater Beverly YMCA

Greater Beverly YMCA

2018 CAMP ENROLLMENT PACKET GREATER BEVERLY YMCA CHILD INFORMATION SHEET

Camper Name ​_____________________________ Date of Birth ​_________ ___________________

Address _________________________________ Telephone ​ ______________________________ Sex ​__________​

Eye Color _________

Weight ​___________​

Primary Language

Hair Color _______________

Height __​____________

​______________________________________________

Medication ________________________________________________________________________ Allergies __________________________________________________________________________ My child’s photographs can be used for promotional printed literature?

Yes

No

My child’s photographs can be used on YMCA sanctioned social media?

Yes

No

PARENT/GUARDIAN INFORMATION Parent/Guardian Name ___________________ Parent/Guardian Name ________________________ Relationship to Child _____________________ Relationship to Child _________________________ Home Address __________________________ Home Address ______________________________ Home Phone Number _____________________ Home Phone Number ________________________ Cell Phone _____________________________ Cell Phone _________________________________ E-mail Address _________________________ E-mail Address _____________________________ Business Name _________________________ Business Name _____________________________ Business Address ________________________ Business Address ___________________________ Business Phone Number __________________

Business Phone Number _____________________

*Please circle the best number to call in the event of an emergency.

EMERGENCY CONTACT INFORMATION _________________________________________________________________________________ Name Address Relationship Home Phone Cell Phone I ​Check here to give permission for Camper to be picked up by emergency contact. __________________________________________________________________________________ Name Address Relationship Home Phone Cell Phone I ​Check here to give permission for Camper to be picked up by emergency contact. __________________________________________________________________________________ Name Address Relationship Home Phone Cell Phone I ​Check here to give permission for Camper to be picked up by emergency contact.

______________ Parent Initial ​2018 CAMP ENROLLMENT PACKET Camper Name_______________________________________

Date of Birth___________________

CONSENT INFORMATION I I hereby give the Beverly YMCA permission to administer basic First Aid and/or CPR to my child and/or take my child to a hospital and to secure medical treatment when I cannot be reached or when delay would be dangerous to my child’s health. I I certify that I will supply the YMCA with documentation of a current physical examination and immunizations to measles, mumps, rubella, diphtheria, pertussis, tetanus and poliomyelitis in accordance with public health department requirements and failure to do so will result in my child not being able to attend camp. (Exemptions are allowed for physical or medical reasons.) I I certify that YMCA camp leadership staff may contact my child’s school and/or teacher(s) in order to best accommodate my child’s needs. S Sunscreen/Bug Spray provided may be applied by YMCA staff. If sunscreen/bug spray is not provided by parents/guardians, YMCA provided sunscreen/bug spray may be applied. ____________________________________________________________________________ Parent/Guardian Signature Date

FIELD TRIP/ACTIVITY PERMISSION I, ​___________________________​, give permission for my child to participate in all of the regularly scheduled activities involved with camp including, but not limited to: Field Trips. Parents will be notified in writing and/or camp newsletters about field trips to various locations. Transportation will be provided by the YMCA of the North Shore and/or Beverly Public Schools. Participating in regularly scheduled Adventure based activities on the Greater Beverly YMCA Challenge Course, Archery Range and/or Rock Wall. Swimming at Sterling YMCA or Hamilton Community pool on scheduled days. _____________________________________________________________________________ Parent/Guardian Signature Date MEDICAL CONTACT INFORMATION Doctor’s Name__________________________ Address ___________________________________ Doctor’s Phone _________________________

Participating Hospital _________________________

Insurance Company_______________________ Policy Number _____________________________

Special Instructions_________________________________________________________________ 2018 CAMP ENROLLMENT PACKET

Camper Name_______________________________________

Date of Birth___________________

GREATER BEVERLY YMCA SUMMER CAMP CHILD GUIDANCE PLAN – ​YMCA COPY Parent/Guardian Name

____________________________________________________________

I have read the ​Greater Beverly YMCA Summer Camp Parent Handbook​ and I understand information in regards to, but not limited to, illness policies, payment policies, items to pack for my child and necessary information about my child I should provide to camp staff. I have read the ​Greater Beverly YMCA Guidance Plan ​and I understand that YMCA Camp Staff will follow steps and procedures as listed in regards to my child’s behavior management. I further understand that my child may be suspended or removed from camp should behaviors dictate. We do not want you to miss out on anything exciting, so Campers should listen to Camp Staff, stay with their group, keep their hands to themselves, use appropriate language and treat everyone respectfully for a summer full of FUN! ______________________________ Child’s Signature (ages 6 and up)

