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BUILDING KIDS WITH CHARACTER Licensed Child Care Registration 2013-2014

JOE AND MARY MOTTINO FAMILY YMCA a branch of the YMCA of San Diego County

760.758.0808 2013-2014 Child Care 1


locations & hours

page 3


page 4

program standards

page 5

safety standards

page 6 & 7

social services standards

page 8

registration standards

page 9


monthly child care fees

page 10

payment services dates

page 11

registration forms page 12-20 (to be completed & returned at registration session)

for more information:

LETTER FROM THE CHILD CARE TEAM Dear Parent, Every day, before and after school, we’re here to provide experiences for your child to learn new skills, build deeper friendships, play silly games, celebrate fun holidays and explore the world. With healthy snacks, homework time, arts & crafts, community service projects, sports & more. Kids in our programs are happy, healthy and well-adjusted. We focus on three things at the Y - Youth Development, Healthy Living, and Social Responsibility. This booklet contains general information about our programs, as well as information on registration and payment. We hope that you’ll find it helpful as we plan for the upcoming school year. Please feel free to contact us with any questions Nicole Ketcher (Child Care Director) - or 760.758.0808 x.122 or Eric Snyder (Child Care Payment Tech) - or 760.758.0808 x.145 Here’s to a great school year,


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CHILD CARE SITE LOCATIONS LEADERSHIP CONTACT INFORMATION Nicole Ketcher Child Care Director Eric Snyder Payment Technician MOTTINO FAMILY YMCA 4701 Mesa Drive Oceanside, CA. 92056

(760) 758-0808 ext. 122 (760) 758-0808 ext. 145


IVEY RANCH ELEMENTARY (License # 372006402) 4275 Via Rancho Road, Oceanside CA 92057 Site Cell Phone (760) 687-5712 School Office Phone (760) 967-9720 Principal: Duanne Legg From Mottino Family YMCA front driveway turn left onto Mesa Drive. Turn right onto Via Rancho Rd. Program held in the YMCA trailer in back of school grounds along the fence facing Mesa Drive. CHRISTA MCAULIFFE ELEMENTARY (License # 372006251) 3701 Kelton Drive, Oceanside CA 92056 Site Cell Phone (760) 484-4601 School Office Phone (760) 722-8357 Principal: Cheree McKean From Mottino Family YMCA front driveway turn Left onto Mesa Drive. Turn left onto College Blvd. Turn right onto Marvin Street. Turn left onto Cameo Drive. Turn right onto Brandies Drive. Turn left onto Kelton Drive. Program held in YMCA trailer at the back south west corner of the school. REYNOLDS ELEMENTARY (License # 372005941 and License Exempt Program) 4575 Douglas Dr. Oceanside CA 92057 LIC Site Cell (760) 687-3499 School Office Phone (760) 433-8949 Principal: Dr. Gina Zyburt From Mottino Family YMCA front driveway turn Left onto Mesa Drive. Turn Right onto College Blvd. Turn Left on Hwy 76. Turn right onto Douglas Drive. Program held in YMCA trailer on playground on east side of school in front of the blue hand ball wall or in the multipurpose room. EMPRESA ELEMENTARY (License # 376700327) 4701 Mesa Drive, Oceanside, CA 92056 Site Cell Phone (760) 529-1298 School Office Phone (760) 940-8454 Principal: Debbie Gosselin Program is held in the modular trailer (“Studio C”) behind the main YMCA facility. Please go around the outside of the facility to the trailer in back for pick up and drop off of children.

The YMCA Licensed and Licensed Exempt Child Care Programs ONLY operate on the 180 days schools are in session. Day Camp is available for a fee for holidays and teacher in-service days and MUST BE REGISTERED FOR AND PAID FOR SEPARATELY AT OUR MAIN BRANCH @ 4701 Mesa Drive, Oceanside, CA 92056. Day camps may or may not be held at your child’s school. Look for camp flyers or call the YMCA @ (760)758-0808 or visit our web site at for more info.

grades & SCHEDULE accommodating your schedule to care for your kids

GRADES: K-5th Kindergarten: Kinder care is available at select school locations where there is interest. Students enrolled in AM Kinder will eat their lunch and have rest time at the YMCA. We recommend that parents send a clean blanket weekly, and have a change of clothes on site for their child. 1st-5th Grades: we offer before and after care for elementary-aged kids on all school days. Kids will be given a nutritious snack, homework time, sports, games and more!

