Early Childhood Education

Enrollment Packet, 2017-18

KENOSHA YMCA

ENSURE A BRIGHTER FUTURE

DIRECTIONS

Below you will find our Early Childhood Education Program Enrollment

Packet. This packet must be completed and turned in when registering

your child for the KENOSHA YMCA ECE.

For your convenience we have created fields that will allow you to

complete the forms on your computer. Be sure to complete ALL areas. Once

completed you will have to print them to sign and return.

Should you have any questions please contact LISA ECKARDT at

262.654.9622 ext. 236 or via email at leckardt@kenoshaymca.org.

Thank you and we look forward to serving your family!

KENOSHA YMCA

7101 53rd Street, Kenosha WI 53144

P 262 654 9622 F 262 653 9886

WWW.KENOSHAYMCA.ORG The Kenosha YMCA (Young Men’s Christian Association) is a 501(c)(3) charitable organization under the Internal Revenue Code,

thereby qualifying for maximum deductibility. An audit report will be provided upon request.

Early Childhood Program

2017-2018 School Year Dear Parents,

WOW!!! It’s time to make plans for the upcoming school year already!

In this packet are the forms necessary to begin the enrollment process. Registration begins May 5th and ends on

August 25th. The packet contains:

___Enrollment Form

___Health History & Emergency Plan

___Annual Attendance Contract or Payment Schedules (monthly agreements)

___Transportation Agreement

___Immunization Record (all ages) and Health Report (4yrs and younger)

___Household Size Income Statement Signed and Dated / CACFP Information

___Authorization to Administer Medication if Applicable

___Parent Policy Book Read and Last Page Signed and Returned

___New Enrollment Fee Paid

___Payment #1 Due 8/25/17 (first 2 weeks of attendance)

***Payment Due Dates for the 2017-2018 school year is for yours to keep

Your child(ren) will officially be enrolled when ALL forms are completed and turned in along with payment in full for

the first 2 weeks of attendance (Payment #1 Due 8/25/17). The Enrollment Fee of $50.00 per child is due at time of

registration for new students only. We have two age groups in our Early Childhood Program. Our Tykes & Tots are for

ages 2-3 yrs and our Preschool Playmates are for ages 4-5 yrs. There is a difference in pricing for these age groups.

Our 2 yr old rate is different than our 3-5 yr old rate. Please be advised your 3 yr old will be placed in our Tykes &

Tots group but you will only be charged the 3-5 yr old rate.

Payments can be made via check, on-line (requires email contact information), at the School to your Site Director,

Kenosha YMCA Member Service Desk, or set up as automatic withdrawal (please indicate on Registration Form so that

we can get this set up).

If you have any questions, please do not hesitate to contact either myself or Lisa Eckardt (Office Assistant

leckardt@kenoshaymca.org or 262.654.9622 ext. 236).

We look forward to building relationships with your kids and helping to meet the needs of your family.

Dr. M. Rachel Burton, Youth and Family Director

rburton@kenoshaymca.org

262.654.9622 ext. 238

Gender (circle) First Day of

Attendance

Last Day of

Attendance

/ / / /

DOB Age

Both Parents Mother Father Grandparent(s) Guardian

Physician Name

Please fill out in Blue or Black Ink ONLY!

7101 53rd St. Kenosha, WI 53144

Kenosha YMCA Early Childhood Program2017-2018

kenoshaymca.org - 262-654-9622 -

Child's Full Name:

**NOTE: All parents/guardians will be permitted to visit during center hours and pick up the child unless access is prohibited or restricted by a court order**

PARENT OR GUARDIAN (provide the information requested for EACH parent or guardian.)

Address (City, State & Zip code required) Telephone #

Program Attending:

Work Name & Address Work # Email Address

Legal Guardian #2 First and Last Name

Work Name & Address Work # Email Address

Cell #

Preferred Medical Facility - Please select one or write in other:

Aurora Medical - 100400 75th St. Kenosha Hospital - 6308 8th Ave. St. Catherine's - 9916 75th St. Other _________________________

I hereby give my consent for emergency medical care or treatment, to be used ONLY if I cannot be immediately reached.