_______________________________ Parent/Guardian’s Signature

_____________ Date

ADDITIONAL INFORMATION We appreciate you placing your trust in us to care for your child this summer. We place the utmost importance upon each child’s safety, well-being and overall camp experience. Please help us by taking a few minutes to share your insights about your child. Information provided on this sheet will be shared with relevant members of the Greater Beverly YMCA summer camp team. What should we know about your child so we can provide the best possible care?

________________________________________________________________________________________________ ________________________________________________________________________________________________ __________________________________________________________________________________________ What would you like most for your child to accomplish or gain from this summer camp experience?

________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________ Is this anything else that you feel is important for us to know about your child?

________________________________________________________________________________________________ ________________________________________________________________________________________________ __________________________________________________________________________________________

2018 CAMP ENROLLMENT PACKET YMCA OF THE NORTH SHORE, INC.

Camper Name ______________________________________ Date of Birth ___________________ RELEASE AND WAIVER OF LIABILITY/ INDEMNITY AGREEMENT/ PHOTO RELEASE IN CONSIDERATION of being permitted to utilize the facilities, services and programs of the YMCA for any purpose, including but not limited to observation of use of facilities or equipment, or participation in any off-site program affiliated with the YMCA, the undersigned, for himself or herself and any personal representatives, heirs, and next of kin, hereby acknowledges, agrees and represents that he or she has, further warranted that such entry into the YMCA for observation or use of any facilities, or equipment or participation in such affiliated program constitutes an acknowledgement that such premises and all facilities and equipment thereon and such affiliated program have been inspected and carefully considered and that the undersigned finds and accepts same as being safe and reasonably suited for the purpose of such observation, use or participation. IN FURTHER CONSIDERATION OF BEING PERMITTED TO ENTER THE YMCA FOR ANY PURPOSE INCLUDING, BUT NOT LIMITED TO OBSERVATION OR USE OF FACILITIES OR EQUIPMENT, OR PARTICIPATION IN ANY OFF-SITE PROGRAM AFFILIATED WITH THE YMCA. THE UNDERSIGNED HEREBY AGREES TO THE FOLLOWING: 1. THE UNDERSIGNED HEREBY RELEASES, WAIVES. DISCHARGES AND COVENANTS NOT TO SUE the YMCA, its directors, officers, employees, volunteers, and agents (hereinafter referred to as “Releasees”) from all liability to the undersigned, his personal representatives, assigns, heirs, and next of kin for any loss or damage, and any claim or demands therefore on account of injury to the person or property or resulting in death of the undersigned, whether caused by the Negligence of the Releasees or otherwise while the undersigned is in, upon, or about (the premises or any facilities or equipment therein or participating in any program affiliated with the YMCA). 2. THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the Releasees and each of them from any loss, liability, damage or cost they may incur due to the presence of the undersigned in, upon or about the YMCA premises or in any way observing or using any facilities or equipment of (the YMCA or participating in any program affiliated with the YMCA whether caused by the negligence of the Releasees or otherwise). 3. THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY FOR, AND RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE due to negligence of Releasee or otherwise while in, about or upon the premises of the YMCA and/or while using the premises or any facilities or equipment thereon or participating in any program affiliated with the YMCA. 4. The YMCA does not condone staff privately providing child care for program participants. Parents or guardians who hire child care providers from among YMCA staff understand that the YMCA is not responsible for staff who conduct outside employment, and hereby release the YMCA from any liability for acts or omissions of any staff who provide child care outside of YMCA employment. 5. By signing this Agreement, I hereby give my permission for the YMCA to take my photograph or a photograph of my child(ren) and use or publish this likeness for YMCA purposes, and I release the YMCA from any claims for such use. 6. The YMCA conducts regular sex offender screenings on all members, participants, and guests. If a sex offender match occurs, the YMCA reserves the right to cancel membership, end program participation, and remove visitation access. 7. By participating in the YMCA Nationwide Membership Program, I agree to release the National Council of Young Men’s Christian Associations of the United States of America, and its independent and autonomous member associations in the United States and Puerto Rico, from claims of negligence for bodily injury or death in connection with the use of YMCA facilities, and from any liability for other claims, including loss of property, to the fullest extent of the law. THE UNDERSIGNED further expressly agrees that the foregoing RELEASE, WAIVER, INDEMNITY AGREEMENT, PHOTO RELEASE is intended to be as broad and inclusive as is permitted by- the law of the State of New Hampshire and the Commonwealth of Massachusetts and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, and further agrees that no oral representations, statements or inducement apart from the foregoing written agreement have been made. I HAVE READ AND AGREE TO THIS RELEASE.

