FULL DAY HOURS: 7:3OAM – 6:00PM

KINDERGARTEN TO GRADE 8 LOCATED AT MEADOWLANDS YMCA FACILITY

YOUR CHILD’S HEALTH & SAFETY IS OUR TOP PRIORITY!We follow all CDC, local health department and licensing guidelines and are working in partnership with our school districts to follow health, safety, cleaning, and PPE protocols.

Students should bring their chrome books, headphones, school work, water bottle, snack and lunch; no glass bottles please.

Meadowlands YMCAFULL DAYSCHOOL AGE CHILDCARE

Andrea FernandezSenior Director of Childcareafernandez@meadowlandsymca.org

201.955.5300 x258SACC@MeadowlandsYMCA.org

2, 3, and 5

day options

390 MURRAY HILL PKWYEAST RUTHERFORD NJ 07073

Child Information (One Form For Each Child)

2020-2021 MEADOWLANDS YMCA FULL DAY SCHOOL AGE CHILDCARE REGISTRATION FORMPlease print and send form to Meadowlands YMCA with the following fees. You will receive an e-mail from CampDoc to setup your account. Child must be registered prior to attending the program. We’re excited to offer you a more convenient way of providing us important information about your student. The former “Parent Pack” will be replaced with the online CampDoc system, which will allow us to: Quickly access important health and safety info on your student. Carry over information year-to-year. Provide an easier process for parents/guardians

PROGRAM DETAILSThe program operates when school is in session and is available immediately after school even on scheduled School Calendar early dismissal days, however, if school is in session and is suddenly closed due to inclement weather or for any other reason, the program will not be open. The program will begin the first day of school and continue until the last day of school.

FINANCIAL ASSISTANCEWe’re committed to helping everyone achieve their potential. As a result of our Annual Support Campaign, financial assistance is available for those needing help paying for the cost of a YMCA program or membership.

To apply for financial assistance, please contact Jane Hansen JHansen@meadowlandsymca.org

First Name _______________________________________________ Last Name ________________________________ Age ________________ Gender q M / q F

Address___________________________________________________________________________________________________ Date of Birth_____________________________

City ______________________________________________________, NJ Zip______________________________ Grade (as of 9/1/2020)________________________

Mother (Guardian) Name ______________________________________________________________________________ Date of Birth____________________________

Email_____________________________________________________________________________________________________________________________________________________

Home Phone______________________________ Work Phone______________________________ Cell Phone_________________________________________________

Father (Guardian) Name _______________________________________________________________________________ Date of Birth____________________________

Email_________________________________________________________Home Phone______________________________ Work Phone_____________________________

_______________________________________Date____/____/____ Signature

PAYMENT METHOD

q Visa qMasterCard q American Express q Cash q Check # __________

Credit Card Number Exp. Date Security Code

__________________________________________________ __________________________________________________Print Name as it appears on Credit Card Sign Name as it appears on Credit Card

Mail to Meadowlands YMCA 390 Murray Hill Parkway East Rutherford, NJ 07073

Email to SACC@meadowlandsYMCA.org

THANK YOU FOR BEING PART OF THE Y FAMILY.

PAYMENT OPTION I authorize the Meadowlands YMCA to bill the RECURRING MONTHLY TUITION to this credit/debit card on the tuition due dates until May 15, 2021. I assume all responsibility to notify the YMCA in writing of any changes that may affect this agreement.

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PLEASE CHECK DAYS OF THE WEEK

Full Day Care q M q T q W q Th q F

7:30AM - 3:30PM

# Days First Child (monthly) Additional Child(ren) (monthly)

2 $384 $346

3 $576 $518

5 $960 $864

7:30AM - 6:00PM# Days First Child (monthly) Additional Child(ren) (monthly)

2 $480 $438

3 $720 $648

5 $1200 $1080

FEES PRICE A. Annual Registration $ 30 B. First Month Tuition $o

Total Enclosed $o

A Message from our Senior Director of Childcare: ANDREA FERNANDEZThe childcare team at the YMCA is excited for another year of serving our community’s children and families. We have proudly and successfully hosted childcare throughout the COVID-19 pandemic since March in our facility without shutting. We will continue to implement the strict procedures mandated by the state of NJ to keep everyone as safe and healthy as possible.Please contact me with questions or concerns. ANDREA F.