DAILY ROUTINE Each day and each program varies a little bit, but generally these are the activities kids get to do on a daily basis: - Nutritious Snack - Homework/Study Time - Free Play - Cooperative Games - Fitness Fun Time/Sports - Arts/Crafts On special days, kids will participate in celebrations, community service projects, cooking classes & more!

MINIMUM DAYS All of the schools we service have minimum days. During the school year, whenever there is a minimum day, we will start care as soon as school gets out.

HOLIDAYS & CAMPS We do not offer Childcare on these holidays, but we will offer day camps at the Y! Look for flyers at your sign-in/out area or visit www. November:

Veteran’s Day, Thanksgiving Break


Winter Break


Winter Break, Martin Luther King Day President’s Day

February: March/April: Various: 4 2013-2014 Child Care

President’s Week Spring Break Teacher In-Service Days

program standards HOLDing standards in place so you know what to expect snack

Lost & found

We serve a healthy snack every day! Snacks contain at least two of the four food groups each day. Please let us know if your child has any food allergies or special food needs. If your child has a big appetite, you may send an extra snack from home. Unhealthy foods like cookies, chips and candy are highly discouraged, as we stand for Healthy Living!

Avoid lost jackets and lunch boxes! Mark all of your child’s things with his/her name. The YMCA is not held responsible for lost or missing items. Unclaimed lost and found items are donated to charity on a monthly basis.


If you unexpectedly running late, please call to let us know. There will be a $5.00 charge for every 5 minutes your child stays after 6:00pm, which will be billed to your account. If you are late and we have not been notified, we will start calling emergency contacts. All authorized contacts will be called until the child is safely checked out. If we are unable to reach the authorized contacts, we will notify Social Services. If late pick-up becomes a pattern, the child may be dismissed from our program.

We are committed to providing homework time and help so that kids can succeed in school! Please encourage your children to use this time wisely, as we can provide time and support but we can’t require them to complete their homework. Our team will work closely with your child to help, but we do not provide one-on-one tutoring.


PARENT INVOLVEMENT Get involved! Join us for special events, give your input and ideas for activities, and share your unique talents with the students in our program. Interested in helping to steer our program? Join the Parent Advisory Committee or PAC. Talk to your Site Supervisor about how you can get involved.

special needs inclusion We encourage ALL kids to participate in YMCA Child Care programs, including those who may need accommodations. If your child has special needs, talk to Child Care Director, Nicole Ketcher.

760.758.0808 2012-2013 Child Care 5

SAFETY standards HOLDing standards in place so youR CHILD IS ALWAYS SAFE Sign In & Out


- State licensing regulations require that you sign your child in and/or out of our program every day with a full parent/guardian signature. - If you pick your child up from school before Child Care starts, please call your YMCA Child Care cell phone and let us know not to expect your child. - Our staff will sign your child into our program at the end of the school day. We will pick up Kindergarten students from their classrooms. 1st-5th grades students are responsible for going directly to the YMCA after school. - We only release children to those authorized on the registration form. Authorized pick-ups must be 18 years or older, and present a valid photo i.d.

If your chid becomes ill while in Child Care, we will contact you to pick him/her up. Keep your child at home if... -They have a fever or had one within the last 24 hours. -They have a cold with heavy nasal drainage. -They have a constant cough. -They have contagious symptoms (an active cold, sore throat, vomiting, coughs, fever, rash or head lice).

ABSENCES Call the Child Care site cell phone, not the school office, if your child will not be coming to YMCA Child Care that day. We verify student absences daily, to insure your child’s health and safety. If we are unable to verify an absence we will notify the local police department.

Your kids may come if... - Their cold is done and has only a minor nasal drip left with no mucus. - Children recovering from Chicken Pox can return if all blisters have developed into scabs. - Children recovering from sore throat, ear infection, or pink eye can return after having been on antibiotics for at least 24 hours. - Lice- child is able to return with school nurse’s note indicating child is nit free.