_________________________________________________________________________________ Parent/Guardian Signature Date 2018 CAMP ENROLLMENT PACKET GREATER BEVERLY YMCA FEE AGREEMENT Camper Name _________________________________ Date of Birth _______________________ As stated in our Camp Parent Handbook, all payments are due by the Thursday before your child attends camp. Failure to pay all balances in full one week prior to services rendered may forfeit your child’s slot in camp. Deposits will not be refunded. The YMCA cannot deduct days missed from your weekly fee. Your fee pays for direct operating costs, such as staff, materials and transportation. When you enroll, you are reserving the time, space, staffing and provisions for your child, whether the child attends or not. Any returned checks or insufficient funds through credit card draft will incur a $25 penalty charge. I have read and understand the YMCA’s Camp Payment Policy. I understand that payment in full for the summer camp is due by the Thursday before services are rendered. _________________________________________________________________________________ Parent/Guardian Signature Date OPTIONAL ELECTRONIC PAYMENT (E-PAY) AUTHORIZATION AGREEMENT I(we) hereby authorize the YMCA of the North Shore to initiate recurring credit card charges to the below referenced credit card account. I (we) understand that the charges will be based on fees that are due and payable at the time of the transaction and prior to services rendered. Should any pre-authorized payment not be honored by my (our) credit card company when received by them, then it is understood that the payment is to be made by me (us) in the amount owed. Credit Card E-Payment Circle One: Visa Mastercard American Express Discover Credit Card Number _________________________________ Expiration Date _________________ CID Number __________________ (3 digits for Visa/MC/Discover, 4 digits for American Express) Credit Card Holder _________________________ Credit Card Holder Phone ________________ Credit Card Holder Address ___________________________________________________________ The YMCA reserves the right to extend the above credit card expiration date 2 years forward upon its expiration. ●

I (we) authorize the YMCA to draft sufficient funds to pay my (our) regular camp tuition and/or other related fees which are due and payable. I (we) understand that the YMCA may, at its discretion, adjust the charges according to the fees incurred.

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Should a draft not be honored by my (our) credit card for any reason, I (we) understand that the YMCA will automatically resubmit the draft for payment. If the draft is not honored on the re-submission, the amount of the draft as well as a $25 service charge will be immediately due and payable to the YMCA.

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I (we) understand that after two unpaid drafts, the YMCA will immediately terminate camp enrollment until I (we) have brought all payments up to date.

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I (we) understand that if I (we) wish to terminate or change my (our) E-Pay, I (we) must give the YMCA a two week written notice.

_________________________________________________________________________________ Card Holder Signature Date 2018 CAMP ENROLLMENT PACKET GREATER BEVERLY YMCA AUTHORIZATION TO ADMINISTER MEDICATION This page is only for those campers who will be receiving medication during the camp day. Medications include, but are not limited to prescription liquids and/or pills, over the counter liquids and/or pills, Epi Pens and inhalers. Parents/Guardians are required to pre-cut pills if necessary. Each medication should be given to the YMCA camp staff in the following way: ● Prescription Medications: In the prescription bottle with prescription label attached. Label must include date of filling, pharmacy name and address, pharmacist’s initials, serial number of prescription, name of patient, name of doctor, name of medication, directions for use and cautionary statements, number of pills included (if applicable). ● Over the Counter medications: In original container with original label and directions for use. Without proper documentation, labeling and physician signatures we will not be able to distribute medication to your camper. Please be sure to provide medications directly to the Camp Office upon arrival at camp. Name of Camper ___________________________________________________________________ Age ______________________

