VIBES SUMMER - YMCA CAMP Y-KODA 2022 Summer Camp Brochure - Plymouth ...
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SUMMER
VIBES
YMCA CAMP Y-KODA
2022 Summer Camp Brochure
Register online today!
WELCOME TO YMCA CAMP Y-KODA
WELCOME TO CAMP
SAVE ON CAMP!
CAMP CONTACTS Did you know that Y members receive the lowest rates
for camp? Ask us about membership today! Please note:
General Office: (920) 467-6882 in order to receive the member rate you must have an
active membership at the time of program registration and
participation.
Jeremiah Dentz, Executive Director
jdentz@sheboygancountyymca.org
NEW!!
Kaitlyn Rautmann, Summer Camp Director
krautmann@sheboygancountyymca.org ONLINE
REGISTRATION
Mackinzi Beaty, Maywood Camp Director NOW AVAILABLE!
mbeaty@sheboygancountyymca.org
sheboygancountyymca.org/camp-y-koda
Terese Koene-Carroll, Camp Registrar
tcarroll@sheboygancountyymca.org TABLE OF CONTENTS
Welcome Letter & Ways to Save .............................................3
Benefits of Camp........................................................................4
Open House & Camp Staff........................................................5
What to Expect.................................................................... 5 - 7
Locations & Transportation .....................................................8
Extended Care & Thursday Nights .........................................9
Registration Information .............................................. 10 - 11
Camp Contacts All Camps At a Glance.................................................... 12 - 13
Kids Need Camp....................................................................... 14
Table of Contents
In-Person Registration Forms...................................... 15 - 18
Mission Camp Y-Koda Information & Camp Descriptions...... 19 - 27
Statement CIT Camp & Volunteer Program............................................ 28
Maywood Information & Camp Descriptions............. 29 - 31
YMCA CAMP Y-KODA MISSION: To promote responsible
stewardship of our environment and enhances participant
quality of life by offering hands-on education opportunities.
2 Register at www.sheboygancountyymca.org/camp-y-koda
WELCOME FAMILIES & CAMPERS
Another amazing summer awaits you with Camp Y-Koda, with more than 60 different camp
offerings over the course of our 11-weeks. Take a look through the brochure and I’m certain
you will find a camp that suits your camper.
I think most of us can agree that outdoor time has become increasingly important to all of
us during the last couple of years as the term “virtual” seems to be mentioned in every other
WELCOME LETTER & WAYS TO SAVE
sentence. I have great news! There is nothing virtual about summer camp with Camp Y-Koda!
We work and play within the outdoor world where everything is real, hands-on and authentic.
All of the senses are fully engaged; the smell of a campfire, the refreshing feel of the cool lake
water on a hot day, and the sight of friends everywhere.
Our campers are immersed in the tangible elements of summer in Wisconsin. They spend their days running, walking, skipping,
playing, swimming, and singing. They get hot, wet, tired, happy, and dirty. Most importantly, they are outside and away from
their screens, deriving all the benefits that fresh air has to offer.
Leave the virtual world behind, and join us for a “REAL” experience this summer with Camp Y-Koda. We look forward to being
a part of your summer.
- Jeremiah Dentz
Executive Director
10% OFF EARLY BIRD SPECIAL
Register between February 15 and April 1
Register a camper before April 1, 2022 and receive 10% OFF the total cost of your child’s
camp fees! Use Code: 22EARLYBIRD when registering online!
WAYS TO SAVE
EXCLUDES: Bus Transportation Costs, Extended Care Costs & One-Time Registration Fee.
Register early and save!
YMCA SUMMER MEMBERSHIP
Valid: June 14 - August 31, 2022
Purchase a summer youth membership for your child and they will receive the YMCA member
rate for camps! Visit our website to find rates and the application form. Active membership is
required prior registering your child for camp.
FINANCIAL ASSISTANCE
Scholarships are available for those who may need assistance covering the cost of
their camp experience. Forms are available on our website or at the Sheboygan YMCA
and Sheboygan Falls YMCA.
Early Bird Special
YMCA Summer
Membership
Financial
Assistance
ANNUAL SUPPORT CAMPAIGN: Provides scholarships Annual Support
for financially challenged and at-risk youth who wish to Campaign
experience summer camp. Your support makes a positive
difference in the lives of children in our community. Visit
our website to make a donation today!
Register early and save 3
BENEFITS OF CAMP
CAMP Y-KODA AND MAYWOOD SUMMER CAMPS ARE:
$
SAFE AFFORDABLE FUN!
• Well trained, qualified • Field trips are included in • All Camp Games
counselors who receive more cost of camps. • Archery (7 Yrs+)
than 40 hours of pre-camp • Arts & Crafts
training. • Thursday night sleepover for • BB Gun (9 Yrs+)
campers included. • Biking
• 1:6 staff to camper ratio for • Camper’s Choice Time
• All snacks throughout the
pee wee campers ages 4 - 5. • Campfires
week are provided.
• Canoeing
• 1:12 staff to camper ratio • Breakfast on Friday for • Climbing Wall (9 Yrs+)
for campers ages 6 – 8. campers who sleepover • Fishing
Thursday night. • Gaga Ball
• All counselors are at least • Gardening
18 years old. • Lunch for all campers • Healthy Living Habits
included on Friday. • High Ropes (9 Yrs+)
• All staff are certified in CPR, • Kayaking
AED and First Aid. • Very affordable bussing and • Lake Exploration
extended care fees. • Nature Study
• We are a State of Wisconsin • Paddle Boarding
Licensed Day Camp that • Financial assistance is • River Tubing
meets all child care licensing available through application • Sleepovers
guidelines. process. • Slingshots (7 Yrs+)
• Slip ‘n Slide
• Additional scholarship
• ALL water activities are • Songs & Skits
opportunities for specific
supervised by certified • Sports
camp experiences.
lifeguards. • Team Building
• Become a Y member and save • Swimming
even more! • More, more and more!
4 Register at www.sheboygancountyymca.org/camp-y-koda
CAMP STAFF
Every parent wants their child
to have great role models and we’ve
found them! They understand the magic
of camp and work hard to ensure that your
child has an amazing experience keeping with the
traditions and core values that Camp Y-Koda has
to offer. Staff are carefully screened and selected
based on experience working with children, maturity,
sound judgement and sensitivity. Safety is our top
MEET THE CAMP STAFF
priority. Every member of our team goes through
the requirements of the Wisconsin Department
of Children, which includes certification and
trainings in CPR, First Aid, Lifeguarding,
Child Abuse Prevention, Shaken
Baby Prevention and more.
SUMMER CAMP OPEN HOUSE NIGHTS PARENT HANDBOOK & CAMP RESOURCES
Come discover summer with YMCA Camp Y-Koda! At our sheboygancountyymca.org/camp-y-koda
summer camp open houses, you will have the opportunity Visit our website to find our Parent Handbook and Camp
to explore our camp offerings, tour the grounds and meet Resources page. Our resource page includes everything you
with our camp directors to address any questions you have need to know to get your child ready for camp. You’ll find
about the upcoming camp season. helpful tips on our policies, what to pack, information on
our sleepover and more! We’ve included specific tips on Pee Open Houses
Our grounds will be open at Camp Y-Koda to walk the Wee Camp, Day Camp, Specialty Camps, Resident Camps,
property, purchase camp gear, view the cabins, facilities Adventure Trips and Maywood Camp information. Parent Handbook
and so much more!
