YES!

Teen Trip
Free ASYMCA Field Trip for Military Teens Ages 13 to 15

Dear Military Families,

The San Diego Armed Services YMCA is proud to invite your child to the YES! Teen
program. To confirm your child’s participation, registration forms and a refundable
twenty dollar deposit (cash/or check only) must be submitted to the Armed Services
YMCA at 3293 Santo Rd, San Diego, CA, 92124 before July 1, 2009.

Each refundable deposit will be available for return to parent signing below the final day
of the last registered YES! outing. Should the family fail to cancel their child’s space at
least two weeks prior to the outing or the child not attend, the deposit will be considered a
donation to the non profit Armed Services YMCA.

I have read the YES! Parent Guidebook and understand the YES! polices and program
information.

_______________________________________________ __________________

Parent Signature Date

Child Name: _______________________________ Gender: __________ Age: _______

Active Duty Sponsor Name:___________________ Branch: __________ Rank: _______

OFFICE USE ONLY: COMPLETE UPON RETURN OF DEPOSIT

__________________ __________________________________________

Date Deposit Returned Signature

YES! Teen Outing 2009 California Disney Adventure Park

July 30, 2009
Drop off: 8:00 a.m. Pick up: 7:30 p.m.
3293 Santo Road San Diego 92124 – Playground

The San Diego Armed Services YMCA is excited to provide a summer program
exclusively for teens! Military teens will have the opportunity to explore Southern
California through a day long excursion to Disney California Adventure Park.

www.militaryymca.org 858-751-5755
 Youth and Community Outreach Department
Release of Liability Form: Adults and Minors

Parent/Guardian Name(s) (print)______________________________________________________________________

Parents Date(s) of Birth (same order)__________________________________________________________________
Address________________________________City_________________Zip____________Military Housing? Yes/NO
Email Address________________________________________Service Branch_____________________Rank______
Home Phone__________________________Work__________________________Cell__________________________
Emergency Contact________________________________________________________________________________
EC Home Phone_______________________EC Work_______________________EC Cell_______________________
Minor Children Participating:
Name______________________________________________________________Date of Birth___________________
Name______________________________________________________________Date of Birth___________________
Name______________________________________________________________Date of Birth___________________
Activity or Group____________________________________________________Date(s)________________________
Location_________________________________________________________________________________________

I, the undersigned parent/person having legal custody/guardianship of the above said minor, give permission for the
minor to participate in the San Diego Armed Services YMCA program described above. The minor is physically able
and mentally prepared to participate in all activities as described in the announcement for the program. I hereby
voluntarily and knowingly assume all risks and dangers inherent and incidental to the activities of the program. I will
not hold the San Diego Armed Service YMCA liable for any injuries incurred during the program or while my
child(ren) is/are in transit to and from the program whether caused by equipment or the act or omissions of others
excepting damage or injury solely caused by the willful misconduct or negligence of the San Diego Armed Services
YMCA, or its employees, volunteers, or agents.

I do hereby authorize the San Diego Armed Services YMCA as agent for the undersigned, to consent with respect to
the minors, to any x-ray examination, anesthetic, medical, dental, or surgical diagnosis or treatment, and hospital
care which is deemed advisable by, and is to be rendered under general or special supervision of, any physician
and surgeon licensed under the provisions of the California Medical Practice Act on the medical staff of any hospital,
whether such diagnosis or treatment is rendered at the office of the physician or at the hospital. I understand that
the San Diego Armed Services YMCA is not responsible for costs incurred for medical care. If I participate in the
program, whether as coach, instructor, aide, spectator, or participant, I presently waive as to the San Diego Armed
Services YMCA and staff, officers and directors thereof, any claim presently known or unknown for damage to
property or personal injury whether caused by equipment or the acts or omissions of others including San Diego
Armed Services YMCA personnel.

My Child(ren) will _____ Walk Home _____Be picked up. Person(s) who may pick up child(ren)____________________

_______YES My child(ren) can receive a healthy snack _______NO My child(ren) cannot receive a healthy snack

Food Allergies, if any:______________________________________________________________________________

****Parent/Guardian (Signature)____________________________________Date___________________****

I hereby grant full permission for my child and/or myself to be photographed by the San Diego Armed Services YMCA
staff for any legitimate purpose without payment or compensation.

****Parent/Guardian (Signature)____________________________________Date___________________****
 Immunization History:
Are all Immunizations up to date?: ˆYES ˆNO Date of Last Tetanus Shot (if known):

Ethnicity ˆ Black/Afr. American ˆ Asian/Pac Islander ˆ Hispanic/Latino

(for statistical reporting only) ˆ White/Caucasian ˆ Native American ˆ Other:____________________
THIS SECTION TO BE COMPLETED IF CURRENTLY UNDER
DOCTOR’S CARE, OR *ASTERISK-HEALTH CONDITION CHECKED
ON FRONT OF THIS FORM
Note: A Doctor's written authorization is only required if the camper has a history of Asthma, Heart Defect/Disease,
Seizures, Diabetes, has been recently hospitalized, or is currently under a Doctor's care. If so, complete this section.