DOB ____________________________

Camp Attending _______________________________ Dates Attending ______________________ Parent/Guardian _______________________________ Home Phone __________________________ Work Phone ___________________________ Emergency Phone _____________________________ Camper Food/Drug Allergies __________________________________________________________ Diagnosis (at parents’ discretion) _______________________________________________________ Name of Prescriber __________________________________ Phone _________________________ Prescriber Address _____________________________________________________ Name of Medication ___________________________ Dosage Given at Camp ___________________ Route of Administration ________________________ Frequency During Camp __________________ Date of Order ____________________________

Duration of Order _________________________

Quantity Received On ____________Special Storage Instructions ____________________________ Expiration Date of Medication ________________________________________ Specific Directions (ie: on empty stomach, with water, etc.)__________________________________ Possible Side Effects/Adverse Reactions _________________________________________________ AUTHORIZATION TO ADMINISTER I, ______________________________ hereby authorize The Greater Beverly YMCA Summer Camps to administer to my child, __________________________________ the medication(s) listed above, in accordance in Department of Public Health Regulations 105 CMR 430.160.

_________________________________________________________________________________ Parent/Guardian Signature Date

2018 CAMP ENROLLMENT PACKET

Meningococcal Disease and Camp Attendees: Commonly Asked Questions

November 2015

What is meningococcal disease? Meningococcal disease is caused by infection with bacteria called ​Neisseria meningitidis​. These bacteria can infect the tissue (the “meninges”) that surrounds the brain and spinal cord and cause meningitis, or they may infect the blood or other organs of the body. In the US, about 1,000-1,200 people get meningococcal disease each year and 10-15% die despite receiving antibiotic treatment. Of those who survive, about 11-19% may lose limbs, become hard of hearing or deaf, have problems with their nervous system, including long term neurologic problems, or have seizures or strokes. How is meningococcal disease spread? These bacteria are passed from person-to-person through saliva (spit). You must be in close contact with an infected person’s saliva in order for the bacteria to spread. Close contact includes activities such as kissing, sharing water bottles, sharing eating/drinking utensils or sharing cigarettes with someone who is infected; or being within 3-6 feet of someone who is infected and is coughing and sneezing. Who is most at risk for getting meningococcal disease? People who travel to certain parts of the world where the disease is very common, microbiologists, people with HIV infection and those exposed to meningococcal disease during an outbreak are at risk for meningococcal disease. Children and adults with damaged or removed spleens or persistent complement component deficiency (an inherited immune disorder) are at risk. People who live in certain settings such as college freshmen living in dormitories and military recruits are at greater risk of disease from some of the serotypes. Are camp attendees at increased risk for meningococcal disease? Children attending day or residential camps are ​not​ considered to be at an increased risk for meningococcal disease because of their participation. Is there a vaccine against meningococcal disease? Yes, quadrivalent meningococcal polysaccharide (Menomune) and meningococcal conjugate vaccines (Menactra and Menveo) protect against 4 serotypes (subgroups), A, C, W, and Y, of meningococcal disease. Meningococcal serogroup B vaccines (Bexsero and Trumenba) protect against serogroup B meningococcal disease. Should my child receive meningococcal vaccine? Meningococcal vaccine is ​not​ recommended for attendance at camps. However, these vaccines may be recommended for children with certain high-risk health conditions, such as those described above. Parents of children who are at higher risk of infection, because of certain medical conditions or other circumstances (see above, “Who is most at risk?”), should discuss vaccination with their child’s healthcare provider. How can I protect my child from getting meningococcal disease? The best protection against meningococcal disease and many other infectious diseases is thorough and frequent handwashing, respiratory hygiene and cough etiquette. Individuals should: 1. wash their hands often, especially after using the toilet and before eating or preparing food (hands should be washed with soap and water or an alcohol-based hand gel or rub may be used if hands are not visibly dirty); 2. cover their nose and mouth with a tissue when coughing or sneezing and discard the tissue in a trash can; or if they don’t have a tissue, cough or sneeze into their upper sleeve. 3. not share food, drinks or eating utensils with other people, especially if they are ill. If your child is exposed to someone with meningococcal disease, antibiotics may be recommended to keep your child from getting sick. You can obtain more information about meningococcal disease or vaccination from your healthcare provider, your local Board of Health (listed in the phone book under government), or the Massachusetts Department of Public Health Division of Epidemiology and Immunization at (617) 983-6800 or toll-free at (888) 658-2850 or on the MDPH website at ​www.mass.gov/dph​. Provided by the Massachusetts Department of Public Health in accordance with M.G.L. c.111, s.219.