JYC Summer 2017 2.pub (Read-Only)
JYC Summer Youth Programs 2017 Registration Form Name of Participant: __________________________________________ Address:____________________________________________________ Date of Birth: ________________ Grade: ______ Parent/Guardian Name____________________________________________ Home/Cell Phone: ___________________ Work Phone: __________________ E-mail Address: ______________________________________________ Emergency Contact (other than parent/guardian): Name: ________________________________Phone: ____________________ Relation: ____________________
JYC Youth Programs
Summer 2017 For Youth Entering Grades 5-9 For residents of the Towns of Caroline and Ithaca and the Villages of Cayuga Heights and Lansing
Any allergies, special needs, or medical conditions of which we should be aware?
Please Check All That Apply
_____ Yes, I give permission for my child to fully participate in JYC Youth Summer 2017 programs and for Cornell Cooperative Extension staff to transport youth to get to and from activities, field trips and to transport youth home if necessary. _____ Yes, I give permission for program staff and/or other emergency care personnel to administer first aid or medical treatment in the event of an emergency involving my child. _____ Yes, I give permission for my child to use a knife for carving and cooking purposes after they have had instruction on safe use and handling. _____ Yes, I give permission for my child to participate in program evaluation activities for the purpose identifying the program’s value and ways to strengthen and improve it in the future. Activities may include: skills checklists, informal discussion, surveys, observation, or group activities. Any feedback or information gathered will remain anonymous. ______Yes, I give permission for my child’s photo to be taken during the activity and for any photo to be use for documentation and publicity purposes. ______If my child is unable to attend a scheduled event, I will alert the program manager at © 227-9532 or 272-2292 ext. 229. ______ Yes, I understand that my child should bring their own snack, lunch and water for the day. I also understand that they should dress appropriately for the programs that they are attending. ______I fully understand and acknowledge that there are inherent risks and dangers in my child’s participation in the above activities and my child’s participation in such activities and use of any equipment related to such activities may result in injury, illness, or death, and damage to personal property. I understand other participants, accidents, forces of nature, or other incidents may cause these risks and dangers and I hereby accept these risks and dangers.
Parent Signature: ____________________________________________ Date: ________________
Please direct any and all questions to: Beth Bannister JYC Youth Program Educator Phone: (607) 272 2292 ext. 229 Email: [email protected]
Facebook: https://www.facebook.com/ JointYouthCommission/
Summer 2017 Programs Most Programs are Monday-Thursday in various locations. Please check dates and locations.
Cooking, Local Foods and Farms (7/5/17—7/7/17) Wed-Friday
JYC Youth Programs Summer 2017 **A suggested donation of $20/program helps us continue to run incredible youth programs! No one will be turned away due to lack of funds**
12pm-5pm @ Cornell Cooperative Extension, 615 Willow Ave. Ithaca Want to visit local farms and markets, create your own menu and cook a delicious feast? Bring your creativity to this mouth watering program! Friday take a meal home for your family!
Lake Life (7/10/17—7/13/17) 9:00 am-4:00 pm @ Cornell Cooperative Extension Come explore the unique and important waterways of Cayuga Lake. Be prepared to get your feet wet! The first 3 days we will travel to Myers Park in Lansing for swimming, water life science, fishing and bird watching. Thursday we will head to the Ithaca Farmer’s Market area for some special water activities including canoeing.
Choose Your Own Adventure(7/24/17 - 7/27/17) 9:00 am-1:30 pm @ Dewitt Middle School Are you interested in anything? This is the program for you! Youth will decide what projects we participate in. Crafts, graphic novels, stop motion, geocaching, volunteering—there are many options. Youth will learn to use TCAT to explore new places as well—Scavenger Hunt anyone?
DIY Summer Edition (7/31/17 - 8/3/17) 9:00 am-4:00 pm @ Lansing Middle School Do It Yourself- Summer Edition will provide individual and group projects, so come learn some new skills and make something awesome for yourself!
Magic and Board Games Week (8/8/17—8/11/17) Tues-Friday 12 pm-5:00 pm @ The Enchanted Badger Join us at Ithaca’s best game store for games and Magic. New players are welcome—-we will teach you. EDH, standard, drafting options also for experienced players.
