1. Please Keep the first two informational pages of this
registration package for your own information!!
2. Dear Parents,
Thank you for registering your daughter for our GirlSpace Day Camp. We here at the YWCA
appreciate your continued support. The following is information for you as parents as well as the
information we need for licensing purposes. You will need to complete and sign the attached form for
the GirlSpace Day Camp. The form must be into me on or before June 15, 2012. Registration is open to
girls between the ages of 8 -13 years old.
Information for parents:
Location: Northern United Place
Times: Drop off – 11:45 am – 12:15 pm NO EARLIER AS WE ONLY HAVE ACCESS TO THE SPACE AT
NOON
Pick up – 4:45 pm – 5:00 pm PLEASE ENSURE YOUR DAUGHTER IS PICKED UP BEFORE 5 PM
Cost: FREE
3. Items your child has to have every day:
Indoor foot wear (no slippers, heals or slipper soled shoes)
Walking shoes
Sunscreen & bug spray
Water bottle
Outdoor clothing (hats, sweaters, rain jackets)
Play clothes (clothes that are okay to get dirty during craft time and outdoor time)
We may require other items on set days according to outings and other themed activities but we will
let you know accordingly.
If your child arrives at the program without the above items the child will not be permitted to stay
until they have these items.
LUNCH: We will not be serving lunch. However, if you wish to drop off your child with their lunch, this
is fine, she can eat it during the designated drop off time (11:45 am – 12:15 pm)
We will be doing outings in the community and hope that the children will have a great time at our
GirlSpace Day Camp program. Please keep in mind that if your child misbehaves on an outing they will
not be allow to attend the next community outing which means you will need to pick them up at those
set times. We hope this does not happen but do need to keep you as parents notify of the rules.
Contact # for GirlSpace Day Camp
Program Site phone: 445-7606 (during program hours)
Ashley, Coordinator GirlSpace Program- 920-2777 ext. 311 (office line)
Janette, Director Child & Youth Services- 445-5745
Fax 920-4105
If you have any questions or concerns please call me at 873-4293.
________________________________________
Janette Morris, Director Child & Youth Services
4. Permission Slip
Parents/Guardians:
I ___________________ the parent/guardian of ___________________
give my permission for my daughter to attend any and all offsite
activities with the YWCA GirlSpace Day Camp program and its staff.
This permission slip will be used for the children attending the
GirlSpace Day Camp program which runs from July 2nd, 2012 – July
26th, 2012.
__________________________
Parent/Guardian Signature
5. Photo Release
The YWCA of Yellowknife seeks your support in its efforts to highlight the work of the GirlSapce
program. We have hired a professional photographer, Kirsten Murphy, to take pictures. YWCA
Yellowknife therefore requests your permission to include pictures of your child/children in our
publications. Our publications include slide shows, posters, brochures, our website, our annual
report, banners and other displays. Our publications are used for educational, promotional and
informational purposes in connection with the YWCA.
I give my permission to the YWCA of Yellowknife and Kirsten Murphy
Photography to use pictures of my child/children in publications for educational,
promotional and informational purposes, as described above.
_____Yes, I give consent . _____No, I do not give consent.
Your name (please print): _________________________________
Your child/children’s names (please print):
1._________________________ 2. _____________________________
Your signature: _______________________________________________
6. Date: _____________________________________________________
Registration Information
Child’s Name: _______________________________________ Gender: _________
Date of Birth: ______________________ Health Care Number: _________________
Medical Conditions/Allergies: ___________________________________________
Parents/Guardians Name:_______________________________________________
Home Address: ___________________________ Home Telephone No.: _______________
Parent/Guardians place of business: ________________________________________
Business/Cell phone Number:_________________________________________________
Parent/guardian E-Mail:________________________________________________________
Pick Up Information
Regular Pickup person (Name, relationship & phone #);
The following person MAY NOT pick up my child (ren):
7. If a child’s parent is not allowed to pick up her we will require a copy of the custody or
restraining order.
Emergency Information
Emergency Contacts, other than parents/guardians:
Name: _______________________________________________
Address: ____________________________________________
Phone Numbers:
Home: _____________________________ Other: ________________________
Child’s Physician: ____________________________________________
Physician’s Phone Number: _____________________________________
Are your child’s immunizations current? _______________________________
If your child has allergies, please list them and the reactions:
_____________________________________________________________________
Medication that’s taken on a regular basis, also specify for medical condition:
Are there any other medical issues we should be aware of? If so, please note
them:
8. Please state any other concerns/comments that we should be aware of:
____________________________ ____________________________
Parent/Guardian Director, Child & Youth Services
Date: __________________ Date: ________________
9. This July’s GirlSpace Day Camp will adhere to the f ollowing schedule.
Participants may register f or which week( s) they wish to attend. Attending ever y
week is not mandatory. Part icipants may register f or all f our weeks if they
choose—providing there is spa ce available. Groups are limit ed in size —so
register as ear ly as possible to ensure your daughter can par ticipate. There is
no cost f or participants . Each week has its own theme, with activities and
outing tailor ed to its theme.
Nature’s Art Box: Connect with nature! This week will focus on being good stewards of the earth,
and we will make many crafts with its resources. Examples of activities include hikes, swimming,
camping at Fred Henne**, and lots of crafts!
Social Activism Week: Learn about our rights and responsibilities. Learn about different social issues
that affect girls and all people, here and abroad. Learn how to support a cause, and see how other
children around the world have supported social causes. This week will involve a small fundraising
project (bake sale, lemonade stand, car wash etc), and the proceeds will be donated to a cause of
the girls’ choice. The girls will also have the opportunity to do some volunteer work. Of course, there
will also be lots of crafts, outings and fun!
Get Up and Go! – This is the physical education week. The emphasis will be put on physical
activities. Activities may include jump rope, hiking, yoga, walking, swimming, parks, etc. We will
learn about lots of fun ways to stay active and not rely on electronic gadgets for fun! This will be
supplemented with community outings, crafts, and girl power!
Little Chefs Week – This week will involve cooking or baking a meal/snack each day. We will learn
about healthy eating habits, kitchen safety, fun and easy recipes, and supplement this with lots of
other fun, games, crafts, and outings!
**Stay tuned for more details on the camping trip to Fred Henne. This is currently
unconfirmed!
My daughter would like to attend (please check each week that she will be attending):
Nature’s Art Box (July 2-6th)
Social Activism Week (July 9-13th)
Get Up and Go! (July 16-20)
