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CCCAP Summer Day Camp

Summer Day Camp Week(s)











Please press "enter" to start a new line of text after each child's name
Please press "enter" to start a new line of text after each child's name
Please press "enter" to start a new line of text after each child's DOB
COVID-19 WAIVER 

NOTICE: THIS IS A LEGALLY BINDING AGREEMENT. Read this document carefully and in entirety. By signing this agreement, you give up your right to bring a court action to recover compensation or obtain any other remedy for any personal injury or property damage however caused arising out of your participation in YMCA of the Pikes Peak Region’s Programs and Activities, now or at any time in the future.  Acknowledgment of Risk  I hereby acknowledge and agree that participation in any YMCA of the Pikes Peak Region’s activities and programs comes with inherent risks. I have full knowledge and understanding of the inherent risks associated with participation in YMCA of the Pikes Peak Region’s activities and programs, including but in no way limited to: (1) slips, trips, and falls, (2) aquatic injuries, (3) athletic injuries, and (4) illness, including exposure to and infection with viruses or bacteria. I further acknowledge that the preceding list is not inclusive of all possible risks associated with YMCA of the Pikes Peak Region’s activities and programs participation and that said list in no way limits the operation of this Agreement. Coronavirus / COVID-19 Warning & Disclaimer Coronavirus, COVID-19 is an extremely contagious virus that spreads easily through person-to-person contact. Federal and state authorities recommend social distancing as a means to prevent the spread of the virus. COVID-19 can lead to severe illness, personal injury, permanent disability, and death. Participating in YMCA of the Pikes Peak Region programs or accessing YMCA of the Pikes Peak Region’s facilities could increase the risk of contracting COVID-19. YMCA of the Pikes Peak Region in no way warrants that COVID-19 infection will not occur through participation in YMCA of the Pikes Peak Region’s programs of accessing YMCA of the Pikes Peak Region’s facilities.  Waiver, Release, Indemnification & Covenant Not to Sue  In consideration of my participation in YMCA of the Pikes Peak Region’s activities and programs, I, _(Participant Name captured below), the undersigned participant, agree to release and on behalf of myself, my heirs, representatives, executors, administrators, and assigns, HEREBY DO RELEASE YMCA of the Pikes Peak Region, its officers, directors, employees, volunteers, agents, representatives and insurers (“Releasees”) from any causes of action, claims, or demands of any nature whatsoever including, but in no way limited to, claims of negligence, which I, my heirs, representatives, executors, administrators and assigns may have, now or in the future, against YMCA of the Pikes Peak Region on account of personal injury, property damage, death or accident of any kind, arising out of or in any way related to the use of YMCA of the Pikes Peak Region’s facilities/equipment or participation in YMCA of the Pikes Peak Region whether that participation is supervised or unsupervised, however the injury or damage occurs, including, but not limited to the negligence of Releasees.  In consideration of my participation in YMCA of the Pikes Peak Region’s activities and programs, I, the undersigned participant, agree to INDEMNIFY AND HOLD HARMLESS Releasees from any and all causes of action, claims, demands, losses, or costs of any nature whatsoever arising out of or in any way related to my participation.  I hereby certify that I have full knowledge of the nature and extent of the risks inherent in YMCA of the Pikes Peak Region’s activities and programs participation and that I am voluntarily assuming said risks. I understand that I will be solely responsible for any loss or damage, including personal injury, property damage, or death, I sustain while participating in YMCA of the Pikes Peak Region’s activities and programs and that by signing this agreement I HEREBY RELEASE Releasees from all liability for such loss, damage, or death. I further certify that I am in good health and that I have no conditions or impairments which would preclude my safe participation in YMCA of the Pikes Peak Region’s activities and programs.  Also, In an effort to mitigate the spread of COVID-19, I hereby give permission for my temperature to be taken and recorded in a HIPAA compliant manner for public health purposes.
PARENT FEE AGREEMENT 

Please read the following information carefully. You will be held accountable for the following policies:  

I understand that as a CCCAP participant, I am responsible for the proper authorization(s) needed for the programs I attend. I understand that I will only be registered for programs that I am authorized for as well as the dates that I am authorized for. 

I understand that as a CCCAP participant I am responsible for checking in and out of the ATS system daily. In the event that I do not check in and out, the YMCA can hold me accountable for payment for each day that I do not check in and out. 

I understand that as a CCCAP participant, I must notify the YMCA via email at [email protected] of any absences or changes in care needed immediately as the YMCA must report non-attendance and cancellation to the CCCAP office within 3 days. 

If I have a Parent Fee:
1. I understand that my account will automatically be set up to draft on the 5th of the month.
2. I understand that if my child attends one day out of the month that I will be required to pay the full parent fee. I understand that credits/refunds will NOT be given due to inclement weather closures.  
3. I understand that if my bank or credit card account number is changed, I must contact the child care office no later than five days before the draft date of the 5th of the month.
4. I understand that my child may be removed from a YMCA program for failure to pay parent fees in a timely manner.  

Returned Payments:
I understand that if my payment is returned, my payment will be reprocessed with the payment method I have on file the following Friday. I understand that the YMCA will contact me via email to collect payment. I understand that if payment is not made in full before the 15th of the month, my child will be removed from the roster for the remainder of the summer.