When you visit our Camp Resources page, you’ll find a Camp Resources
CAMP Y-KODA OPEN HOUSES additional downloadable documents such as, but not limited
May 18 - Tuesday.................4:00pm - 6:00pm to: the camp brochure, registration forms, financial forms,
May 20 - Thursday...............4:00pm - 6:00pm state licensing forms, waiver forms, detailed schedules,
May 26 - Wednesday............4:00pm - 6:00pm events and more.
Can't attend any of these dates? No problem! Call camp
at 920-467-6882 to schedule a tour with one of our
directors.
Register early and save 5
A TYPICAL DAY OF CAMP
Each day of camp provides a variety of safe
and fun adventures!
8:15AM - 8:30AM - CHECK-IN YOUR CAMPER
8:30AM - OPENING CEREMONY
Each morning we meet with our counselors, raise
WHAT TO EXPECT
the flag and get excited for the day ahead!
8:45AM - ICE BREAKERS
Each day we have ice breakers and games to get
to know the other campers and make friends.
CAMP DAY: 9:00AM - 3:30PM
CAMP POOL
Campers begin their adventure with a wide
All groups using our pool are supervised by camp staff who
variety of small and large group activities,
are lifeguard certified by the American Red Cross. Each
nature activities, arts & crafts, water fun,
camper is required to take a swim test to determine their
games, sports, special themed activities
swimming ability. If your child passes the swim test, they
and more while growing as individuals!
will wear a green wristband. If they do not pass, they are
Mornings are so busy that we can’t help
required to stay in the roped-off shallow end. The deepest
but build up an appetite. Mid-day we’ll kick
part of our pool is 4 ½ feet and the shallowest area is 2
back and relax by eating lunch and making
½ feet. Lifejackets are available to use upon request. More
new friendships out at the campsite.
pool information can be found in the Parent Handbook.
Water fun begins after lunch with a jump in
the swimming pool, swimming at the lake CAMP STORE
or enjoying a variety of water activities The camp store is your official source for a wide variety of
such as our slip n’ slide, tubing in the river novelty items and camp “swag” such as t-shirt’s, sweatpants,
and much more! To end our day, campers long sleeve sweatshirts, hats and more! Campers may also
will enjoy a snack and one last activity. purchase nutritious snacks and refreshments on only
Tuesday & Thursday of each camp week. The store is also
open during the Thursday Family Program. The store is
3:45PM - CLOSING CEREMONY not open on Monday & Friday. Snack items are $0.25 to
We round out our day with a closing ceremony: $1.50. Merchandise items range from $1.50 to $50.00. We
lowering the flag, a camp song and end of day recommend purchasing all merchandise items on Thursday
reminders. night.
4:00PM - CHECK-OUT & DEPARTURE PLEASE READ: If your child is registered for Maywood
Each afternoon we say goodbye to our counselors Camps, Maywood Campers do not have the option to
and friends as we get picked up or head to the visit store. Families are welcome to visit Camp Y-Koda to
bus to go home and share our exciting camp day! purchase items from the store.
Typical
Day of Camp
PLEASE READ: Thoughout the week campers
participate in an all-camp games. Campers
Camp Pool
choose their own activity on selected days of the
week. Specialty camps may take off-site trips or
Camp Store
require more time for instruction so the activity
period in the morning may be longer. The rest of
the daily schedule is adjusted accordingly.
Detailed schedules can be found on our website:
www.sheboygancountyymca.org/camp-y-koda.
6 Register at www.sheboygancountyymca.org/camp-y-koda
WHAT TO BRING EACH DAY
Please send along the following items each day with your child to camp.
Please send your campers in clothing that is OK to get dirty, as your child will be playing outside rain or shine!
BACKPACK HAT
LUNCH SUN BLOCK SPF 15+
BUG SPRAY RAIN PONCHO
CLOSED
WATER BOTTLE
TOE SHOES
WHAT TO EXPECT
SWIMSUIT CAMP SHIRT
TOWEL A SMILE
PLEASE READ: Please label your child’s name on everything
they bring to camp. If any other supplies are needed, PLEASE DO NOT BRING
camp will inform you. Camp Y-Koda and the YMCA is not Our camp encourages children and teens to learn
responsible for any misplaced, stolen or lost items at camp. and play in nature, and we strongly believe in the
All lost & found items at camp are held for two weeks, and importance of less distractions during our camp
will be discarded soon after. Our lost & found collection program. These items are not to be brought to camp
is available to view during our weekly Thursday Parent each day. If brought to camp, these items will be taken
Program. away and kept in the office until a parent comes to
pick them up. They will not be returned to the child at
the end of the day.
CAMP T-SHIRT • Toys (playing cards, fidget toys, dolls, legos, etc.)
A camp t-shirt is included in the • Cellular Devices (phones, smart watches, tablets)
registration fee. Campers receive • Ipods & portable music players
their t-shirt at the beginning of • Weapons, Alcohol and drugs
their first camp week. They receive • Animals and pets
only one t-shirt, regardless of how • Portable gaming systems
many weeks of camp they attend. • Credit Cards and large amounts of money
• Radios and walkie talkies
LUNCH & COOKOUT • Vehicles, skateboards, and roller blades
Campers must bring a bag lunch • Jewelry and other valuable items
with them to camp Monday
- Thursday unless otherwise
specified. Camp provides lunch
only on Fridays as all campers
participate in an authentic
campfire cookout. Milk is
provided every day with lunch
as well as a nutritious afternoon
snack. All meals are provided
for off-site adventure trips and Camp Packing LIst
resident camps.
Camp T-Shirt
ELECTRONICS AND CELL PHONE POLICY
Cell phones and other electronic devices are NOT permitted Lunch & Cookout
at Camp Y-Koda or Maywood. Our programs promote the
opportunity for participants to learn and play in nature Electronics Policy
and we strongly believe in the importance of disconnecting
during the camp experience. Please leave them at home. If What NOT to
brought to camp, these devices will be taken away and Bring
kept in the office until a parent comes to pick them up.
They will not be returned to the child at the end of the day.
Register early and save 7
LOCATIONS & TRANSPORTATION
LOCATIONS NORTH BUS ROUTES TO CAMP Y-KODA
We offer camp at two different locations in Sheboygan
County. Each camp offers different camp options and have N1 - Sheboygan YMCA, 812 Broughton Dr.
bus transportation available to and from camp each day. Route #1 North Pick-up 7:40am Drop-off 4:45pm
YMCA Camp Y-Koda N2 - North High School, North 10th St. Parking Lot
W3340 Sunset Road Route #2 North Pick-up 8:00am Drop-off 4:30pm
Sheboygan Falls, WI 53085
N3 - Cleveland Park, Cleveland Ave & North 25th St.
Maywood Environmental Park Route #3 North Pick-up 8:05am Drop-off 4:25pm
3516 Mueller Road
Sheboygan, WI 53083 N4 - Maywood Environmental Park, 3615 Mueller Rd.
Route #4 North Pick-up 8:10am Drop-off 4:15pm
TRANSPORTATION SOUTH BUS ROUTES TO CAMP Y-KODA
There is a $15.00 per week fee for those who use the bus
service as part of their summer camp experience. Please S1 - South High School, Washington Ave. Parking Lot
indicate which stop your camper will use on page 15 of the Route #1 South Pick-up 7:45am Drop-off 4:40pm
registration form.
S2 - Kohler School, School St. Entrance
Changes in transportation must be made in writing. Phone Route #2 South Pick-up 8:05am Drop-off 4:20pm
calls are not accepted. You may send a note with your child
or email to camp. S3 - Sheboygan Falls YMCA Parking Lot, 305 Buffalo St.