MEDICATIONS We can only administer prescription medication if the parent/guardian has given us written authorization to do so. We store all medication out of reach of kids. - Bring medication straight to staff. Do not leave it in your child’s backpack. - Complete a Medication Release form & give it to YMCA staff. This must be completed before medication can be given. - All prescription medication must be in original containers with clear, dated, unaltered labels, as prescribed by doctor.

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safety standards HOLDing standards in place so youR CHILD IS ALWAYS SAFE child abuse prevention


Every YMCA staff member has been through an extensive Child Abuse Prevention training, and we place a high emphasis on prevention, identification and reporting of any abuse. We are legally-mandated reporters of suspected abuse.


BATHROOM use Students will not be sent to the restroom unsupervised. Staff will inspect the restroom to insure there are no safety hazards, and will supervise children by staying within hearing range. Children will enter the restroom one at a time or in groups of 3 or more. No staff member will be alone with one child at any time.

accidents & injuries We put safety first! Every YMCA staff member is CPR, First Aid and AED certified. We provide basic first aid on site. We will contact you if the injury is beyond basic first aid. If the injury is life-threatening, our staff will do whatever is necessary to get emergency medical treatment, and every effort will be made to contact the parent immediately. Parents are responsible for any medical charges.

- Respect the authority of staff. - Behave in a manner that does not disrupt or interfere with the rights of other students and staff. - Attend the Child Care program on contracted days and on time.

Parent - Accept and respect the right of the Joe and Mary Mottino Family YMCA to require discipline standards of behavior for all students.

Staff - Model appropriate behavior. - Redirect negative student behavior. - Offer a positive rewards system.

DISMISSAL FROM PROGRAM A child can be dismissed from our program if he or she presents behavior that is a safety hazard to him/ herself or others. We will suspend care if payments are 15 days late, or if there are consistent late pickups. We cannot refund any fees paid if your child is suspended or dismissed from the program.

emergencies & disasters We hold emergency drills regularly so everyone knows what to do if a real life emergency occurs. Our staff are trained to deal with emergency situations. If you are near one of our Child Care sites during a drill, you may be asked to participate. If an emergency occurs, all staff members will remain with the kids until every child is safely united with his/her parent/guardian. If phone service is interrupted due to the emergency, please listen to the radio for direction instead of trying to make it to the YMCA immediately. Rest assured, we will do everything possible to take care of your child during this entire time.

760.758.0808 2013-2014 Child Care 7

social services standard telling parents about our staff safety requirements

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REGISTRATION standards HOLDing standards in place so youR CHILD IS ALWAYS SAFE ENROLLMENT & PROGRAM FEES Students must be fully enrolled before they can participate in our Child Care program. Enrollment consists of submitting all forms and fees. Please make sure to keep us updated if any of your information changes.

PAYMENT There is a $50.00 non-refundable registration fee due at the time of registration. Also due at the time of registration is a $100 non-refundable deposit to secure your child’s fall enrollment. This $100 holding deposit will be credited to your September child care monthly payment. This deposit cannot be credited to any other programs. All monthly child care payments must be paid by Automatic Transfer System (ATS) from a credit card or debit card on the 15th or a checking account on the 10th of each month. Fees are calculated on a set rate based on the 180 day school calendar, over a 9 month calendar period billed September through May. Child Care operates on days that school is in session. Day Camp is available on most holidays and teacher in-service days; camp fees are not included in the monthly child care payment and are an addition fee.


financial assistance

Members save! Sign up for a Family 1 or Family 2 membership to get the best price on Child Care, and full access to facility! Enjoy the salt-chlorinated pool, group exercise classes, family fitness opportunities, and member pricing on youth sports, dance, and swim lessons!