Signature of Parent or Guardian Date

Contact when parent/guardian cannot be reached who can receive information on your child and are authorized as a pick-up person that staff can release your child into his/her care)

AUTHORIZED PEOPLE TO CALL & EMERGENCY CONTACT FOR YOUR CHILD. (Provide additional names & information for people authorized to:

Address (City, State & Zip code required)

Contact #1 First and Last Name Home #

Relationship to child

Cell #

I have had an opportunity to review the policies of the day care center and a summary of the Wisconsin Rules for Licensed Day Care Centers. YES NO

Contact #2 First and Last Name Home # Cell #

Signature of Parent or Guardian Date Signed

Please Attach any documentation (court order, etc.) to back up all custody concerns.

Legal Guardian #1 First and Last Name

I have been informed of pets in the center and their degree of contact with the enrolled children. YES NO

Note: If pets are added after a child is enrolled, parents shall be notified in writing prior to the pet’s addition to the center.

*Transported Field Trips always require an additional permission slip. This slip will include all details of the field trip.

I give permission for my child to participate in Field Trips and other activities during operating hours. Walking YES NO Transported* YES NO

Address (City, State & Zip code required) Relationship to child

Child lives with: (select one)

SPECIAL CUSTODY CONCERNS: → This Section MUST be signed even if there are NO concerns ←

Address

Home #

Cell #

Address (City, State & Zip code required)

Address (City, State & Zip code required) Home #

Signature of Parent or Guardian Date

PHYSICIAN & MEDICAL FACILITY INFORMATION

Phone #

Are there any custody concerns regarding this child that we need to be aware of while the child is in our care?

Yes No If YES, please explain:

HEALTH HISTORY & EMERGENCY CARE PLAN

NAME (Last, First & MI):

COMPLETE HOME ADDRESS:

TELEPHONE #: DOB: 1st Day of Attendance:

NAME (Last, First & MI): CELL: WORK #:

NAME (Last, First & MI): CELL: WORK #:

PHYSICIAN NAME: MEDICAL FACILITY ADDRESS: PHONE #:

1. Check any special medical conditions that your child may have: NONE

Physical Handicapps Epilepsy/Seizure Disorder Asthma Diabetes

Cerebral Palsy / Motor Disorder Emotional / Behavior Disorder including ADD, ADHD, or ODD (please check)

Gastrointestinal or Feeding Concerns Including Special Diet and Supplements

Other condition(s) requiring special care, please specify:

2. Does your child have any allergies?

Food Allergies: No

Non-Food Allergies: No

IF YES, fill out a - e. Attach additional information if needed. If NO, skip to #3.

a. Triggers that my cause problems, please specify:

b. Sign or Symptoms to watch for, please specify:

c. Steps the child care provider should follow:

d. When to call parents regarding symptoms or failure to respond to treatment:

e. When to consider that the condition requires emergency medical care or reassesment:

3. Is there additional information that may be helpful to the child care provider? NONE

Yes, specify:

4. Does your chld take any medication? (This information is needed for emergency purposes, even if not taking while in program.)

Please list:

Identify any child care staff to whom you have given specialized training or instructions to help treat symptoms.

a.

b.

c.

d.

5. I will provide sunscreen & insect repellant for my chld when applicable. I give permission to the Kenosha YMCA staff to apply or

assist in applying sunscreen & insect repellant to my child daily. YES NO

YES NO

7. Insurance Company: Policy #:

8. Name of policy holder: Group #:

Signature of Parent or Guardian Date Signed (mm/dd/yyyy)

a. b. c. d.Review Dates:

SUNCREEN & BUG REPELLANT

Suncreen Brand & SPF:Insect Repellant Brand:

MEDIA RELEASE

6. I hereby release, consent and authorize the Kenosha YMCA and its agents to use my child's photograph/likeness/voice,

as it pertains to their participation with the Y, in any manner for promotional efforts without expectation of or right to any

reimbursement in connection with its use.

INSURANCE INFORMATION

CHILD'S INFORMATION

PARENT / GUARDIAN INFORMATION

PHYSICIAN/MEDICAL FACILITY INFORMATION

Yes, specify food(s): _____________________________________________________

Yes, specify: ____________________________________________________________

(initials)

(initials)

(initials)

(initials)

I have read the Kenosha YMCA Program Policy booklet and agree to abide by the policies stated

therein. This includes paying weekly fees 2 weeks BEFORE services are rendered OR Wisconsin

Shares copays. I understand services will be declined without payment.

B. Agreement To Participate On-Site

I will transport and sign my child in/out of the Kenosha YMCA Early Childhood Ed. Program on

the days I have indicated on the Annual Attendance Agreement/Monthly Payment Schedule.

Parent/Guardian Email Address: ______________________________________________________________________________________________________________

D. Parent Swimming Assessment

Additional swimming information: _ _ _______________________________________________________________________________________________________________________________

( ↑ Please √ check mark the most accurate assessment ↑ )

Cannot Swim Beginner Swimmer Intermediate Swimmer Strong Swimmer

I have observed that my child ______________________________________________,

has the following swimming ability.

2016-2017 Policy & Transportation AgreementYouth & Family Department

Child’s Name: _______________________________________________________________________________________________________________________________________________________________________________________________________________

A. Policy Agreement

Please share your email address with us for important program updates as well as online

payment sign up.

(must be completed in order for your child to be able to swim at the Kenosha YMCA while in the BASP Program)

Signature of Parent or Guardian Date Signed

C. Agreement To Participate & Transportation Agreement to the Kenosha YMCA

I will allow the Kenosha YMCA to transport my child to the Callahan Family Branch during the

Before & After School Program hours on the days indicated/posted at the school my child

attends. I give permission for my child to attend ALL activities.

S:\MARKETNG\YOUTH & FAMILY FORMS\2017-2018\Early Childhood\ECE Attendance Contract.doc

2017-2018 Annual Attendance & Payment Contract Early Childhood Program

Child’s Name: ____________________________________________________ Child’s Age:

1. I understand that the hours listed below are my contracted days and I am responsible for bi-weekly payments of contracted fees despite actual attendance. Additional charges will apply for additional days, however. Fees not paid in advance wi ll result in declined services. Failure to abide by this may also result in additional fees. I understand I will not receive adjustments in fees for absences, illnesses, and emergency/weather related closures (unless approved by the Early Childhood Coordinator).

2. I understand if my schedule and child care needs change, I will need to fill out a new Contract. I also understand if my

schedule changes often enough I may be asked to use Monthly Payment Schedules and forfeit the benefits of an Annual Attendance Agreement.

3. I am aware of my child’s scheduled hours at the center and agree to bring and sign my child in and out on time and

call in the event that my child will be absent. 4. A written notice from the parent/guardian of withdrawal from the center is required at least two weeks prior to the last day of

attendance. Failure to comply will result in a two week surcharge. 5. I understand that I will earn 5 flex days per school year, per child after the first month of attendance. I will attempt to give a

two week notice prior to using any flex days. Unused days will not be carried forward to the following year’s allotment. Refunds will not be issued in exchange for flex days. If my schedule changes often, I understand I forfeit my flex days and will be required to fill out a Monthly Payment Schedule.

6. My child’s enrollment may be terminated for failure to abide by this contract, failure to pay fees by required due date, failure to

follow center policies and procedures as outlined in the Policy & Information Booklet or failure to comply with DHFS license requirements.

7. I understand that the services indicated below are my child’s contracted services in the Early Childhood Program:

Fees based on individual child care needs. Minimum of 2 options required. Member or Multiple child/ General Public Rate

PROGRAM 2 years 3-5 years MON TUES WED THURS FRI

Half Day $26/ $31 $23/ $28

□ Half Day

□ Full Day

Arrival Time:

_______

Departure Time:

_______

□ Half Day

□ Full Day

Arrival Time:

_______

Departure Time:

_______

□ Half Day

□ Full Day

Arrival Time:

_______

Departure Time:

_______

□ Half Day

□ Full Day

Arrival Time:

_______

Departure Time:

_______

□ Half Day

□ Full Day

Arrival Time:

_______

Departure Time:

_______

Full Day $38/ $43 $35/ $40

By signing below, I agree to adhere to the above Annual Attendance Agreement & Payment Contract and will take the appropriate steps if other arrangements need to be met.

Parent/Guardian Signature: __________________________________________________ Date: ______________________ Office Use Only: Enter date the sick/ vacation day was used. Day 1_______Day 2_______Day 3_______ Day 4_______Day 5_______

DEPARTMENT OF HEALTH SERVICES Division of Public Health F-44192 (Rev. 09/08)

DAY CARE IMMUNIZATION RECORD

STATE OF WISCONSIN ss. 252.04,Wis. Stats.

COMPLETE AND RETURN TO DAY CARE CENTER . State law requires all children in day care centers to present evidence of immunization against certain diseases within 30 school days (6 calendar weeks) of admission to the day care center. These requirements can be waived only if a properly signed health, religious, or personal conviction waiver is filed with the day care center. See “Waivers” below. If you have any questions on immunizations or how to complete this form, please contact your child’s day care provider or your local health department. PERSONAL DATA PLEASE PRINT STEP 1 Child’s Name(Last, First, Middle Initial)

Date of Birth (Month/Day/Year) Area Code/Telephone Number

Name of Parent/Guardian/Legal Custodian (Last, First, Middle Initial)

Address (Street, Apartment number, City, State, Zip)

IMMUNIZATION HISTORY

STEP 2 List the MONTH, DAY AND YEAR the child received each of the following immunizations. DO NOT USE A (4) OR (X) except to indicate whether the child has had chickenpox. If you do not have an immunization record for this child, contact your doctor or local public health department to obtain the records.

TYPE OF VACCINE First Dose Month/Day/Year

Second Dose Month/Day/Year

Third Dose Month/Day/Year

Fourth Dose Month/Day/Year

Fifth Dose Month/Day/Year

Diphtheria-Tetanus-Pertussis (Specify DTP, DTaP, or DT)

Polio

Hib (Haemophilus Influenzae Type B)

Pneumococcal Conjugate Vaccine (PCV)

Hepatitis B Measles-Mumps-Rubella (MMR)

Varicella (chickenpox) vaccine Vaccine is required only if the child has not had chickenpox disease.

Has the child had Varicella (chickenpox) disease? Check the appropriate box and provide the year if known. Yes year _____________________ (Vaccine is not required) No or Unsure (Vaccine is required)

REQUIREMENTS

STEP 3

The following are the minimum required immunizations for the child’s age/grade at entry. All children within the range must meet these requirements at day care entrance. Children who reach a new age/grade level while attending this day care must have their records updated with dates of additional required doses.

AGE LEVELS NUMBER OF DOSES 5 months through 15 months 2 DTP/DTaP/DT 2 Polio 2 Hib 2 PCV 2 Hep B 16 months through 23 months 3 DTP/DTaP/DT 2 Polio 3 Hib1 3 PCV2 2 Hep B 1 MMR3 2 years through 4 years 4 DTP/DTaP/DT 3 Polio 3 Hib1 3 PCV2 3 Hep B 1 MMR3 1 Varicella At Kindergarten entrance 4 DTP/DTaP/DT 4 4 Polio 3 Hep B 2 MMR3 2 Varicella

1If the child began the Hib series at 12-14 months of age, only 2 doses are required. If the child received one dose of Hib at 15 months of age or after, no additional doses are required. Minimum of one dose must be received after 12 months of age (Note: a dose 4 days or less before the first birthday is also acceptable).

2If the child began the PCV series at 12-23 months of age, only 2 doses are required. If the child received the first dose of PCV at 24 months of age or after, no additional doses are required.