Digital Photography (8/14/17—8/17/17) 9:00 am-4:00 pm @ Dewitt Middle School Come explore the fun and rewarding world of digital photography. Students can bring their own camera or share one of the 4H cameras. Participants can look forward to learning about composition and editing to make their work something truly unique.
Sky’s the Limit (8/28/17 - 8/31/17)
Please check programs that your child will be attending. Cooking Local Foods and Farms (7/5/17—7/7/17) Wed-Friday 12pm-5pm @ Cornell Cooperative Extension, 615 Willow Ave. Ithaca
Lake Life (7/10/17—7/13/17) 9:00 am-4:00 pm @ Cornell Cooperative Extension Choose Your Own Adventure (7/24/17 - 7/27/17) 9:00 am-1:30 pm @ Dewitt Middle School DIY Summer Edition (7/31/17 - 8/3/17) 9:00 am-4:00 pm @ Lansing Middle School Magic and Board Games Week (8/8/17—8/11/17) Tues-Friday 12 pm-5:00 pm @ The Enchanted Badger Digital Photography (8/14/17—8/17/17) 9:00 am-4:00 pm @ Dewitt Middle School Sky’s the Limit (8/28/17 - 8/31/17) 9:00 am-4:00 pm @ Brooktondale Community Center
Youth must be picked up by a parent or guardian at the program site at the conclusion of each program, unless pickup/drop-off is arranged otherwise. Please contact Beth for information about rides and carpooling. Detach this half of form, complete (front & back), and return to: Attn: Beth Bannister CCETC 615 Willow Ave Ithaca NY 14850
Space is limited, so register now!
9:00 am-4:00 pm @ Brooktondale Community Center Are you interested in the beauty or science of flight? Aerospace, engineering, model planes and rockets? Sky’s the Limit will be full of flight, whether it’s building models or observing birds and other animal flyers. There will be trips to a Local Airport, the Lab of Ornithology and the National Soaring Museum in Big Flats, NY to see gliders in action!
Cornell Cooperative Extension of Tompkins County is an employer and educator recognized for valuing AA/EEO, Protected Veterans, and Individuals with Disabilities and provides equal program and employment opportunities.
JYC Youth Programs
Summer 2017 For Youth Entering Grades 5-9 For residents of the Towns of Caroline and Ithaca and the Villages of Cayuga Heights and Lansing
Any allergies, special needs, or medical conditions of which we should be aware?
Please Check All That Apply
_____ Yes, I give permission for my child to fully participate in JYC Youth Summer 2017 programs and for Cornell Cooperative Extension staff to transport youth to get to and from activities, field trips and to transport youth home if necessary. _____ Yes, I give permission for program staff and/or other emergency care personnel to administer first aid or medical treatment in the event of an emergency involving my child. _____ Yes, I give permission for my child to use a knife for carving and cooking purposes after they have had instruction on safe use and handling. _____ Yes, I give permission for my child to participate in program evaluation activities for the purpose identifying the program’s value and ways to strengthen and improve it in the future. Activities may include: skills checklists, informal discussion, surveys, observation, or group activities. Any feedback or information gathered will remain anonymous. ______Yes, I give permission for my child’s photo to be taken during the activity and for any photo to be use for documentation and publicity purposes. ______If my child is unable to attend a scheduled event, I will alert the program manager at © 227-9532 or 272-2292 ext. 229. ______ Yes, I understand that my child should bring their own snack, lunch and water for the day. I also understand that they should dress appropriately for the programs that they are attending. ______I fully understand and acknowledge that there are inherent risks and dangers in my child’s participation in the above activities and my child’s participation in such activities and use of any equipment related to such activities may result in injury, illness, or death, and damage to personal property. I understand other participants, accidents, forces of nature, or other incidents may cause these risks and dangers and I hereby accept these risks and dangers.