Financial Assistance is available to those who qualify. We will be approving assistance at registration sessions. Please bring either a copy of your most recent 1040 tax return form or two of your most recent pay stubs.

drops or changes in enrollment If you need to make changes or drop care, we will need a written two-week notice by the 15th of the month prior to the month the change is going to occur. This notice allows us to bill you correctly for your care.

receipts & tax statements We will automatically send you a year-end tax receipt the last week of January to the email address provided in your registration packet. Please give us two weeks to process any additional requests for monthly receipts.

third party assistance We accept 3rd Party Assistance from - Child Development Associates (CDA) - YMCA Child Care Resource Service (CRS) - County of San Diego and Military Subsidy Program through NACRRA For Third Party billing, please bring a copy of your third party certification letter to your registration session. For questions regarding either Financial Assistance or Third Party Billing please contact Nicole Ketcher, Child Care Program Director, at 760.758.0808 ext. 122 or email

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MONTHLY CHILD CARE FEES Oceanside Unified School District Child Care Fees Member Rate

Participant Rate

1st-5th Grades Before Care After Care Before and After Care

$246 $326 $461

$283 $375 $530

AM Kinder Before Care After Care Before and After Care

$246 $509 $633

$283 $585 $728

PM Kinder Before Care After Care Before and After Care

$510 $326 $649

$586 $375 $746

Vista Unified School District Child Care Fees Member Rate

Participant Rate

1st-5th Grades Before Care After Care Before and After Care

$165 $379 $440

$190 $435 $506

AM Kinder Before Care After Care Before and After Care

$165 $545 $605

$190 $626 $695

PM Kinder Before Care After Care Before and After Care

$387 $379 $625

$445 $435 $718

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PAYMENT SERVICE DATES Please note that we draft monthly child care fees based on 180 days of school, and divide that evenly into a 9 month billing cycle that runs September-May. No monthly child care fees are draft in the month of August or June, these days are factored into the 9 month billing cycle. Bank Draft September 10, 2013

October 10, 2013

November 10, 2013

December 10, 2013

January 10, 2014

February 10, 2014

March 10, 2014

April 10, 2014

May 10, 2014

Credit Card Draft September 15, 2013

Service Days Covered Oceanside Unified: 8/20-9/30

October 15, 2013

Vista Unified: 8/19-9/30 Oceanside Unified: 10/1-10/31

November 15, 2013

Vista Unified: 10/1-10/31 Oceanside Unified: 11/1-11/30

December 15, 2013

Vista Unified: 11/1-11/30 Oceanside Unified: 12/1-12/31

January 15, 2014

Vista Unified: 12/1-12/31 Oceanside Unified: 1/1-1/31

February 15, 2014

Vista Unified: 1/1-1/31 Oceanside Unified: 2/1-2/28

March 15, 2014

Vista Unified: 2/1-2/28 Oceanside Unified: 3/1-3/31

April 15, 2014

Vista Unified: 3/1-3/31 Oceanside Unified: 4/1-4/30

May 15, 2014

Vista Unified: 4/1-4/30 Oceanside Unified: 5/1-6/4 Vista Unified: 5/1-6/5

760.758.0808 2013-2014 Child Care 11

2013-2014 School year ymca childcare registration OFFICE USE ONLY

Year On Site Start Date ID # Type of Care Payment Method FA % & Expiration YMCA Rep. Initials/Date

PERSONAL INFORMATION School: Grade: Name: Age: Birthdate: Gender: Address: City/St./Zip: Parent 1: Home/Cell: Cell/Work: Email: Parent 2: Home/Cell: Cell/Work: Email:

HEALTH INFORMATION Is your child currently taking any medication? Y N Medication(s)/Dosage(s): (Medications administered during program require a complete MEDICAL RELEASE FORM and must be delivered to site staff in the original container with a doctor’s prescription for your child.) Are your child’s immunizations current?



Let us know of any ALLERGIES, serious injuries, chronic illnesses, medical conditions, operations, restrictions on physical activity, accommodations, and/or special needs: Name of Health Insurance Company/Policy Number: Family Doctor Name/Phone Number: Dentist Orthodontist Name/Phone Number:

CHILD RELEASE AUTHORIZATION/EMERGENCY CONTACT Persons other than the above Legal Custodial Parent(s)/Guardian(s) authorized to sign child out of YMCA program: NAME RELATIONSHIP PHONE(S) 1. 2. 3. 4.