3MMR vaccine must have been received on or after the first birthday (Note: a dose 4 days or less before the 1st birthday is also acceptable). 4Children entering kindergarten must have received one dose after the 4th birthday (either the 3rd, 4th or 5th) to be compliant (Note: a dose 4 days or less before the 4th birthday is also acceptable).

COMPLIANCE DATA AND WAIVERS

STEP 4

IF THE CHILD MEETS ALL REQUIREMENTS (sign at STEP 5 and return this form to the day care center), OR IF THE CHILD DOES NOT MEET ALL REQUIREMENTS (check the appropriate box below, sign and return this form to day care center).

Although the child has not received all required doses of vaccine for his or her age group, at least the first dose of each vaccine has been received. I understand that it is my responsibility to obtain the remaining required doses of vaccines for this child WITHIN ONE YEAR and to notify the day care center in writing as each dose is received.

NOTE: Failure to stay on schedule or report immunizations to the day care center may result in court action against the parents and a fine of up to $25.00 per day of violation.

For health reasons this child should not receive the following immunizations __________(List in STEP 2 any immunizations already received) ______________________________________________________________________ Physician’s Signature Required

For religious reasons this child should not be immunized. (List in STEP 2 any immunizations already received)

For personal conviction reasons this child should not be immunized. (List in STEP 2 any immunizations already received):

SIGNATURE

STEP 5

To the best of my knowledge this form is complete and accurate. ____________________________________________________________________________ ______________________________________ SIGNATURE - Parent, Guardian or Legal Custodian Date Signed

DEPARTMENT OF CHILDREN AND FAMILIES dcf.wisconsin.gov/ Division of Early Care and Education

DCF-F-CFS0060-E (R. 07/2013)

CHILD HEALTH REPORT – CHILD CARE CENTERS

Use of form: Use of this form is voluntary; however, completion of this form meets the requirements of DCF 202.08(4), DCF 250.07(6)(L)3.,

and DCF 251.07(6)(k)3. Failure to comply with these rules may result in issuance of a noncompliance statement. Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04(1)(m), Wisconsin Statutes].

Instructions: Each child under 2 years of age shall have an initial health examination not more than 6 months prior to nor later than 3 months after being admitted to the center and a follow-up health examination at least once every 6 months thereafter. Except for a school-aged child, each child 2 years of age or older shall have an initial health examination not more than one year prior to nor later than 3 months after being admitted to a center and a follow-up health examination at least once every 2 years thereafter. The parent / guardian shall give this form to the physician, physician assistant or HealthCheck provider to be completed, signed and dated. The licensee shall obtain a copy for the child’s record. Note: Children are also required to have on file at the child care center documentation of immunizations; it may be helpful if the parent / guardian were to include a copy of the child’s immunization record when submitting this form to the child care center.

PARENT OR GUARDIAN – Complete this section. Name – Child (Last, First, MI)

Birthdate – Child (mm/dd/yyyy)

Address – Child (Street, City, State, Zip Code)

Name – Parent or Guardian (Last, First, MI)

Address – Parent or Guardian (Street, City, State, Zip Code)

HEALTH PROFESSIONAL – Complete this section. Instructions for feeding and care of child with special problems, including allergies – Specify (attach information as necessary).

Yes No Does the child have a milk allergy? If “Yes”, identify the recommended milk substitute.

Date of most recent blood lead test: (mm/dd/yyyy). Note: Children on Medicaid are required to be tested at

around ages 12 months and 24 months or once between the ages of 3 and 5 years if no previous test is documented. Lead testing is optional for children who are not on Medicaid.

Immunization(s) not to be administered to child due to medical reason(s) – Specify.

AUTHORIZATION

I certify that I have examined the above child on this date and that he / she is able to participate in child care activities.

