Ymca Goddard School Day Out Fun Club Enroll Form
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1GODDARD
SCHOOL DAY OUT FUN CLUB
AGES
REGISTRATION INFORMATION
Kindergarten - Age 12
The YMCA offers licensed child care for students when school
is not in session, excluding major holidays. Each School Day
DATES
Out (SDO) Fun Club features a variety of fun, educational and
2015
2016
physical activities.
Sept 28
Jan 4*, 18*
Oct 21, 22
Feb 1, 24, 25
Participants are not required to attend a regular School Age
Nov 6, 25*
Mar 25
Child Care (SACC) program. However, online KDHE forms
must be completed at , and
a registration form received three (3) business days
*Camp held at Northwest YMCA, 13838 W 21st N
YMCA will have no child care options available on Oct 23 and Feb 26.
prior to attendance.
Winter & Spring Break Camp signups on a separate form.
Space is limited, and registrations are processed in the order
received. Register in person at any YMCA location (directors
DROP-OFF & PICK-UP
may not accept registrations at SACC or SDO sites).
Explorer Elementary, 444 S 167th St W
Full payment is required two (2) working days prior to the day
Northwest YMCA, 13838 W 21st N
of camp. Payment is non-refundable, non-transferable.
6:30am/6:00pm
A minimum of 10 participants is required to provide all-day
care. If 10 children do not enroll, parents/guardians will be
CONTACT
notified no less than two (2) days prior to day camp.
Jon McReynolds, 264-1610 ext. 5535
Late registrations are assessed a $10 per day late fee. All late
registrations must be pre-approved by Jon McReynolds at
264-1610 ext. 5535 and will be based on availability.
COST PER DAY
NOTICE: All persons authorized to pick up a child must be
$10 SACC Participant
prepared to show identification (no exceptions).
$15 for YMCA Member/District Teacher
$25 for Community Participant
Greater Wichita YMCA
|
ACTIVITIES & WHAT TO BRING
Include your email below to receive specific information.
Child’s Name: __________________________________
Enroll for the following dates (check all that apply):
Winter & Spring Break Camp signups on a separate form.
Age: _____
Grade: _____
Gender: _____
2015:
Sep 28
Oct 2 1
Oct 22
Nov 6
Nov 25
School Name: __________________________________
2016:
Jan 4
Jan 18
Feb 1
Parent/Guardian: _______________________________
Feb 24
Feb 25
Mar 25
Work Phone: ___________________________________
Drop-off Location:
Explorer Elementary
(9/28, 10/21, 10/22, 11/6,
2/1, 2/24, 2/25, 3/25)
Northwest YMCA
(11/25, 1/4, 1/18)
Home Phone: ___________________________________
Y Member/District Teacher:
Yes
No
Email: _________________________________________
Current SACC Participant:
Yes
No
Community Participant:
Yes
No
List any allergies for child:
_____________________________________________
_____________________________________________
OFFICE USE ONLY: PROGRAM CODES
All SACC accounts must be current to participate. Complete SACC enrollment packet
_____________________________________________
must be on file. Sample codes will follow this format:
13SEP 057GODDSEP26
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