Route #3 South Pick-up 8:15am Drop-off 4:10pm
Buses run every week with several pick-up and drop-off
points throughout Sheboygan, Kohler and Sheboygan Falls. NORTH BUS ROUTES TO MAYWOOD
A camp staff member is assigned to each bus as a monitor.
N1 - Sheboygan YMCA, 812 Broughton Dr.
Route #1 North Pick-up 7:40am Drop-off 4:45pm
Locations
N2 - North High School, North 10th St. Parking Lot
Transportation
Route #2 North Pick-up 8:00am Drop-off 4:30pm
• Bus Routes
N3 - Cleveland Park, Cleveland Ave. & North 25th St.
Route #3 North Pick-up 8:05am Drop-off 4:25pm
8 Register at www.sheboygancountyymca.org/camp-y-koda
EXTENDED CARE
Camp Y-Koda offers before and after camp care at the
Sheboygan YMCA, Sheboygan Falls YMCA and Camp Y-Koda. SHEBOYGAN YMCA EXTENDED CARE
Below are the times and locations that are available. YMCA Location: Front Lobby by Entrance
staff will not be available before 7:15am. A late pick-up
fee of $5.00 per 15 minutes after 5:30pm will be charged. AM Care: 7:15am - 7:40am PM Care: 4:45pm - 5:30pm
SHEBOYGAN FALLS YMCA EXTENDED CARE
The fee for extended care is $25.00 per week. Pre-
EXTENDED CARE & THURSDAY NIGHTS
registration is required; please mark the appropriate box on Location : Front Lobby or Gymnasium
your registration form. If you do not sign up for extended AM Care: 7:15am - 8:15am PM Care: 4:10pm - 5:30pm
care, you are expected to be at the designated bus or camp
YMCA CAMP Y-KODA EXTENDED CARE
location to pick up your child.
Location: Playground or Johnsonville Lodge (if it rains)
PLEASE READ: Extended care is not available at AM Care: 7:15am - 8:30am PM Care: 4:00pm - 5:30pm
Maywood. Campers who need extended care should sign
up for bussing and extended care at the Sheboygan YMCA.
THURSDAY NIGHT FAMILY PROGRAM - ONLY AT CAMP Y-KODA
On Thursdays, campers leave at 4:00pm and then return later with their family for the
Thursday Family Program. During the week, groups prepare songs and skits to perform at
the program. This event allows families to meet the counselors, tour the grounds and see
the activities the camper has been doing all week. The program begins at 7:30pm for weeks
1-7 and at 7:00pm for weeks 8-11. Families are encouraged to arrive 30 minutes prior
to drop items off and shop at the camp store. When the program is finished, we offer an
optional authentic camp sleepover for campers. Please see below for more information on
THURSDAYS AT CAMP
Sleepover, Night Activities & S’mores!
the sleepover. When the program is finished, all campers not sleeping over can go home with
their families and return to camp on Friday. The Family program and sleepover will be held
rain or shine.
If the Family Program & sleep over is cancelled due to inclement weather, it will be announced
on our website www.sheboygancountyymca.org/camp-y-koda and Facebook page.
THURSDAY CAMP SLEEPOVER - ONLY AT CAMP Y-KODA
Although the sleepover is optional, camp strongly recommends having your camper sleepover
for the authentic camp experience and continue learning life skills. Campers will sleep in our
cabins or lodges, and partake in night activities and have a campfire to roast s’mores.
After the family program is finished, parents are to walk their child to their counselor. If
campers have medication to take during their time at camp, medication must be turned into
the camp director and sign the required form. Medication must be in the original container.
For more information on medication, please read the Parent Handbook.
PLEASE READ: If your child is registered for a Pee Wee Camp, Pee Wees do not have the
option to sleepover. Bedtime snacks & breakfast is served to all campers who attend the
sleepover.
MAYWOOD CAMPS: If your child is registered for Maywood Camps, campers do not have
the option to sleep over at Maywood. Campers do not have the option to join Camp Y-Koda
sleepovers unless they are registered for a Camp Y-Koda camp.
WHAT TO BRING
TO THE SLEEPOVER
CHANGE OF CLOTHES Extended Care
FRIDAY BREAKFAST
Camp Y-Koda has partnered with FLASHLIGHT Thursday Family
Nourish Farms of Sheboygan Falls, BUG SPRAY Program
WI to provide healthy breakfast
foods to our campers who attend the SLEEPING BAG/TWIN BEDDING Thursday
camp sleepover. Learn more about Sleepover
SWEATSHIRT
Nourish Farms at nourishfarms.org
TOILETRIES Friday Breakfast
PILLOW & BLANKET
Sleepover
PAJAMAS
Packing List
Register early and save 9
FIRST DAY TO REGISTER
Registration will begin on Tuesday, February 15, 2022. All CONTACT US!
required enrollment forms & immunization record must be
completed in full and received prior to attending camp. YMCA CAMP Y-KODA
W3340 Sunset Road, Sheboygan Falls, WI 53085
REGISTRATION FORMS P 920-467-6882 • F 920-467-7240
All forms required for registration can be downloaded on
our website, www.sheboygancountyymca.org/camp-y-koda BILLING & REGISTRATION:
or picked up at a YMCA Branch. Online registration for Terese Koene-Carroll, Camp Registrar
REGISTRATION INFORMATION
camps is available. tcarroll@sheboygancountyymca.org
HOW TO REGISTER
Before starting your registration, please have ALL GENERAL CAMP QUESTIONS:
immunization, medical and health history information
Jeremiah Dentz, Executive Director
ready before starting the registration process. Please see
our checklist on page 11. Please pick one option below: jdentz@sheboygancountyymca.org
• ONLINE - Visit our website at www.sheboygancountyymca. Kaitlyn Rautmann, Summer Camp Director
org/camp-y-koda and create an account. All forms & krautmann@sheboygancountyymca.org
immunization information are required to complete your
child’s registration online and to reserve their spot.
Please note: In order to receive the member rate you
must have an active family or youth membership at the PAYMENT SCHEDULE
time of program registration and participation. Camp balances are due by the following dates:
Weeks 1 - 3........Final payment is due by........May 15, 2022
• IN PERSON - At YMCA Camp Y-Koda, Sheboygan YMCA Weeks 4 - 7........Final payment is due by....... June 15, 2022
or Sheboygan Falls YMCA. Weeks 8 - 11.....Final payment is due by........ July 15, 2022
• EMAIL OR MAIL - All Forms & Immunization Record can be Please contact us if you have questions regarding the
sent to one of our contacts listed. Please note: Payment payment schedule.
is required to reserve your child’s spot and forms will
not be entered until we have the required information & CANCELLATION POLICY/NON-REFUNDABLE FEES
payment. • The $15.00 registration fee and all $25.00 camp deposits
are non-refundable under any circumstances.
PLEASE READ: There are limited number of spaces per • Any payment made in addition to required deposit is
camp. We HIGHLY RECOMMEND that you register online refundable only if notified of cancellation in writing by
and register for all your weeks at once to guarantee a spot May 1, 2022.
for your child. Registrations are processed in the order • No refunds on cancellations received after May 1, 2022.
received.
FRIEND REQUEST
Non-Online Registration methods are entered Monday- If your child plans to attend camp with a friend or group
Friday and will not be entered until payment & missing of friends, you may request they be placed with the same
information is received. Confirmation of your child’s counselor by filling in the “Friend Request” section on the
enrollment will be made via email through our online registration form.
registration platform. If you do not receive a confirmation
email, please contact Camp Y-Koda. PLEASE READ:
• In order to be in the same group, children must be in the
PAYMENT METHODS same age category and attend the same camp.
