2026 West Cook YMCA Adventure Camp Enrollment Form
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  • 2026 West Cook YMCA Adventure Camp Enrollment Form

  • The first step in the enrollment process for the West Cook YMCA Adventure Camp is to complete the following enrollment form. Once you have completed the entire form an email will be sent confirming we have received your completed enrollment form. A West Cook YMCA team member will follow up to confirm the next steps.

    Additional forms that will be required include your camper(s)'s health exam form so please prepare to have it on hand so that when our staff reach out to complete the process you will be able to upload with your registration packet.   

    Location: West Cook YMCA | 255 S Marion St. Oak Park IL 60302

    Dates: June 8th - August 14th

    Ages: 5 -13 years

    Day and Time: Monday-Friday from 9:00am – 4:00pm

    Before Extended Care: 7:00am – 9:00am

    After Extended Care: 4:00pm – 6:00pm

    Y Member Cost per Week: $250

    Non-Member Cost per Week: $325 

    Extended Care Cost per Week: $50 and includes before and after extended care

    Non-refundable Deposit Due at the end of the month: $25 per camper per week

     

  • PARENT/GUARDIAN INFORMATION

    Parent/Guardians listed on this page are allowed to pick up on a regular basis and under any condition.
  • Parent/Guardian 1 Date of Birth*
     - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Camper(s) resides with Parent/Guardian 1*
  • Would you like to add another parent/guardian? Please note: If a second parent or guardian will be picking up your child(ren), please add them here.*

  • PARENT/GUARDIAN INFORMATION (Cont.)

    Parent/Guardians listed on this page are allowed to pick up on a regular basis and under any condition.
  • Parent/Guardian 2 Date of Birth*
     - -
  • Same residence as Parent/Guardian 1*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Camper(s) resides with Parent/Guardian 2*

  • Camper 1 Information

  • Camper 1 Date of Birth*
     - -
  • Camper 1 Gender*
  • Camper 1 Race*
  • Camper 1 Ethnicity*
  • Camper 1 T-shirt Size*
  • What weeks would you like to enroll Camper 1?
  • What weeks will you need extended care for camper 1?*
  • Medical Permission Authorization
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Would you like to add another camper?*

  • Camper 2 Information

  • Camper 2 Birthdate*
     - -
  • Camper 2 Gender*
  • Camper 2 Race*
  • Camper 2 Ethnicity*
  • Camper 2 T-shirt Size*
  • What weeks would you like to enroll Camper 2?
  • What weeks will you need extended care for camper 2?*
  • Medical Permission Authorization
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Would you like to add another camper?*

  • Camper 3 Information

  • Camper 3 Birthdate*
     - -
  • Camper 3 Gender*
  • Camper 3 Race*
  • Camper 3 Ethnicity*
  • Camper 3 T-shirt Size*
  • What weeks would you like to enroll Camper 3?
  • What weeks will you need extended care for camper 3?*
  • Medical Permission Authorization
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Would you like to add another camper?*

  • Camper 4 Information

  • Camper 4 Date of Birth*
     - -
  • Camper 4 Gender*
  • Camper 4 Race*
  • Camper 4 Ethnicity*
  • Camper 4 T-shirt Size*
  • What weeks would you like to enroll Camper 4?
  • What weeks will you need extended care for Camper 4?*
  • Medical Permission Authorization
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Would you like to add another camper?*

  • Camper 5 Information

  • Camper 5 Date of Birth*
     - -
  • Camper 5 Gender*
  • Camper 5 Race*
  • Camper 5 Ethnicity*
  • Camper 5 T-shirt Size*
  • What weeks would you like to enroll Camper 5?
  • What weeks will you need extended care for Camper 5?*
  • Medical Permission Authorization
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Would you like to add another camper?*

  • Camper 6 Information

  • Camper 6 Date of Birth*
     - -
  • Camper 6 Gender*
  • Camper 6 Race*
  • Camper 6 Ethnicity*
  • Camper 6 T-shirt Size*
  • What weeks would you like to enroll Camper 6?
  • What weeks will you need extended care for Camper 6?*
  • Medical Permission Authorization
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof

  • Family Information

  • When necessary, who should be contacted first?*

  • Approval for West Cook YMCA Activities

    Please check all the appropriate choices that you are approving or not approving.
  • Photo/Video Permission*
  • Emergency Medical Authorization: The purpose of this authorization is to enable parents and guardians to authorize provision of emergency treatment for children who become ill or injured while under our supervision when parents or guardians cannot be reached.
  • Swimming Authorization: The purpose of this authorization is to give permission to allow your camper to use the West Cook YMCA pool for free swim and participate in swim lessons under the supervision of a lifeguard and swim instructors. Members of the West Cook YMCA may be using the pool at the same time as campers.*
  • Date of Signature*
     - -

  • Health History Form

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Does your camper need medication dispersed during program?*

  • Emergency Contacts

    Emergency contacts will only be contacted in the case of a situation where we need to get a hold of parents/guardians and we have not been able to. Emergency contacts will also be allowed to pick up children from the program. If anyone other than those listed will be picking up your child, you must contact Youth Development Program Staff via daycamp@westcookymca.org. Phone authorization will not be sufficient. For the safety of your camper, anyone picking up your camper must have a picture ID. Anyone without proper authorization will not be allowed to take your child
  • Relationship to child*
  • Format: (000) 000-0000.
  • Would you like to add another emergency contact?*
  • Relationship to child*
  • Format: (000) 000-0000.
  • Do you wish to authorize additional individuals to pick up your camper(s)?*

  • Additional Authorized Pick-Up

    All individuals who wish to pick up your camper must be listed below, excluding parents and guardians listed under general information. If anyone other than those listed will be picking up your child, you must contact Youth Development Program Staff via daycamp@westcookymca.org. Phone authorization will not be sufficient. For the safety of your child, anyone picking up your camper must have a picture ID. Anyone without proper authorization will not be allowed to take your camper.
  • Format: (000) 000-0000.
  • Would you like to add an additional pick-up person?*
  • Format: (000) 000-0000.
  • Would you like to add an additional pick up person?*
  • Format: (000) 000-0000.

  • The West Cook YMCA Adventure Camp nonrefundable $25 deposit per week per camper is due by the end of the month to reserve your registration. The balance of your family's camp fees is due the Wednesday prior to start of each week your family is registered and we will contact you to set up auto draft of your family's fees.

    If you have any questions, please do not hesitate to email us at daycamp@westcookymca.org. We will be responding to inquiries on Mondays and Wednesdays.

    Enrollment confirmations will be sent every 2 weeks leading up to final registrations by August 3rd.

    Please email, or drop off a copy of your camper's most recent copy of a physical. This will be need to be submitted by June 1st.

  • Please complete the following checklist to ensure your registration is completed prior to submission:*
  • Should be Empty: