Camp Shaver 2010 Camper Registration
Please fill out one registration form for each camper/CIT/LIT
* Camper's Name
* Date of Birth (Month/Day/Year)
Age
* Street Address
* City:
State:
* Zip:
Camper Email Address:
Parent Email Address:
* Gender
# of Previous Years at Camp?
Last Year's Counselor
School Attending in Fall 2009
Grade
Father's Name
Mother's Name
With Whom Does Camper Live?
* Home Phone Number
Father's Work Number
Mother's Work Number
* Emergency Contact Name (other than parent)
* Emergency Contact Phone
Cabin Mate Request (Limit one, must be mutual)
How did you hear about YMCA Camp Shaver?

           *  Does camper have any special needs? Yes No

In order to meet camper’s needs please list any mental and/or physical disabilities or behavior disorders. This includes, but is not limited to, breathing difficulties, learning disabilities, ADHD, Communication skills, visual or hearing difficulties, physical impairments, etc.

New Pricing for 2010

NOTE: Sessions 1 & 2 have a special discounted price this year, so sign up early for a great deal!
(2nd and 3rd child discounts do not apply for Sessions 1 & 2)

Why three prices: Realizing that families have differing abilities to pay for a camp experience, we have instituted a voluntary 3-tier pricing program. Please take a moment to look at the rate descriptions and determine which one your family is able and willing to pay for your child’s camp experience. This is strictly an honor system: select the fee and dates that are right for your family. This program is voluntary and in no way influences the experience children receive. Prices include youth program membership.

Choose the camp fees that best suit your families ability to pay.

  • Rate A- This fee is based on the actual cost to operate camp programs including wear and tear and depreciation...............$525
  • Rate B-This fee is partially subsidized for those families who cannot afford the actual cost of camp.....................................$475
  • Rate C- This is our traditionally subsidized rate and does not reflect the true cost of operating camp programs....................$425
    We have additional financial assistance available for those who need it. (Financial aid forms can be obtained at any YMCA branch)
Please choose the sessions and activities below that this camper is registering for:

TRADITIONAL CAMP - AGES 7-14
FULL
 Session 1 June 6 - 12
FULL
 Session 2 June 13 - 19
Session 3 June 20 - 26
Session 4 June 27 - July 3
FULL
 Session 5 July 11 - 17
(Session Full)
Session 6 July 18 - 24
Session 7 July 25 - 31
Session 8 August 1 - 7

Climb On! (Optional for Session 4 and 8 ONLY)
Climb On! Is for campers Age 13-15 years old. The whole week is focused on climbing, rappelling, and high ropes. We recommend that campers are in reasonable shape and have some experience climbing. The fee for this program is in addition to regular camp fee.
Climb On! is $100
(this option is only for those
signed up for Session 4 or 8):

Counselor-In-Training (CIT) Age 16(rising junior)
CIT’s are volunteer positions and must submit a Volunteer application as well as registration form.
Fill in dates you would like to attend
(max 5 weeks):

Leader-In-Training (LIT) Age 15 (rising sophomore)
* All LIT sessions are 3 weeks
LIT 1 June 6 - June 26
$850
LIT 2 July 11 - Jully 31
$850

Mandatory Camper Agreement
Please have the camper read these questions and check the "YES" box if he/she is in agreement. If "NO" is checked, you will be contacted by a Camp Shaver staff member to discuss any issues.
  1. I want to be a camper at YMCA Camp Shaver.
  2. I will do my best to live by all of the camp rules.
  3. I will do my best to make my time at camp a good experience for myself and my fellow campers.
  4. I understand that failure to live up to the above may result in my dismissal from camp.
Does the camper agree to these questions?
 Yes No
Mandatory Parent/Guardian Agreement

Please have the parent/guardian read these questions and check the "YES" box if he/she is in agreement. If "NO" is checked, you will be contacted by a Camp Shaver staff member to discuss any issues.

  1. I agree to have my camper examined by a physician within 6 months prior to attending camp.
  2. I understand that my deposit of $75 per session is non-refundable.
  3. All other camp fees are due two weeks prior to the beginning of the camp session attending.
  4. In case of accident or illness, the Camp Director has my permission to secure medical attention if unable to contact me immediately.
  5. I agree that YMCA Camp Shaver is released from liability in connection with medical treatment and
    unavoidable accidents.
  6. My child has my permission to leave the camp grounds with authorized Camp Staff for scheduled trips and outings.
  7. I fully understand the inherent risks involved in activities my child will be choosing. I accept all risks including those activities preliminary and subsequent to the chosen activities.
  8. I give my permission for my child’s picture to be used in YMCA Camp Shaver promotional material.
  9. The Camp Director reserves the right to decline the application of any child, or send home any child who, according to the director’s discretion, is not a desirable associate for the other campers, or puts themselves or others at risk.
  10. All campers will receive a camp T-shirt upon completion of the last session they are signed up for. The camp store will be open on opening and closing day for additional cash purchases.
Does the parent/guardian agree to these questions?
Yes No
Parent Packet - Important Information!
There is important information for you in the 2010 Parent Packet on our Camp Shaver website. Please download and print this file immediately. You can find it under the Downloads section of the Camp Shaver site on the bottom right side of the home page. For special situations, we can send your packet in the mail. Please click the button below if you need us to mail your packet.

I will print my own Parent Packet    Please mail my Parent Packet to the address I provided above

Payment Options
Your payment options will be listed on the following page after you Submit your form.