• ONLINE REGISTRATION: Credit Card & E-Check will only • We will make every effort to grant your request.
be accepted. However, placement is not guaranteed as certain age
Registration
• IN-PERSON REGISTRATION: Cash, Check, Credit or Debit groups are separated by State Licensing Regulations
• First Day to
are only accepted. and we cannot make exceptions.
Register
• What is Needed
• How to Register You can pay for each week of camp by the specified payment
• Payment plan and the deadlines as stated in your Parent Handbook.
Schedule
• Cancellation PLEASE READ: Occasionally, camp scheduling, field trips,
Policy & Non- and content are subject to change due to ratios, inclement
Refundable weather, and unforeseen events or circumstances. We will
Fees do our best to notify parents when these changes occur.
Payment Methods
NEW!!
ONLINE
Friend Request REGISTRATION
NOW AVAILABLE!
Contact Us
10 Register at www.sheboygancountyymca.org/camp-y-kodaFILL OUT the enrollment packet, including:
REGISTRATION CHECKLIST
1 • Camp Registration Information Pages 15 - 18
IN-PERSON REGISTRATION INFORMATION
• Waiver Forms (if applicable)
• Active YMCA Membership is required prior to receiving membership rates.
remember to complete the following:
When registering in-person,
SUPPLY:
2 • Immunization Records (for all ages)
• Financial Assistance approval letter (if applicable)
• Any additional documents you wish camp should have on file
3 READ the Parent Handbook
PAY:
4 • $15.00 One-Time Registration Fee
• $25.00 per week camp deposit
• Pay any outstanding balance prior to your child’s first day of camp
PLEASE READ: If registering in-person, all the above steps
Check-out page 2 to find ways are required to reserve your child’s spot in the desired
to save on your child’s camp fees! camp.
Children will be taken off rosters if:
• All required paperwork is not on file at least 10 days
prior to the start of your child’s first day of camp. This is
a State Licensing Mandate and we cannot allow a child to
attend without completed paperwork.
• There is an outstanding balance on any camp. The
payment schedule is listed on page 10.
NON-DISCRIMINATION STATEMENT: In the operation of
the summer camp program, no child, as defined by program
regulations, will be discriminated against because of race,
sex, color, age, national origin or handicap. Any person
who believes that a child has been discriminated against in
any USDA related activity should write immediately to the
Secrary of Agriculture, Washington, D.C. 20250
In-Person
Registration
Checklist
• Enrollment
Forms
• Immunization
Record
• Read Handbook
• Pay Fees
Register early and save 111 WEEK 1: JUNE 13 - 17, 2022 5 WEEK 5: JULY 11 - 15, 2022
Camp Age Y Member Participant Camp
Day Camp 6 - 13 $195.00 $215.00 Day Camp
Pee Wee “Kickoff to Summer” Camp 4-5 $225.00 $245.00 Pee Wee “Splish Splash” Camp
W Blast From the Past Camp 9 - 12 $220.00 $240.00 W Mini Arts & Crafts Camp
E Boots and Saddles Camp 7 - 10 $335.00 $355.00 E Mini Super Hero Camp
E E
Buggin’ Out Camp 6-8 $215.00 $235.00 Ninja Warrior Camp
K K
Counselor in Training Camp 14 - 16 $252.00 $272.00 Road America Racing Camp
2022 CAMPS AT A GLANCE
1 Parkour Camp 9 - 12 $225.00 $245.00 5 Wizardry Resident Camp
Timber Play Camp 6-8 $215.00 $235.00 Maywood Enchanted Forest Camp
Maywood Wilderness Retreat Camp
2 WEEK 2: JUNE 20 - 24, 2022 6 WEEK 6: JULY 18 - 22, 2022
Camp Age Y Member Participant Camp
Day Camp 6 - 13 $195.00 $215.00 Day Camp
Pee Wee “Little Chef” Camp 4-5 $225.00 $245.00 Pee Wee “Ooey Gooey Creations” Camp
W Boots and Saddles II Camp 11 - 14 $335.00 $355.00 W Archery Basics Camp
E High Ropes Camp 9 - 14 $220.00 $240.00 E Boots and Saddles Camp
E E
Kiwi Creations Camp 6-8 $275.00 $295.00 Mid-Summer Mania Camp
K K
Mermaids & Tritons Camp 5-7 $225.00 $245.00 Mini Wet ‘n Wild Camp
2 Popsicle Stick Creation Camp 7 -10 $225.00 $245.00 6 Wildman’s Adventure Trip
Safari Camp 9 - 12 $215.00 $235.00 Maywood Mini Quarry Quest Camp
Maywood Quarry Quest I Camp
3 WEEK 3: JUNE 27 - JULY 1, 2022 7 WEEK 7: JULY 25 - 29, 2022
Camp Age Y Member Participant Camp
Day Camp 6 - 13 $195.00 $215.00 Day Camp
Pee Wee “Zookeeper” Camp 4-5 $225.00 $245.00 Pee Wee “Little Farmer” Camp
W Amazing Animals Camp 6-8 $225.00 $245.00 W Advanced Fishing Camp
E Camp Cookin’ for Kids Camp 9 - 12 $225.00 $245.00 E Boots and Saddles Camp
E E
Slimy Arty Party Camp 6-8 $225.00 $245.00 Color Wars Camp
K K
Zombie Apocalypse Camp 9 - 12 $215.00 $235.00 Mini All Week Pool Party Camp
3 Wildman’s Adventure Trip 12 - 16 $525.00 $545.00 7 Stranded Resident Camp
Maywood Capture the Flag Camp 10 - 14 $205.00 $225.00
Maywood Water Otters Camp 7-9 $205.00 $225.00
4 WEEK 4: JULY 5 - 8, 2022 (No Camp on Monday July 4, 2022) 8 WEEK 8: AUGUST 1 - 5, 2022
Camp Age Y Member Participant Camp
Day Camp 6 - 13 $156.00 $176.00 Day Camp
Pee Wee “Lil Athlete” Camp 4-5 $180.00 $200.00 Pee Wee “Beach Bash” Camp
W Asteroids & Orbits Camp 6-8 $180.00 $200.00 W Boots and Saddles II Camp
E Choose Your Own Adventure Camp 12 - 16 $172.00 $192.00 E Bullseye Camp
E E
Glamping Camp 9 -12 $172.00 $192.00 Great Unbirthday Camp
K K
Junior Kayak Camp 8 -10 $180.00 $200.00 Mini Super Sports Camp
4 Water Striders Camp 5 -7 $172.00 $192.00 8 Tenting It Camp
Pictured Rocks Adventure Trip
Maywood Roughing It Camp
Maywood Wild Child Camp
12 Register at www.sheboygancountyymca.org/camp-y-koda9 WEEK 9: AUGUST 8 - 12, 2022
Age Y Member Participant Camp Age Y Member Participant