Name – MD, PA or HealthCheck Provider (type or print)

Address (Street, City, State, Zip Code)

SIGNATURE – MD, PA or HealthCheck Provider Date of Examination

Dosage Time Prescription

YES NO From: To:

YES NO From: To:

YES NO From: To:

YES NO From: To:

YES NO From: To:

Date Time

I HEREBY AUTHORIZE ADMINISTRATION OF THE FOLLOWING MEDICATION(S) TO MY CHILD BY STAFF OF THE

KENOSHA YMCA YOUTH & FAMILY DEPARTMENT. (INSTRUCTIONS: Place form in child's file when medication is no longer

required.)

D.O.B: ___________________________________________________Child's Name: ___________________________________________________________________________

Dates for Medication to be givenName of Medication

AUTHORIZATION TO ADMINISTER MEDICATIONYouth & Family Department

Medication Log

Name & Dosage of MedicationPerson Administering

Medication

Signature of Parent or Guardian: Date Signed:

Special Instructions:

Date Time Name & Dosage of MedicationPerson Administering

Medication

For Group Child Care & Outside of School Hours Centers                                                       FFY 2018, Rev. 6/17 

http://dpi.wi.gov/community‐nutrition/cacfp/child‐care/memos: Guidance Memorandum 1C 

HOUSEHOLD SIZE—INCOME STATEMENT An adult household member must complete this form (HSIS) and return it to the center.  

First and Last Name(s) of Enrolled Child(ren)  Center

PART 1:  BENEFITS If any member of your household currently receives FoodShare Wisconsin, Wisconsin Works Cash Benefits, and/or FDPIR (Food Distribution Program on Indian Reservations), check the box for the benefit currently received and list the case number.                         Then, complete PART 3 and return HSIS to the center. Do not complete PART 2.  

If no one receives these benefits, go to PART 2. 

  FoodShare Wisconsin (10 or 16 digit  #)         Wisconsin Works Cash Benefits (10 digit #)            FDPIR (9 digit #) 

Case Number/Quest Card Number:  ___________________________________________ If only receiving W‐2 Child Care Assistance, do not list a case number; you must complete Part 2 of this form for eligibility determination.

PART 2:  TOTAL HOUSEHOLD SIZE AND INCOME 1)  List full names of all household members, including yourself and all children.  (Ages are optional.) 2)  List all gross income (before deductions or taxes, social security, etc) on the same line as the person who receives it. Self‐employed 

household members should report net income. Check the box for how often it is received. Record each income only once.   If you listed a case number in Part 1, you do not need to list household and income information below. 

 

Check if 

Foster  Child 

2)  List gross income and how often it is received 

Checkif no 

income

Gross income from work  W

eekly 

Every 2 W

eeks 

Twice per Month 

Monthly 

Annually 

Welfare Payments,

Child Support,and/or Alimony  W

eekly 

Every 2 W

eeks 

Twice per Month 

Monthly 

Annually 

Pensions, Retirement,   

Social Security, SSI, VA benefits  W

eekly 

Every 2 W

eeks 

Twice per Month 

Monthly 

Annually 

All Other Income 

Received Last Month (indicate 

frequency)

1)   List full names of all household members below   Age 

    $  $   $             /___

    $  $   $             /___

    $  $   $             /___

    $  $   $             /___

    $  $   $             /___

    $  $   $             /___

PART 3:  ALL HOUSEHOLDS 

ETHNICITY AND RACE DATA COLLECTION – Completion is optionalThis center is required by Federal law to ask the following two questions concerning ethnicity and race. Your answers are strictly for statistical reporting and will have no effect on determination of eligibility for benefits. Please answer both questions.  IS YOUR CHILD(REN) HISPANIC OR LATINO?     Yes, Hispanic or Latino          No, neither Hispanic nor Latino 

SELECT ONE OR MORE OF THE FOLLOWING CATEGORIES THAT APPLY TO YOUR CHILD(REN):   American Indian or Alaska Native   Black or African American   White    Asian   Native Hawaiian or Other Pacific Islander    

ADULT HOUSEHOLD MEMBER SIGNATURE AND LAST FOUR DIGITS OF SOCIAL SECURITY NUMBER (SS#)If Part 2 is completed, the adult signing the form must list the last four digits of his/her SS# OR check “None” if he/she does not have a SS#. I CERTIFY that all of the above information is true and correct and that all income is reported. I understand that this information is being given for the receipt of federal funds; that agency officials may verify the information on this form; and that deliberate misrepresentation of the information may subject me to prosecution under applicable state and federal laws.