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BRANCH RELEASE/WAVIER FOR YMCA MINORS Name of Minor: I, the undersigned parent/person having legal custody/guardianship of the above said minor, give permission for the minor to participate in all YMCA programs. The minor is physically able and mentally prepared to participate in all activities as described in the announcement for the program. In consideration of said minor being permitted to enter any branch of the YMCA of San Diego County (“YMCA”) for observation, use of facilities and/or equipment, or participation of the above in any program, I, on behalf of myself (as parent, guardian, coach, aide, spectator or participant) hereby: 1. Acknowledge that (i) I have read this document, (ii) I have inspected the YMCA facilities and equipment, (iii) I accept them as being safe and reasonably suited for the purposes intended and (iv) I voluntarily sign this document. 2. Release YMCA, its directors, officers, employees and volunteers (collectively “Releasees”) from all liability to me for any loss or damage to property or injury or death to person, whether caused by releasees or otherwise and while such minor is in or near any YMCA branch. 3. I agree not to sue Releasees for any loss, damage, injury or death described above and I will indemnify and hold harmless Releasees and each of them from any loss, liability, damage or cost they may incur due to said minor’s presence in, upon or near the YMCA’s branch; whether caused by the negligence of Releasees or otherwise. 4. I assume full responsibility for, and risk of, bodily injury, death or property damage due to the negligence of Releasees or otherwise. 5. I do hereby authorize the YMCA as agent for the undersigned, to consent with respect to said minor, to any x-ray examination, anesthetic, medical, dental, or surgical diagnosis or treatment, and hospital care which is deemed advisable by, and is to be rendered under general or special supervision of, any physician and surgeon licensed under the provisions of the California Medical Practice Act on the medical staff of any hospital, whether such diagnosis or treatment is rendered at the office of the physician or at the hospital. I understand that the YMCA is not responsible for costs incurred for medical care. I intend this document to be as broad and inclusive as is permitted by the laws of the State of California; if any portion hereof is held invalid, I agree the balance shall continue in full force. I give my permission to the YMCA of San Diego County (YMCA) to use my picture or other likeness, or a picture or other likeness of any of my child in the YMCA’s general publicity and campaign materials. If no, please check:

Contracted Parent Signature Printed Parent Name

Date YMCA Rep. Initials/Date

760.758.0808 2013-2014 Child Care 13


I understand that ONLY the legal custodial parent(s)/guardian(s) and “Child Release/Emergency Contacts” listed on the

registration form will be able to sign my child out of the program AND I understand they will be able to do so

at any time.

I understand that ONLY I can make changes to my child’s child care schedule and/or payment plan. I would like to give

permission to the following legal custodial parent(s)/guardian(s) to do the same: (1)

(2) (Please note however, that the above person(s) will not be able to make any

that affect payment if you use our bank draft option and the above person(s) name(s) is(are) not on

the account)

I understand that ONLY I can make changes to my child’s child care registration form. I would like to give permission

to the following legal custodial parent(s)/guardian(s) to do the same: (1)


I agree that I or the other legal custodial parent(s)/guardian(s) or “Child Release/Emergency Contacts” listed on the

child care registration form will notify the on site child care staff whenever my child is absent from the program.

I agree to sign my child into the program when I drop him or her off and out of the program when I pick him or her up.

I understand that all persons authorized by me to do the same MUST be at least 18.

I agree to always bring my I.D. upon signing out and taking my child from the program (and to notify all adults

authorized by me who sign out and take my child from the program to bring their I.D.)

I understand that the YMCA is not responsible for my child until YMCA staff sign him or her into the program.

1st-5th graders must walk from their class to the YMCA program on their own after school (Except for the Empresa

program. These students meet staff on campus at the blue tables outside of the cafeteria and walk with staff to the

YMCA trailer.)

I agree to notify on site program staff and/or the Site Supervisor or Child Care Director immediately should I have

any questions or concerns regarding the program.

I have received the Parent Handbook and I agree to comply with all written policies concerning admission,

financial obligations, and program operations.

I understand that YMCA Child Care rates did not increase; they have simply been restructured in order to make it

easier for parents to plan - each month will be the same rate. I understand that fees will now be calculated on a set

rate based on the 180-day school year, over a 9-month calendar period (September - May).

I understand that if I have qualified for YMCA branch financial assistance I must reapply three weeks before my

financial assistance expires; my monthly child care fees will automatically default to regular non-assistance full

monthly child care fees after my expiration date if I do not reapply in a timely fashion or if I no longer qualify.

I Understand that the Child Care program DOES NOT operate on holidays and teacher in-service days.