Health Examination by Licensed Physician

Child's Name: Birthdate: Sex:

Parent's Name:
Because of this camper's medical history, we have asked that your written authorization be provided prior to their attendance at
YMCA Camp. Please realize that camp is held at either mountain (4300 feet elevation) or oceanfront settings. The programs are
very active, with strenuous hiking, games, swimming and camp activities. Your careful consideration is appreciated.

I have examined the child named on this form within the past two years. Date Examined:

After examination and my review of his/her health history, it is my opinion that this person is physically able to engage in
camp activities, except as noted below.

Height: Weight: Blood Pressure:

Is the applicant under the care of a physician for any conditions? o Yes o No Please explain:

Any specific activities to be encouraged or limited by physician's advice?:

Any medically prescribed meal plan or dietary restrictions:

Any treatment or medications to be continued at camp (please give specific dosages):

Any allergies? (Food, drugs, plants, insects, etc):

Additional health information:

Licensed Physician Signature: Date:

Address: Phone:

Date of Form Completion: By:

 PARENT
GUIDEBOOK
Free Day Trips for Military Youth
YES!
It is tough being a kid these
days – particularly when
dealing with the stress of
belonging to a military family.
Our Youth Development
programs help kids cope while
providing them with positive,
fun opportunities to get to
know themselves and each
other.
San Diego Armed Services YMCA
3293 Santo Road, San Diego, CA 92124
YES! (Youth Enrichment Summer)
outings afford children in military
This Parent Guidebook has
useful information to prepare
families, the opportunity to your child for YES! as well as
explore a variety of Southern an overview of YES! policies
California attractions.
and procedures. Please take
time to review this with your
The Armed Services YMCA is
child and get excited about
delighted to offer the YES!
program for the third consecutive YES!
summer to San Diego military
kids. YES! youth trips, for children
ages 7 to 12, include a day at
YMCA Camp Surf and the Wild Contents:
Animal Park.
Staff & Activities 2
New this summer, a YES! teen trip
for kids ages 13 to 15 to Disney’s
California Adventure Park will be Preparing for YES! 3
a great chance for military teens
to meet and connect over the YES Policies 4
summer!
Visit our website www.militaryymca.com for more information on
the over 40 free programs and services available to your family!
 YES! Staff
YES! staff are full time Armed
Services YMCA Youth and
Community Outreach (YCO)
staff members that want to host
an awesome summer packed
with fun, adventure, and
exploration!

Our staff is passionate about

supporting military youth and

YES! Outings:
take pleasure in maintaining a
structured, educational
program in an atmosphere of
fun and excitement.
Disney’s California Adventure Park The ASYMCA takes seriously
July 30th the importance of child
protection and safety. We have
Teens 13-15 years: specific, tested policies and
Military teens explore Southern California and connect procedures for all staff that
with other military teens through a day long excursion work with children.
to Disney’s California Adventure Park. Experience
great adventures! The following are some of our
proven safety practices:

San Diego Wild Animal Park 1. The ASYMCA has comprehensive

pre-employment screening for
August 6th & August 27th staff members and program
volunteers, including interviews,
reference and nation-wide
Kids 7-12 years: criminal history checks.
Journey into Africa at the San Diego Wild Animal Park,
make new friendships, and have a blast learning 2. All staff members regularly
exploring this educational attraction with other military work with school aged youth in
kids! Discover animal adaptations, explore different informal educational settings
habitats, and get hands-on with scientific experiments. and are certified in pediatric
First Aid and CPR.

YMCA Camp Surf

August 13th & August 20th

Kids 7-12 years:

Kids will have a blast learning fun new activities
including archery, wall climbing, boogie boarding and
surf lessons. Children will have a water training and
safety course prior to water activities and will be closely
supervised by both Camp Surf lifeguards and ASYMCA
staff when they are in the water.
 YES! Staff
Preparing for YES!
YES! Clothes
YES! is fun. Occasionally fun can also mean messy! Dress Karena Vigliotti: Program Director
your child in old clothes so they are ready to play hard and Beginning her third summer at the
get dirty! Children are required to wear closed toed shoes Armed Services YMCA, Karena comes
and socks daily and should arrive to YES! with sunscreen to us from Massachusetts and is a
already applied. Remember, YES! Is not a fashion show! graduate of St. Lawrence University
with a degree in Psychology. Her
What to Bring energy,
It is recommended that you send your child with a enthusiasm,
backpack to keep all their belongings together. All and love for
belongings should be labeled with your child’s name working with
before sending to camp. Please also be sure your camper children of all
has sunscreen and a sweatshirt. ages has made
her time at the
What not to Bring Armed Services
Children may not bring electronic devices (cell phones, YMCA a
digital cameras, iPods, video games), toys, jewelry, or tremendous
money to Camp Hero. The Armed Services YMCA is not thrill. Karena discovered a love for
responsible for any items that are lost or stolen. camp her first week at the Armed
Services YMCA and is excited to see
YCO youth summer programs grow!
Deposits