Signature of Adult Household Member   Signature Date Mo./Day/Yr.  Last 4 digits of SS# (or check “None” if you do not have a SS#)

***‐**‐__ __ __ __       None 

FOR CENTER USE ONLY – All 3 sections and the Effective Month of Determination must be completed 

Section 1: Basis of Determining Eligibility (A or B) 

Section 2:Eligibility Determination 

Section 3:Determining Official’s Initials  & Approval Date

A.  Household Size & Income 

Total Household Size ________ 

*Total Income $_________/______                                      ($ Amount)           (Time Period) 

B. Benefits/Foster 

 FoodShare WI 

 W‐2 Cash Benefits

FDPIR 

Foster Child(ren)

    Free                                     

  Reduced 

   Non‐Needy 

______________________

**Effective Month of Determination 

____________________________ Month/Year 

*Convert to yearly income only when multiple pay frequencies are reported:  Weekly x 52; Every 2 weeks x 26; Twice a month x 24; Monthly x 12 **This form expires one year from the Effective Month of Determination.  

Child and Adult Care Food Program 

Chrissie

Typewritten Text

Kenosha YMCA:

Payment # Payment Due Date Dates of Service Total Amount Due

***PLEASE KEEP THIS FORM FOR YOUR REFERENCE***

Youth & Family Department

BASP & ECE Payment Due Dates 2017-2018

1 August 25th 2017 9/5/17 to 9/15/17 $

6 November 10th 2017 11/13/17 to 11/24/17 $

9/18/17 to 9/29/17 $

3 September 29th 2017 10/2/17 to 10/13/17 $

5 October 27th 2017 10/30/17 to 11/10/17 $

2 September 15th 2017

4 October 13th 2017 10/16/17 to 10/27/17 $

9 December 22nd 2017 12/25/17 to 1/5/18 $

10 January 5th 2018 1/8/18 to 1/19/18 $

7 November 24th 2017 11/27/17 to 12/8/17 $

8 December 8th 2017 12/11/17 to 12/22/17 $

13 February 16th 2018 2/19/18 to 3/2/18 $

14 March 2nd 2018 3/5/18 to 3/16/18 $

11 January 19th 2018 1/22/18 to 2/2/18 $

12 February 2nd 2018 2/5/18 to 2/16/18 $

17 April 13th 2018 4/16/18 to 4/27/18 $

18 April 27th 2018 4/30/18 to 5/11/18 $

15 March 16th 2018 3/19/18 to 3/30/18 $

16 March 30th 2018 4/2/18 to 4/13/18 $

***Winter Camp, Spring Camp and Kids Day Out fees are NOT included in the regular Before & After School

Program fees. Each Camp OR KDO day is SEPARATE and requires a new enrollment form for EACH KDO day or

Camp. Those fees MUST be paid before the Camp or KDO day in order for your child to attend.

21 June 8th 2018 (1 week) 6/11/18 to 6/15/18 $

19 May 11th 2018 5/14/18 to 5/25/18 $

20 May 25th 2018 5/28/18 to 6/8/18 $

We will NOT have a program on the following dates: 11/23-11/24/2017, 12/25/17, 1/1/18, 3/30/2018

and 5/28/2018

Any Questions

Please Contact Youth & Family Office

262-654-9622 ext. 236

KDO Dates Half Days Winter Camp Spring Camp

10/27/17,11/3/17

1/15/18, 1/19/18,

2/23/18, 3/23/18

10/26/17, 11/22/17, 2/22/18,

5/25/18, 6/14/18

12/20/17 and 12/22/17, 12/26-

12/29/17 and 1/2/184/2/18 to 4/6/18