6 - 13 $195.00 $215.00 Day Camp 6 - 13 $195.00 $215.00
4-5 $225.00 $245.00 Pee Wee “Storybook” Camp 4-5 $225.00 $245.00
6-8 $225.00 $245.00 W BB Gun Camp 9 - 12 $215.00 $235.00
6-8 $215.00 $235.00 E Boots and Saddles Camp 7 - 10 $335.00 $355.00
E
9 - 12 $230.00 $250.00 Color Wars II Camp 12 - 16 $225.00 $245.00
K
12 - 16 $385.00 $405.00 Hook, Line & Sinker Camp 6-8 $215.00 $235.00
2022 CAMPS AT A GLANCE
9 - 13 $385.00 $405.00 9 Mad Scientist Camp 6-8 $225.00 $245.00
7-9 $205.00 $225.00 Wet ‘n Wild Camp 9 - 12 $255.00 $275.00
10 - 14 $205.00 $225.00 Maywood Season Finale Camp 7-9 $215.00 $235.00
Maywood Quarry Quest II Camp 10 - 14 $250.00 $270.00
10 WEEK 10: AUGUST 15 - 19, 2022
Age Y Member Participant Camp Age Y Member Participant
6 - 13 $195.00 $215.00 Day Camp 6 - 13 $195.00 $215.00
p 4-5 $225.00 $245.00 Pee Wee “Under the Sea’ Camp 4-5 $225.00 $245.00
7-9 $215.00 $235.00 W Bedazzled Camp 6-8 $225.00 $245.00
E
7 - 10 $335.00 $355.00 E Kiwi Creations II Camp 8 - 10 $275.00 $295.00
9 - 12 $220.00 $240.00 K Little Ninjas Camp 6-8 $215.00 $235.00
6-8 $230.00 $250.00 Twisted Sports Camp 9 - 12 $215.00 $235.00
1
12 - 16 $525.00 $545.00 0 Apostle Islands Adventure Trip 12 - 16 $485.00 $505.00
7-9 $250.00 $270.00
10 - 14 $250.00 $270.00
11 WEEK 11: AUGUST 22 - 26, 2022
Age Y Member Participant Camp Age Y Member Participant
6 - 13 $195.00 $215.00 Day Camp 6 - 13 $195.00 $215.00
4-5 $225.00 $245.00 Pee Wee “Let’s Go Camping” Camp 4-5 $225.00 $245.00
9 - 12 $215.00 $235.00 W High Ropes Camp 9 - 14 $220.00 $240.00
E
7 - 10 $335.00 $355.00 E Mini Wet ‘n Wild Camp 6-8 $230.00 $250.00
8 - 12 $215.00 $235.00 K Season Finale Camp 9 - 12 $215.00 $235.00
6-8 $220.00 $240.00
1
9 - 13 $385.00 $405.00 1
Age Y Member Participant
6 - 13 $195.00 $215.00
4-5 $225.00 $245.00
11 - 14 $335.00 $355.00
9 - 12 $215.00 $235.00
5-8 $215.00 $235.00
6-8 $215.00 $235.00
9 - 12 $270.00 $290.00
12 - 16 $445.00 $465.00
10 - 14 $215.00 $235.00
7-9 $205.00 $225.00
Register early and save 13KIDS
NEED
CAMP
In a typical summer,
campers will experience:
2250
minutes
KIDS NEED CAMP
outdoors each week.
1900
minutes
playing each week.
225
minutes
swimming each week.
60
minutes
singing each week.
170
opportunities
to meet new friends!
0
minutes
on cell phones/electronics!
and hundreds upon hundreds of minutes
exploring, swinging, splashing, digging,
creating, learning, trying, tagging,
climbing, laughing, building and more!
14 Register at www.sheboygancountyymca.org/camp-y-koda2022 CAMP Y-KODA & MAYWOOD REGISTRATION FORM - For In-Person Registration
Camper LAST Name_____________________________________________________FIRST Name________________________________________________ Birth Date___________________________ Age____________
R WEEK 1: 6/13-6/17,2022 R WEEK 2: 6/20-6/24, 2022 R WEEK 3: 6/27-7/1, 2022 R WEEK 4: 7/5-7/8, 2022
Camper LAST Name___________________________________________________________________________________________________________ Camper FIRST Name___________________________________________________________________________________________________
Extended Care Extended Care Extended Care Extended Care
Day Camp Day Camp Day Camp Day Camp
Pee Wee Camp Pee Wee Camp Pee Wee Camp Pee Wee Camp
Blast From the Past Camp Boots and Saddles II Camp Amazing Animals Camp Asteroids & Orbits Camp
Boots & Saddles Camp High Ropes Camp Camp Cookin’ for Kids Camp Choose Your Own Adventure
Buggin’ Out Camp Kiwi Creations Camp Slimy Arty Party Camp Glamping Camp
Counselor in Training Camp Mermaids & Tritons Camp Zombie Apocalypse Camp Junior Kayak Camp
Parkour Camp Popsicle Stick Creation Camp Wildmans Adventure Trip Water Striders Camp
Timber Play Camp Safari Camp Maywood Capture the Flag
Maywood Water Otters Camp
R WEEK 5: 7/11-7/15, 2022 R WEEK 6: 7/18-7/22, 2022 R WEEK 7: 7/25-7/29, 2022 R WEEK 8: 8/1-8/5, 2022
Extended Care Extended Care Extended Care Extended Care
Day Camp Day Camp Day Camp Day Camp
Pee Wee Camp Pee Wee Camp Pee Wee Camp Pee Wee Camp
Mini Arts & Crafts Camp Archery Basics Camp Advanced Fishing Camp Boots & Saddles II Camp
Mini Super Hero Camp Boots & Saddles Camp Boots & Saddles Camp Bullseye Camp
Ninja Warrior Camp Mid-Summer Mania Camp Color Wars Camp Great Unbirthday Camp
Road America Racing Camp Mini Wet ‘n Wild Camp Mini All Week Pool Party Camp Mini Super Sports Camp
Wizardry Resident Camp Wildman’s Adventure Trip Stranded Resident Camp Tenting It Camp
Maywood Enchanted Forest Maywood Mini Quarry Quest Pictured Rocks Adventure Trip
Maywood Wilderness Retreat Maywood Quarry Quest I Camp Maywood Wild Child Camp
Maywood Roughing It Camp
R WEEK 9: 8/8-8/12, 2022 R WEEK 10: 8/15-8/19, 2022 R WEEK 11: 8/22-8/26, 2022 PLEASE NOTE:
The completed 2022 registration
Extended Care Extended Care Extended Care
forms on pages 15 -18 are required
Day Camp Day Camp Day Camp for each camper AT THE TIME OF
REGISTRATION.
Pee Wee Camp Pee Wee Camp Pee Wee Camp
BB Gun Camp Bedazzled Camp High Ropes Camp A Day Care Immunization Record is
required for all children. You may:
Boots & Saddles Camp Kiwi Creations II Camp Mini Wet n’ Wild Camp
• Contact your child’s doctor
Color Wars II Camp Little Ninjas Camp Season Finale Camp for a copy and attach it to the
registration forms.
Hook, Line & Sinker Camp Twisted Sports Camp
• Obtain a copy on-line at
Mad Scientist Camp Apostle Island Adventure Trip https://www.dhfswir.org and
attach it to the registration
Wet n’ Wild Camp
forms.
Maywood Season Finale Camp • Fill out the form on page 18.