YES!
Andrea Fields: Program Leader
YES! registration forms and a Andrea joined the YCO staff last
twenty dollar refundable deposit summer for YES! and is excited to
will be required to register. begin her second summer at the
Deposits will be available for Armed Services YMCA. A Southern
return to parents the final day of California native, summer has always
YES! Eligibility the last registered YES! outing. been her
YES! is open to children of military Should the family fail to cancel favorite season!
service members from all service their child’s space at least two Andrea is a
branches. The military service weeks prior to the outing or the senior at San
member must be rank E6 or below child not attend, the deposit will Diego State
and assigned to a San Diego be considered a donation to the University,
military installation or San Diego non profit Armed Services YMCA. pursuing a
based ship. Children must be degree in
between seven and twelve years
Emergency Procedures Women’s Studies and Social Work.
old by August 1st to be eligible for Contacting YES! Kids She looks forward to directing her
Youth YES! and between thirteen passion for empowering youth and
If you should need to reach your
and fifteen years by August 1st for child during YES! please call our their families into meaningful summer
Teen YES! There will be no age programs for military youth.
front desk at 858-751-5755. They
exceptions. Priority will be given will take your message and get the Lyndsay Calhoun: Program Leader
to children who have not information to your child. Starting her first summer at the
participated in 2009 Operation Children are not permitted to Armed Services YMCA, Lyndsay is a
Outdoors. bring cell phones to YES! San Diego native and graduate of
University of
Financial Contributions Child Illness or Injury
California, San
The Armed Services YMCA is If your child becomes ill at YES!
Diego with a
proud to provide over 40 free our staff will contact you to pick
degree in
programs to San Diego military them up. Please have
Sociology. Her
service members and their families arrangements to do so in a timely passion to reach
each month. Should you wish to manner. If you child is injured
children of all
make a contribution to the Armed staff will take whatever steps are ages through
Services YMCA in support of necessary to obtain medical care.
education and recreation, has
programs like YES! you may do so If we are unable to reach you and brought her to the ASYMCA from
by sending your donation to the your child needs medical attention
they will be transported to the Vilseck, Germany where she worked
Armed Services YMCA at 3293 with military youth and their families.
Santo Road, San Diego, CA 92124 hospital by an ambulance. All She is eager and ready to embark on
or call 858-751-5755 for more expenses for emergency medical
the fun exploration of Southern
information. care are the responsibility of the
California!
parent.
Field Trip
Transportation
YES! participants will travel by
Armed Services YMCA buses.
The following are some of our
transportation safety practices:
1. Each bus driver is a Armed
Services YMCA staff member who
has completed comprehensive
pre-employment screening
including interviews, drug and
alcohol testing, and reference
and nation-wide criminal history
checks.
2. Each driver is required to perform
a pre-trip inspection for their bus
before transporting passengers.
3. Each Armed Services YMCA bus is
outfitted with seat belts and
routinely inspected by the
California Highway Patrol.
We do our best to maintain a reliable
schedule of departure and arrival times
and accomplish all planned activities.
Please do your part to help by arriving
on time to YES! and ready for the day’s
activities. We appreciate your
understanding that trips are subject to
change as necessary for health or safety
of the participants and staff.
Important Times
8:00 a.m.
YES! opens for drop off
8:30 a.m.
Buses begin leaving for field trips
4:00 p.m.
Buses return from youth YES!
4:30 p.m.
Youth YES! Pick Up
7:15 p.m.
Buses return from teen YES!
7:30 p.m.
Teen YES! Pick Up
Camp Policies Behavior Management
Guidelines
Drop Off It is the Armed Services YMCA’s
YES! opens for drop off at 8:00 goal to provide a healthy, safe,
and secure environment for all day
a.m. each day. YES! buses begin
to leave at 8:30 a.m. YES! camp participants. Children who
participants that arrive after field attend the program are expected
trip transportation has departed to follow the behavior guidelines
can not be accommodated. based on the four core values and
to interact appropriately in a
Pick Up group setting.
All YES! participants must be
picked up and signed out by an Behavior Guidelines:
adult listed on the authorized pick- 1. We will care for ourselves and
up list. Please show courtesy to for those around us.
YES! staff by arriving promptly for 2. Honesty will be the basis for
pick up. YES! participants not all relationships and
picked up within 30 minutes of the interactions.
schedule pick up time will be 3. People are responsible for
supervised by ASYMCA staff and their actions.
every attempt will be made to
contact parents and emergency
4. We respect each other and the
environment.
contacts. If within an hour the
parents are not reachable, Child Our staff is trained and is expected
Protective Services will be called. to resolve behavior problems in a
positive manner. In the event
Attendance problems persist the child may be
YES! is a full day experience. YES! suspended or dismissed from the
participants that are late, or YES! program. Some acts may
absent will be dismissed from result in immediate suspension or
remaining YES! outings. Deposits dismissal including but not limited
will not be refunded for those to: fighting, intentionally harming
dismissed from YES! If you child is others, theft, and possession of
for whatever reason not able to weapons or drugs. Deposits will
attend please contact the Armed not be refunded for those
Services YMCA as soon as possible dismissed from the program due
so that a waitlist child can be to a behavior problem.
invited.