CCCAP Before & After School Care

Please press "enter" to start a new line of text after each child's name
Please press "enter" to start a new line of text after each child's name
Please press "enter" to start a new line of text after each child's DOB
COVID-19 WAIVER 

NOTICE: THIS IS A LEGALLY BINDING AGREEMENT. Read this document carefully and in entirety. By signing this agreement, you give up your right to bring a court action to recover compensation or obtain any other remedy for any personal injury or property damage however caused arising out of your participation in YMCA of the Pikes Peak Region’s Programs and Activities, now or at any time in the future.  Acknowledgment of Risk  I hereby acknowledge and agree that participation in any YMCA of the Pikes Peak Region’s activities and programs comes with inherent risks. I have full knowledge and understanding of the inherent risks associated with participation in YMCA of the Pikes Peak Region’s activities and programs, including but in no way limited to: (1) slips, trips, and falls, (2) aquatic injuries, (3) athletic injuries, and (4) illness, including exposure to and infection with viruses or bacteria. I further acknowledge that the preceding list is not inclusive of all possible risks associated with YMCA of the Pikes Peak Region’s activities and programs participation and that said list in no way limits the operation of this Agreement. Coronavirus / COVID-19 Warning & Disclaimer Coronavirus, COVID-19 is an extremely contagious virus that spreads easily through person-to-person contact. Federal and state authorities recommend social distancing as a means to prevent the spread of the virus. COVID-19 can lead to severe illness, personal injury, permanent disability, and death. Participating in YMCA of the Pikes Peak Region programs or accessing YMCA of the Pikes Peak Region’s facilities could increase the risk of contracting COVID-19. YMCA of the Pikes Peak Region in no way warrants that COVID-19 infection will not occur through participation in YMCA of the Pikes Peak Region’s programs of accessing YMCA of the Pikes Peak Region’s facilities.  Waiver, Release, Indemnification & Covenant Not to Sue  In consideration of my participation in YMCA of the Pikes Peak Region’s activities and programs, I, _(Participant Name captured below), the undersigned participant, agree to release and on behalf of myself, my heirs, representatives, executors, administrators, and assigns, HEREBY DO RELEASE YMCA of the Pikes Peak Region, its officers, directors, employees, volunteers, agents, representatives and insurers (“Releasees”) from any causes of action, claims, or demands of any nature whatsoever including, but in no way limited to, claims of negligence, which I, my heirs, representatives, executors, administrators and assigns may have, now or in the future, against YMCA of the Pikes Peak Region on account of personal injury, property damage, death or accident of any kind, arising out of or in any way related to the use of YMCA of the Pikes Peak Region’s facilities/equipment or participation in YMCA of the Pikes Peak Region whether that participation is supervised or unsupervised, however the injury or damage occurs, including, but not limited to the negligence of Releasees.  In consideration of my participation in YMCA of the Pikes Peak Region’s activities and programs, I, the undersigned participant, agree to INDEMNIFY AND HOLD HARMLESS Releasees from any and all causes of action, claims, demands, losses, or costs of any nature whatsoever arising out of or in any way related to my participation.  I hereby certify that I have full knowledge of the nature and extent of the risks inherent in YMCA of the Pikes Peak Region’s activities and programs participation and that I am voluntarily assuming said risks. I understand that I will be solely responsible for any loss or damage, including personal injury, property damage, or death, I sustain while participating in YMCA of the Pikes Peak Region’s activities and programs and that by signing this agreement I HEREBY RELEASE Releasees from all liability for such loss, damage, or death. I further certify that I am in good health and that I have no conditions or impairments which would preclude my safe participation in YMCA of the Pikes Peak Region’s activities and programs.  Also, In an effort to mitigate the spread of COVID-19, I hereby give permission for my temperature to be taken and recorded in a HIPAA compliant manner for public health purposes.
PARENT FEE AGREEMENT 

Please read the following information carefully. You will be held accountable for the following policies:  

I understand that as a CCCAP participant, I am responsible for the proper authorization(s) needed for the programs I attend (before & after school, adventure days/break camps, summer day camp). I understand that I will only be registered for programs that I am authorized for as well as the dates that I am authorized for. 

I understand that my registration for before & after school does not automatically register me for adventure days and break camps. I understand that prior registration via email is required to attend all break camps and adventure days. 

I understand that as a CCCAP participant I am responsible for checking in and out of the ATS system daily.  In the event that I do not check in and out, the YMCA can hold me accountable for payment for each day that I do not check in and out. 

I understand that as a CCCAP participant, I must notify the YMCA via email at [email protected] of any absences or changes in care needed immediately as the YMCA must report non-attendance and cancellation to the CCCAP office within 3 days. 

If I have a Parent Fee:
1. I understand that my account will automatically be set up to draft on the 5th of the month.
2. I understand that if my child attends one day out of the month that I will be required to pay the full parent fee. I understand that credits/refunds will NOT be given due to inclement weather closures.  
3. I understand that if my bank or credit card account number is changed, I must contact the child care office no later than five days before the draft date of the 5th of the month.
4. I understand that my child may be removed from a YMCA program for failure to pay parent fees in a timely manner.  

Returned Payments:
I understand that if my payment is returned, my payment will be reprocessed with the payment method I have on file the following Friday. I understand that the YMCA will contact me via email to collect payment. I understand that if payment is not made in full before the 15th of the month, my child will be removed from the roster for the remainder of the school year.

CCCAP Interest B&A

Have you ever been authorized by CCCAP?

Are you currently authorized by CCCAP?

 

Before and after school cancellation form

Summer day camp Cancellation Form

Please remember the $20 deposits are non-refundable.
kids playing ball

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