Parent Signature: ____________________________________________ Date: ________________
Please direct any and all questions to: Beth Bannister JYC Youth Program Educator Phone: (607) 272 2292 ext. 229 Email: [email protected]
Facebook: https://www.facebook.com/ JointYouthCommission/
Summer 2017 Programs Most Programs are Monday-Thursday in various locations. Please check dates and locations.
Cooking, Local Foods and Farms (7/5/17—7/7/17) Wed-Friday
JYC Youth Programs Summer 2017 **A suggested donation of $20/program helps us continue to run incredible youth programs! No one will be turned away due to lack of funds**
12pm-5pm @ Cornell Cooperative Extension, 615 Willow Ave. Ithaca Want to visit local farms and markets, create your own menu and cook a delicious feast? Bring your creativity to this mouth watering program! Friday take a meal home for your family!
Lake Life (7/10/17—7/13/17) 9:00 am-4:00 pm @ Cornell Cooperative Extension Come explore the unique and important waterways of Cayuga Lake. Be prepared to get your feet wet! The first 3 days we will travel to Myers Park in Lansing for swimming, water life science, fishing and bird watching. Thursday we will head to the Ithaca Farmer’s Market area for some special water activities including canoeing.
Choose Your Own Adventure(7/24/17 - 7/27/17) 9:00 am-1:30 pm @ Dewitt Middle School Are you interested in anything? This is the program for you! Youth will decide what projects we participate in. Crafts, graphic novels, stop motion, geocaching, volunteering—there are many options. Youth will learn to use TCAT to explore new places as well—Scavenger Hunt anyone?
DIY Summer Edition (7/31/17 - 8/3/17) 9:00 am-4:00 pm @ Lansing Middle School Do It Yourself- Summer Edition will provide individual and group projects, so come learn some new skills and make something awesome for yourself!
Magic and Board Games Week (8/8/17—8/11/17) Tues-Friday 12 pm-5:00 pm @ The Enchanted Badger Join us at Ithaca’s best game store for games and Magic. New players are welcome—-we will teach you. EDH, standard, drafting options also for experienced players.
Digital Photography (8/14/17—8/17/17) 9:00 am-4:00 pm @ Dewitt Middle School Come explore the fun and rewarding world of digital photography. Students can bring their own camera or share one of the 4H cameras. Participants can look forward to learning about composition and editing to make their work something truly unique.
Sky’s the Limit (8/28/17 - 8/31/17)
Please check programs that your child will be attending. Cooking Local Foods and Farms (7/5/17—7/7/17) Wed-Friday 12pm-5pm @ Cornell Cooperative Extension, 615 Willow Ave. Ithaca
Lake Life (7/10/17—7/13/17) 9:00 am-4:00 pm @ Cornell Cooperative Extension Choose Your Own Adventure (7/24/17 - 7/27/17) 9:00 am-1:30 pm @ Dewitt Middle School DIY Summer Edition (7/31/17 - 8/3/17) 9:00 am-4:00 pm @ Lansing Middle School Magic and Board Games Week (8/8/17—8/11/17) Tues-Friday 12 pm-5:00 pm @ The Enchanted Badger Digital Photography (8/14/17—8/17/17) 9:00 am-4:00 pm @ Dewitt Middle School Sky’s the Limit (8/28/17 - 8/31/17) 9:00 am-4:00 pm @ Brooktondale Community Center
Youth must be picked up by a parent or guardian at the program site at the conclusion of each program, unless pickup/drop-off is arranged otherwise. Please contact Beth for information about rides and carpooling. Detach this half of form, complete (front & back), and return to: Attn: Beth Bannister CCETC 615 Willow Ave Ithaca NY 14850
Space is limited, so register now!
9:00 am-4:00 pm @ Brooktondale Community Center Are you interested in the beauty or science of flight? Aerospace, engineering, model planes and rockets? Sky’s the Limit will be full of flight, whether it’s building models or observing birds and other animal flyers. There will be trips to a Local Airport, the Lab of Ornithology and the National Soaring Museum in Big Flats, NY to see gliders in action!
Cornell Cooperative Extension of Tompkins County is an employer and educator recognized for valuing AA/EEO, Protected Veterans, and Individuals with Disabilities and provides equal program and employment opportunities.