Maywood Quarry Quest II
R CAMP Y-KODA TRANSPORTATION R MAYWOOD TRANSPORTATION
R TO Camp Y-Koda R FROM Camp Y-Koda R TO Maywood R FROM Maywood
None: Parent Drop-off None: Parent Pick-up None: Parent Drop-off None: Parent Pick-up
Sheboygan YMCA Sheboygan YMCA Sheboygan YMCA Sheboygan YMCA
North High School North High School North High School North High School
Cleveland Park Cleveland Park Cleveland Park Cleveland Park
Maywood Maywood R EXTENDED CARE R YMCA MEMBERSHIP
South High School South High School R Location R YMCA Member
Kohler Elementary School Kohler Elementary School Sheboygan YMCA Yes, ID #: _____________________________
Sheboygan Falls YMCA Sheboygan Falls YMCA Sheboygan Falls YMCA No
Camp Y-Koda
Register early and save 152022 CAMPER, CONTACT AND HEALTH INFORM - For In-Person RegistrationION
• Please fill out registration information completely. Submit a separate
HEALTH HISTORY AND EMERGENCY CARE PLAN
form for each camper. Forms may be copied. 1. Please check any special medical condition your child may have.
o No specific medical condition
• Registration forms must be on file at least 10 days prior to your child
attending camp at Camp Y-Koda or Maywood.
o Asthma
o Cerebral Palsy/motor disorder
• Day Care Immunization Record is required for all children ages 4-16. o Diabetes
o Epilepsy/seizure disorder
R T-SHIRT SIZE o Gastrointestinal or feeding concerns
o Youth Small o Youth Medium o Youth Large including special diet and supplements
o Adult Small o Adult Medium o Adult Large o Any disorder including
Cognitively Disabled, LD, ADD, ADHD or Autism
FRIEND REQUEST - MUST ATTEND SAME CAMP!
o Other condition requiring special care - specify:
Friend’s Name ______________________________________
________________________________________________
Week__________Camp ______________________________
________________________________________________
Week__________Camp ______________________________
o Milk allergy
if child is allergic to milk, attach statement from medical
Friend’s Name ______________________________________
professional including the acceptable alternative
Week__________Camp ______________________________
o Food allergies - specify foods:
Week__________Camp ______________________________
________________________________________________
________________________________________________
CAMPER INFORMATION Please print clearly! o Non-food allergies - specify:
Name_________________________DOB____________ oMoF ________________________________________________
Address______________________________________________ ________________________________________________
City________________________ State ______ Zip ___________
2. Triggers that may cause problems - specify.
Phone 1___________________ Phone 2 ____________________
________________________________________________
PRIMARY CONTACT INFORMATION ________________________________________________
Name________________________________________________
3. Signs or symptoms to watch for - specify.
Relationship to Camper__________________________________
________________________________________________
Phone 1___________________ Phone 2 ____________________
________________________________________________
Email Required _______________________________________
4. Steps the child care provider should follow. If prescription or
SECONDARY CONTACT INFORMATION non-prescription medications are necessary, a copy of the
Authorization to Administer Medication form (available on
Name________________________________________________
camp’s website) should be attached to this form.
Relationship to Camper__________________________________
________________________________________________
Phone 1___________________ Phone 2 ____________________
________________________________________________
Email Required _______________________________________
5. Identify any staff to whom you have given specialized training/
ADDITIONAL EMERGENCY CONTACT instructions to help treat symptoms.
Name________________________________________________ a.______________________________________________
Relationship to Camper__________________________________ b.______________________________________________
Phone 1___________________ Phone 2 ____________________ c.______________________________________________
Is this person authorized to pick up child? o Yes o No
6. When to call parents regarding symptoms or failure to re-
spond to treatment:
PHYSICIAN/MEDICAL FACILITY INFORMATION
________________________________________________
Physician Name________________________________________
________________________________________________
Phone 1___________________ Phone 2 ____________________
Address - Medical Facility ________________________________ 7. When to consider that the condition requires emergency
medical care or reassessment:
City________________________ State ______ Zip ___________
________________________________________________
PARENTAL AUTHORIZATION FOR CHILD OVER AGE 7 ________________________________________________
Authorization for Child over Age 7 R Yes R No
8. Additional information that may be helpful to camp:
I authorize my child to carry bee sting medication, an o Yes o No
inhaler, insulin syringe, other medication or device. ________________________________________________
________________________________________________
CAMP EXPERIENCE
Does child have prior camp experience? o Yes o No
If yes, please specify____________________________________
16 Register at www.sheboygancountyymca.org/camp-y-koda2022 AUTHORIZATIONS AND PAYMENT INFORMATION - For In-Person Registration
SUNSCREEN/INSECT REPELLENT AUTHORIZATION
CALCULATE COST OF YOUR CHILDS SUMMER CAMP FEES
The sunscreen or repellent should be labeled with the child’s name.
Please select an option below.
SUNSCREEN AUTHORIZATION R Yes R No
OPTION #1 - Paying in FULL
I authorize the center to apply sunscreen to my child. o Yes o No
A. Total Camp Fees (add all costs of each camp)
I authorize the center to allow my child to self-apply $
o Yes o No SUBTOTAL:
sunscreen.
B. Less 10% Early Bird Discount until 4/1/22*
Brand and Ingredient Strength
*Take 10% off the total cost of the camp fees. $
NEW TOTAL:
INSECT REPELLENT AUTHORIZATION R Yes R No
C. One Time Registration Fee: $ 15.00
I authorize the center to apply insect repellent to my child. o Yes o No
D. Total Extended Care @ $25.00 per Week $
I authorize the center to allow my child to self-apply o Yes o No
insect repellent. E. Total Bus Service Fee @ $15.00 per Week $
Brand and Ingredient Strength Total Amount Due:
$
(Add lines A or B and C, D, E)
BUS AND FIELD TRIP PERMISSION
Bussing: I hereby authorize Camp Y-Koda to transport my child OPTION #2 - PAY DEPOSIT/DOWN PAYMENT ONLY
by bus to and from Camp Y-Koda or Maywood at the bus stop that
F. $25.00 Deposit per Week of Camp $
I have specified on page 15. I understand that either myself or one
of the persons indicated below as an authorized pick-up person G. One Time Registration Fee $ 15.00
must be present to pick up my child. I have read and understand
Total Down Payment Due (Add Lines F, G): $
the above statements and I grant my permission as indicated by
my signature. Remainder/Balance Due:
$
(total cost - down payment)
Field Trips: I hereby authorize Camp Y-Koda to transport my
• Please see page 10 for detailed registration information.
child back and forth from Camp Y-Koda or Maywood for field trips.
• If you email the completed forms, payment information may be listed
below or you can call and provide a credit card.
Parent Signature _____________________________________ • Registrations will not be processed or entered without payment or missing
information.
AUTHORIZED PICK-UP PERSON
In the event that I am not available to call or pick up my child, the 2022 PAYMENT SCHEDULE
bus driver and/or camp staff are permitted to leave my child with: Camp balances are due by the following dates:
Weeks 1 - 3........ Final payment is due by............ May 15, 2022
Weeks 4 - 7........ Final payment is due by........... June 15, 2022
Name________________________________________________ Weeks 8 - 11...... Final payment is due by............ July 15, 2022
Phone 1____________________ Phone 2 ___________________
Relationship to Child____________________________________ PAYMENT INFORMATION
o Cash
Name________________________________________________ o Check #___________ (payable to Sheboygan County YMCA)
Phone 1____________________ Phone 2 ___________________ o Credit Card (VISA, Mastercard or Discover)
Relationship to Child____________________________________ Card #__________- __________ - __________ - _________
Expiration Date ____________ Security Code ____________
Driver’s license or photo ID is required to show proof of identity. If
the above named person is not present, the child will be taken to o Please keep my credit card information on file to run
the Sheboygan YMCA. payments on the due dates listed above.
SPECIAL ACTIVITIES PERMISSION AT CAMP Y-KODA CANCELLATION POLICY/NON-REFUNDABLE FEES
• The $15.00 registration fee and all $25.00 camp deposits are non-
I hereby authorize my child to participate in the following activities: refundable under any circumstances.