I understand that Day Camp is available for most holidays and teacher in-service days and that these fees are NOT

included in the monthly Child Care fees. I understand that I must register and pay for Day Camp separately.

I have read, understand and agree with the following documents that were reviewed with me at the time of my child’s

admission: Program Registration and Child Care Admission Agreement Form, Personal Rights Form, Parent’s Rights Form, Branch Waiver and Payment Contract.

see reverse for additional standards 14 2013-2014 Child Care

YMCA child care standards agreement Continued

I understand that the YMCA does not send out a monthly bill.

I understand that the YMCA does not automatically send out receipts for payments. If a receipt is required

monthly, I understand that I must request one and allow 2 weeks after the payment has been made for


I understand that the YMCA has an automatic draft policy and that it is mandatory that my monthly child

care fees are drafted from either a bank account or a credit/debit card.

I understand that if my payment is returned to the YMCA unpaid for any reason, a $10 service fee will be


I understand that the YMCA does not except partial payments.

I understand that no refunds or credits are given for days missed for any reason including suspension or

termination due to behavioral issues (unless a child is out 5 or more days with a dr. excuse and with

director approval).

I understand that if I need to make changes, or if I need to drop care, I will need to submit a written two-

week notice by the 15th of the month prior to the month the change is going to occur.

I understand that I am responsible to pay a $100 non-refundable holding deposit at the time of enrollment

and that this fee will be credited towards my first month child care bill.

I understand that I am responsible for paying a $50 non-refundable registration fee at the time of


I understand that I am responsible for tracking my own expiration date for my child’s youth membership

and financial assistance (if applicable).

I understand that a year end summary of all fees paid will be emailed to the email address on file

(contracted parent only) by the end of January 2013.

I understand that my child care fees will only cover when school is in session.

I understand that camp may be available when school is not in session and I have to register and pay for

camp separate and apart from my monthly child care fees.

I understand that I must call the YMCA site cell phone to notify staff that my child(ren) will be absent from

program. If we have not confirmed an absence within a reasonable amount of time we will file a missing child

report with the local law enforcement agency.

I give the YMCA permission to speak with my child(ren)s teachers and school staff regarding homework, or

other relevant information in order to work as a team with the school to provide the best care possible.

I have received a chart of all of the child care payment dates and dates of service.

Child’s Name Contracted Parent Signature Date Printed Parent Name YMCA Rep. Initials/Date

760.758.0808 2013-2014 Child Care 15

ymca child care payment contract Name of Child Contracted Parent/Guardian Child Care Site: IVEY MCA REY EMP

Grade: 1





K (AM or PM)

