Ymca Belle Plaine School Day Out Fun Club Enroll Form
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1BELLE PLAINE
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.
Oct 16
Jan 4, 18
Nov 25
Feb 15
Participants are not required to attend a regular School Age
Mar 25
Child Care (SACC) program. However, online KDHE forms
must be completed at , and
No program offered: 10/2, 10/30, 3/4
a registration form must be received three (3) business
Winter & Spring Break Camp signups available on a separate form
days prior to attendance.
Space is limited, and registrations are processed in the order
DROP-OFF & PICK-UP
received. Register in person at any YMCA location (directors
Goddard Explorer Elementary, 444 S 167th St W
may not accept registrations at SACC or SDO sites).
Northwest YMCA, 13838 W 21st N
Full payment is required two (2) working days prior to the day
South YMCA, 3405 S Meridian | North YMCA, 3330 N Woodlawn
of camp. Payment is non-refundable, non-transferable.
Valley Center at West Elementary, 501 N Sheridan
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
Greater Wichita YMCA
$25 for Community Participant
|
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 available on a separate form
Age: _____
Grade: _____
Gender: _____
2015:
Oct 16
Nov 25
School Name: __________________________________
2016:
Jan 4
Jan 18
Feb 15
Mar 25
Parent/Guardian: _______________________________
Drop-off Location:
Northwest YMCA
(11/25, 1/4, 1/18)
Goddard Explorer
(3/25)
Work Phone: ___________________________________
South/North YMCA
(10/16, 11/25, 1/4,
1/18, 2/15)
Home Phone: ___________________________________
VC at West Elementary
(10/16, 2/15, 3/25)
Email: _________________________________________
Y Member/District Teacher:
Yes
No
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 057ANDSEP26
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