Archery ............. age 7 and older o Yes o No • Any payment made in addition to required deposit is refundable only if
notified of cancellation in writing by May 1, 2022.
BB Gun ............. age 9 and older o Yes o No • No refunds on cancellations received after May 1, 2022.
Climbing Wall ..... age 9 and older o Yes o No • The $15.00 per week bussing fee is non-refundable.
Sling Shots......... age 7 and older o Yes o No
PARTICIPATION AND PAYMENT AGREEMENT
I approve this application and certify that the applicant is capable of such an
CAMPER SWIMMING SKILLS experience. I grant permission for the applicant to participate in all planned camp
Please R check all that apply. activities, including out-of-camp trips by van, bus or hiking. In case of accident
or illness, the YMCA is authorized to secure emergency medical treatment.
o My child enjoys the water. Prudent attempts will be made to contact the parents immediately. The YMCA
o My child can float. is not responsible for lost, stolen or damaged personal articles. I also authorize
the YMCA to have and use photographs and videos of the person named on this
o My child will jump from the side. application as may be needed for its public relations programs. I agree to waive
o My child is comfortable in chest-deep water. any claims against the YMCA and its members and volunteers for injuries or
damages that may result from the conduct of other persons including participants
o My child can swim 10 - 20 yards. in YMCA programs.
o My child can swim 25 yards.
I agree to pay the balance of camp fees prior to the payment schedule below.
We cannot hold reserved space past that date without full payment. All change
and cancellation requests must be made in writing. I understand no refunds are
For Office Use Only given if a child leaves early because of homesickness or for disruptive behavior as
determined by the Executive Director.
Receipt #________________________ Date________________
Parent Signature _________________________ Date ______________
Amount $________________________ Staff________________
Register early and save 17DEPARTMENT OF HEALTH SERVICES STATE OF WISCONSIN
Division of Public Health Wis. Stat. § 252.04
F-44192 (Rev. 12/2017) CHILD CARE IMMUNIZATION RECORD
COMPLETE AND RETURN TO CHILD CARE CENTER. State law requires all children in child care centers to present evidence of immunization against
certain diseases within 30 school days (6 calendar weeks) of admission to the child care center. These requirements can be waived only if a properly
signed health, religious, or personal conviction waiver is filed with the child care center. See “Waivers” below. If you have any questions about immunizations,
or how to complete this form, please contact your child’s child care provider or your local health department.
PERSONAL DATA PLEASE PRINT
STEP 1 Child’s Name(Last, First, Middle Initial) Date of Birth (Month/Day/Year) Area Code/Telephone Number
Name of Parent/Guardian/Legal Custodian (Last, First, Middle Initial) Address (Street, Apartment number, City, State, Zip)
IMMUNIZATION HISTORY
STEP 2 List the MONTH, DAY AND YEAR the child received each of the following immunizations. DO NOT USE A (√ √) OR (X) except to indicate whether
the child has had chickenpox. If you do not have an immunization record for this child, contact your doctor or local public health department to
obtain the records.
First Dose Second Dose Third Dose Fourth Dose Fifth Dose
TYPE OF VACCINE
Month/Day/Year Month/Day/Year Month/Day/Year Month/Day/Year Month/Day/Year
Diphtheria-Tetanus-Pertussis
(Specify DTP, DTaP, or DT)
Polio
Hib (Haemophilus Influenzae Type B)
Pneumococcal Conjugate Vaccine (PCV)
Hepatitis B
Measles-Mumps-Rubella (MMR)
Varicella (chickenpox) vaccine
Vaccine is required only if the child has
not had chickenpox disease.
Has the child had Varicella (chickenpox) disease? Check the appropriate box and provide the year if known.
Yes year _____________________ (Vaccine is not required)
No or Unsure (Vaccine is required)
REQUIREMENTS
STEP 3 The following are the minimum required immunizations for the child’s age/grade at entry. All children within the range must meet these
requirements at child care entrance. Children who reach a new age/grade level while attending this child care must have their records updated
with dates of additional required doses.
AGE LEVELS NUMBER OF DOSES
5 months through 15 months 2 DTP/DTaP/DT 2 Polio 2 Hib 2 PCV 2 Hep B
16 months through 23 months 3 DTP/DTaP/DT 2 Polio 3 Hib1 3 PCV2 2 Hep B 1 MMR3
2 years through 4 years 4 DTP/DTaP/DT 3 Polio 3 Hib1 3 PCV2 3 Hep B 1 MMR3 1 Varicella
At Kindergarten entrance 4 DTP/DTaP/DT 4 4 Polio 3 Hep B 2 MMR3 2 Varicella
1
If the child began the Hib series at 12-14 months of age, only 2 doses are required. If the child received one dose of Hib at 15 months of age or
after, no additional doses are required. Minimum of one dose must be received after 12 months of age (Note: a dose 4 days or less before the
first birthday is also acceptable).
2
If the child began the PCV series at 12-23 months of age, only 2 doses are required. If the child received the first dose of PCV at 24 months of
age or after, no additional doses are required.
3
MMR vaccine must have been received on or after the first birthday (Note: a dose 4 days or less before the 1st birthday is also acceptable).
4
Children entering kindergarten must have received one dose after the 4th birthday (either the 3rd, 4th or 5th) to be compliant (Note: a dose 4 days
or less before the 4th birthday is also acceptable).
COMPLIANCE DATA AND WAIVERS
STEP 4 IF THE CHILD MEETS ALL REQUIREMENTS (sign at STEP 5 and return this form to the child care center), OR
IF THE CHILD DOES NOT MEET ALL REQUIREMENTS (check the appropriate box below, sign and return this form to child care center).
Although the child has not received all required doses of vaccine for his or her age group, at least the first dose of each vaccine has been
received. I, understand that it is my responsibility to obtain the remaining required doses of vaccines for this child WITHIN ONE YEAR and
to notify the child care center in writing as each dose is received.
NOTE: Failure to stay on schedule or report immunizations to the child care center may result in court action against the parents and a
fine of up to $25.00 per day of violation.
For health reasons this child should not receive the following immunizations __________(List in STEP 2 any immunizations already
received)
______________________________________________________________________
Physician’s Signature Required
For religious reasons this child should not be immunized. (List in STEP 2 any immunizations already received)
For personal conviction reasons this child should not be immunized. (List in STEP 2 any immunizations already received):
SIGNATURE
STEP 5
To the best of my knowledge, this form is complete and accurate.
_________________________________________________________________________ ___________________________________
SIGNATURE - Parent, Guardian or Legal Custodian Date Signed
18 Register at www.sheboygancountyymca.org/camp-y-kodaCAMP Y-KODA INFORMATION
SUMMER CAMPS AT
CAMP Y-KODA SITE
ABOUT CAMP Y-KODA
Camp Y-Koda is an 80-acre camp located just west of CONTACT US!
Sheboygan Falls bordered by the Sheboygan River to the
north and east. The camp was founded in 1969 by the General Office: (920) 467 - 6882
Sheboygan County YMCA and has been offering summer Fax: (920) 467 - 7240
camp experiences ever since. Camp Y-Koda features a
beautiful stretch of the Sheboygan River for canoeing, Jeremiah Dentz, Executive Director
kayaking, tubing and nature studies. The property has a jdentz@sheboygancountyymca.org
low and high ropes course complete with a zip line and 40-
foot climbing wall.
Kaitlyn Rautmann, Summer Camp Director
YMCA Camp Y-Koda also features a swimming pool, 4-acre krautmann@sheboygancountyymca.org
lake, bb gun and archery range, basketball and volleyball
courts, playground, soccer field, arts and crafts center and Terese Koene-Carroll, Billing & Registration
camp store, and a huge slip and slide. There are two lodges tcarroll@sheboygancountyymca.org
at camp, Lohmann Lodge and Johnsonville Lodge. They
serve as headquarter areas during inclement weather, our
cafeteria and lodging for resident camps and other indoor LOCATION
programming. Camp has four campsites which include YMCA Camp Y-Koda
cabins, a picnic and campfire area. In addition, Camp has W3340 Sunset Road, Sheboygan Falls, WI 53085
a new pavilion area named the Denison Pavilion, which
houses our Pee Wee campers and is a site for snack and
camp activities. HOURS OF OPERATION
Summer Camp Hours.............8:30am - 4:00pm
Summer Office Hours............7:15am - 5:30pm
About
The office is staffed all night during Thursday night Camp Y-Koda
sleepovers and all resident camps.
Contact
Information
Location
Hours of
Operation
Register early and save 19PEE WEE CAMPS WEEKS 1 - 11
Ages 4 - 5
This program is designed especially for young children to enjoy a great
camp experience. The Pee Wee program is run by its own director who
develops age appropriate curriculum and activities. We pay special
attention to our youngest campers to make sure that their first camp
experience is a positive one. Pee Wees will attend the Family Program,
CAMP Y-KODA PEE WEE CAMPS
but won’t sleep over. All Pee Wee Camps have a theme each week.
PEE WEE “KICKOFF TO SUMMER” CAMP WEEK 1
Let’s get into the swing of summer by simply experience all
Camp Y-Koda has to offer. Swimming, sand castles, arts &
crafts, shelter building and more while meeting other fellow
campers. This is a great way to begin our summer vacation!
PEE WEE “LITTLE CHEF” CAMP WEEK 2
Together campers will learn some easy-to-make and easier-
to-eat recipes! We’ll craft our very own cookbook and cook
delicious treats for our Thursday bake sale, which will be
sold at our Thursday Night Family Program.
PEE WEE “ZOOKEEPER” CAMP WEEK 3
If your child loves animals, then this is the right camp for
them. It’s going to be zootastic and zooperb! Bring your
roar and prepare to go where the wild things are! Mid-week
we’ll join the Amazing Animals camp for a field trip to a zoo!
PEE WEE “LIL ATHLETE” CAMP WEEK 4
It’s time for an action-packed week of teamwork and FUN!
T-ball, soccer, basketball, kickball, relay races, swimming,
you name it... we’ll play it!
PEE WEE “SPLISH SPLASH” CAMP WEEK 5 PEE WEE “LITTLE FARMER” CAMP WEEK 7
Splish, splash you’ll have a blast in all things water! Experience the old time country farm lifestyle during a week
Throughout the week, we’ll splash into the pool with games, of camp farm fun. Learn about caring for animals, planting,
go down the camp slip n’slide and head to the beach for harvesting, cooking and more. There will be lots of farm
more. On Friday, we’ll have our very own pool party! theme activities, crafts and fun for everyone!
PEE WEE “OOEY GOOEY CREATIONS” CAMP WEEK 6 PEE WEE “BEACH BASH” CAMP WEEK 8
Get ready for some ooey gooey fun! Find your inner Einstein Let’s take our group to the beach at camp! Campers will
while making goo, slime and more. We’re sure to get our make awesome sand art, do a little limbo and play beach
hands ooey and gooey this week! games. The fun in the sun never stops!
PEE WEE “STORYBOOK” CAMP WEEK 9
Join us for a week long celebration of reading! Each day, we
will discover a different storybook and our activities will be
designed around the theme of our story! On Friday, we’ll
have our very own dress-up day!
Pee Wee Camps
for Ages 4 - 5 PEE WEE “UNDER THE SEA” CAMP WEEK 10
Get ready to take a splash under the sea by discovering sea
creatures, swimming and spending time at the camp lake.
We’ll learn more about animals that live in the sea such as
sharks, octopuses, fish, sea plants and so much more!
PEE WEE “LET’S GO CAMPING” CAMP WEEK 11
Let’s create the best camping experience while simply being
at camp! We’ll sing campfire songs, create crafts, make
s’mores, go hiking and more. At the end of the week, we’ll
pitch our tents and have our very own mini camp out!
Check-out page 2 to find ways
to save on your child’s camp fees!
20 Register at www.sheboygancountyymca.org/camp-y-kodaCAMP Y-KODA DAY CAMP & SPECIALTY CAMPS
DAY CAMP
Ages 6 - 13 WEEKS 1 - 11
Day Camp is one of the best ways to
experience the fun of Camp Y-Koda! Think of it
as the “sampler” of all the different camp activities.
On any given day during the week, campers may
participate in archery, boating, climbing wall, fishing,
fort building, nature studies, team building and so much
more. The Day Camp activity schedule changes each week.
Campers are placed into groups with similarly aged
children. It is a great way for your child to find out which
activities they enjoy most so their next camp experience
can be a specialty camp to focus on their favorite skill
CAMP Y-KODA WEEKS or activity. PLEASE READ: Day Care Licensing only
Week 1.........6/13 - 6/17 allows archery and sling shots for age 7 and
Week 2.........6/20 - 6/24 older, bb guns for age 9 & older, &the
Week 3........... 6/27 - 7/1 climbing wall for age 9 & older.
Week 4...............7/5 - 7/8
Week 5.........7/11 - 7/15
Week 6.........7/18 - 7/22
Week 7.........7/25 - 7/29
Week 8..............8/1 - 8/5
Week 9........... 8/8 - 8/12
Week 10.......8/15 - 8/19
Week 11....8/22 - 8/26
SPECIALTY CAMPS
All specialty camps are designed around a specific theme or skill. Specialty camp instruction is
in the morning Monday - Thursday. In the afternoon, campers will partake in traditional camp
activities. Selected camps will have specialty camp instruction on Friday also. Throughout
the week, campers may participate in the “all camp” activities, versus their specialty activity.
Some specialty camps take off-site trips that may involve further instruction and therefore
more hours. In addition, some camps may require a completed waiver form.
MERMAIDS & TRITONS CAMP WEEK 2 GREAT UNBIRTHDAY CAMP WEEK 8
Ages 5 - 7 Ages 5 - 8
Now’s your chance to make a splash and have your dream Why celebrate your birthday only for a day, when you can
come true! Our mermaids and tritons will explore life under come to camp and party all week where it’s everyone’s
the sea with mermaid games, finding lost treasures, building birthday! Our birthday week includes cupcake decorating,
sand castles, designing our own crowns and tritons, and craft making, birthday slime, making party necklaces and
most importantly having fun while making friends. For our more. To sprinkle on the fun, campers will partake in their
Thursday overnight, we will make the Johnsonville Lodge very own birthday party Thursday to eat their delicious
an under water palace while watching the movie The Little treats and enjoy classic birthday party games.
Mermaid. This is sure to be a popular camp, don’t wait to
sign up!
Day Camp
WATER STRIDERS CAMP WEEK 4 for Ages 6 - 12
Ages 5 – 7
This camp is designed to build confidence in the water and Specialty Camps
teach basic skills and strokes through games and lessons for Ages 5 - 8
in a fun summer camp setting. Campers will have two hours
of dedicated pool time each day with a certified swim
instructor. This is the perfect camp for beginners or young
swimmers who simply like to spend time in the pool.
Register early and save 21You can also read