Care: AM only

PM Only


Membership: In order to receive member pricing on Child Care, the membership must be active through the entire month that care is provided. If your membership has expired you will have 10 days to renew before being charged the participant rate for that month. The difference between member and participant rates is non-refundable should your membership lapse. Monthly Fees/Refunds/Days of Operation: Monthly fees are distributed over a nine-month calendar (September -May). We do not send out a monthly bill. Monthly fees must be paid via a bank draft on the 10th of the month or via a credit card draft on the 15th of the month. A bank draft/credit card draft form must be filled out and submitted at the time of registration. If your bank account or credit card information changes or expires you must notify the billing department of the change and provide the updated information two weeks prior to the first of the month change is to take place. Fees must be paid in full each month as we do not accept partial payments. No refunds or credits will be given for days missed for any reason (unless child is out ill for 5 or more days with a doctor’s excuse). The Child Care Program operates on the 180 days schools are in session. The Child Care Program and schools are closed the following Observed Holidays: Labor Day, Veteran’s Day, Lincoln’s Birthday, Presidents’ Day, Martin Luther King Jr. Day, and Memorial Day. Payment is expected for holiday closure dates. Day Camp is available for some holidays and teacher in service days, but must be registered and paid for separately. Returned Bank Items Fee and Policy: Any items returned by the bank are subject to a $10.00 fee, this includes non-sufficient funds, changed or closed account, stop payment, etc. Once notified of the returned item, payment must be received within 72 hours or your child care services will be discontinued. In the event that you are discontinued for non-payment of your child care fees and want to re-register you will be required to pay any outstanding balances, applicable late fees and the $50 non-refundable registration fee. In addition to the $10 returned item fee, you will also be charged a $25 late payment fee. If fees are not paid your account will be placed on a financial hold and you will be unable to participate in any future YMCA programs until the balance is paid in full. Required Drop or Change Notification Policy: If you need to make changes or if you need to drop care, we will need a written two-week notice by the 15th of the month prior to the month the change is going to occur. Any change to your child’s registration paperwork (authorized pick ups, new phone number, address, change in medication or medical history etc.) or other need to be submitted in writing to your site supervisor and must be submitted directly by the contracted parent only. Receipt and Year End Statement Request Policy: We do not automatically send out monthly receipts for payment. If you need a receipt for your payment please contact the child care billing department and allow two weeks for processing. A year end statement reflecting all fees paid will be emailed to the contracted parent at end of January. Please ensure that we have your current email address on file. 3rd Party/Alternative Payment Policy: Co-payment and/or parent fees are due on the 1st of each month. If fees are received after the 5th of the month, a $25 late fee will be assessed and if they are not received by the 10th of the month your child will be suspended for 72 hours and then care may be discontinued. You must meet with the Child Care Program Director prior to your child beginning care to ensure that you understand all of our policies regarding third party payments. Financial Assistance: Families receiving Applications for Financial Assistance are available on the membership page of our website or at the Member Services Desk. Please bring your completed application to the Service Center along with appropriate documentation of income, and we will process it within one week once it is received. We will be processing financial assistance applications on-site at registration sessions. Child Care fees and programs are subject to change. You will be given at least two weeks notice if there are any changes to your child’s program (hours of oper I UNDERSTAND AND HAVE READ ALL OF THE ABOVE CHILD CARE POLICIES AND AGREE TO ABIDE BY THEM IN FULL.

Contracted Parent Signature Date Printed Parent Name YMCA Rep. Initials/Date

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draft information PERSONAL INFORMATION Child’s Name:


Contracted Parent: Cell Phone: (

Home Phone: ( )






I understand that monthly drafts take place as follows: Bank draft 10th & Credit Card draft 15th

I understand that if I want to change my payment method, I must notify the child care billing department in

writing no later than the 15th of the month prior to the change that will take place.

I understand that if I do not give required notice to stop/change the draft, the billing department will

continue to draft my account for the next month’s fees and no refunds will be issued.

I understand that I will be drafted regardless of absences, and that the YMCA does not prorate.


Routing Number:

Account Number:


Address: Type of Card (circle): Credit Card Number:

American Express


Master Card


Exp. Date:

Three Digit Security Code on Back of Card:

Staff Verified Initials/Date:

SIGNATURE I understand and have read all draft policies. I commit, by signature, to allow the YMCA to draft, where applicable, my bank account or credit card for payment of the YMCA Before & After School Child Care Program. I understand that in the event I need to change my back account or credit card info, I must notify the child care billing department in writing no later than the 15th of the month prior to the month the change will take place. I understand that it is my responsibility to make all necessary changes to my account by contacting the child care billing department. I understand that no refunds are given. I understand that it is my responsibility to check my monthly bank statement/credit card statement and report any billing errors immediately to the YMCA. I understand that if I cancel my draft through my banking institution, and/or credit card company and do notify the YMCA, child care services will be terminated immediately.

Contracted Parent Signature Date Printed Parent Name YMCA Rep. Initials/Date 760.758.0808 2013-2014 Child Care 17

18 2013-2014 Child Care

760.758.0808 2013-2014 Child Care 19

Mission Statement The Joe and Mary Mottino Family YMCA is dedicated to improving the quality of human life and to helping all people realize to their fullest potential as children of God through development of the Spirit, Mind, and Body.

Receipt of Parent Handbook I, , acknowledge that I have received the parent handbook for the 2013-2014 school year and that I will notify staff if I have any questions regarding the content. Signature Date

20 2013-2014 Child Care

2013-2014 LICENSED CHILD CARE REGISTRATION JOE AND MARY MOTTINO FAMILY YMCA 4701 Mesa Drive, Oceanside, CA 92056 760.758.0808

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760.758.0808 2013-2014 Child Care 21

Mottino YMCA Child Care Booklet 13-14  

Mottino YMCA Child Care Booklet 13-14 school year

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