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R E G I S T R AT I O N F O R M
Last Name
Male
Female
First Name
Birth Date
Circle One
Contact Info
Street Address
City
State
Cell Phone #
Home Phone #
Age at Camp
Zip
2136 Bohemian Highway
Occidental, CA 95465
Camper Name
CatholicCharitiesSF.org
c amp e r in fo r m a t i on
School
Parent/Guardian Name
s e ss i o n in fo r m a t i on
Please Check
oJune 29 – July 3
oJuly 6 – July 10
oJuly 13 – July 17
oJuly 20 – July 24
oJuly 27 – July 31
oA
ugust 3 –
August 7
Register online at
www.cyocamp.org or complete
this registration form.
CYO Day Camp
$215.00 per session
Changing lives,
one memory at a time.
A $100 non-refundable
deposit must be included
with this registration form.
All remaining fees are due
by June 6, 2015 to complete
your registration.
p ay m e n t in fo r m a ti on
Card #
CVV Code (3 digits)
Name on card
Deposit only ($100)
Full Amount ($215)
Please detach this section and mail non-refundable deposit to:
CYO Camp, 2136 Bohemian Highway, Occidental, CA 95465
Find us @
CatholicCharitiesSF
CatholicCSF
Expiration Date
For kids ages 6-11
Set among 217 acres of towering coastal redwoods,
CYO Camp is an awe-inspiring place where campers
experience a fun, positive, and challenging summer
adventure. It is a magical place where children grow,
learn, struggle, persevere, play, explore, and make
memories and friendships that last a lifetime. Sixty
miles north of San Francisco near the historic town
of Occidental, CYO Camp is a Catholic community
where, for more than 65 years, children of all religious
backgrounds learn the values of caring, honesty,
fairness, respect, and responsibility, in a challenging and
nurturing natural environment.
Activites
Daily Schedule
• Swimming
8:00 a.m. Drop-off
• Archery
9:00 a.m. Daily Welcome
• Canoeing
9:30 a.m. Adventure #1
• GaGa Ball
10:45 a.m. Snack
• Hiking
11:00 a.m. Adventure #2
• Arts & Crafts
12:30 p.m. Lunch
• Campfire
1:30 p.m.
Project Time
• Field Games
2:15 p.m.
Pool
3:15 p.m.
Change/Snack
c yo d ay c am p g ro u n d ru l es
YOUTH PROGRAMS
With programs rich in tradition, Catholic Charities CYO
Day Camp creates an environment where youth can
explore the world around them and develop powerful
friendships that will last a lifetime. Summer days are
filled with activities including swimming, gaga ball,
team building games, canoeing, and nature hikes, just to
name a few. Campers create lifelong memories as they
discover the magic of CYO Day Camp.
Huckleberry Village Day Camp
(ages 6–11)
This five-day program offers youth in our local
community the opportunity to take advantage of our
beautiful property and facilities while engaging in
sports, environmental education, and traditional camp
activities. Day Camp’s affordable tuition includes all
activities, lunch, two snacks each day, and an optional
overnight camp-out including dinner and breakfast.
4:00 p.m. Adventure #3
5:00 p.m. Pick-up
CYO SUMMER CAMP REFUND POLICY
All deposits are non-refundable and non-transferable. In
cases of homesickness, dismissal, or voluntary withdrawal,
there is no refund of fees. All cancellations or changes to
registration must be submitted in writing, postmarked no
later than 30 days prior to start of session in order to be
processed and/or to receive a refund, minus deposit. If a
camper does not show for a registered session without
proper notice, there will be no refund issued. Special
circumstances will be handled on a case-by-case basis by
CYO Camp.
CYO DAY CAMP GROUND RULES
I understand that any of the following circumstances could,
in the reasonable discretion of the CYO Day Camp director,
require my son/daughter to return home.
A. The violation of any of the CYO Day Camp ground rules
which include:
1. A
lcohol or narcotics/drugs (including cigarettes) of
any sort are forbidden on CYO Day Camp grounds
or program sites.
2. S
exual behavior or excessive displays of affections
that detract from group participation is neither
acceptable nor permitted.
3. Permission is required from the CYO Day Camp
staff to leave the group or defined boundaries at
any time.
B. Any illness or injury by my son/daughter that would make
their continuing on with camp ill advised.
Lunch and daily snacks provided.
SPECIAL THURSDAY OVERNIGHT!
C. The following items are banned by CYO Day Camp: All
controlled substances, personal sporting equipment,
weapons, and animals.
I understand and agree to the above ground rules. Violation
of these ground rules may result in the camper being sent
home at the parent’s expense. CYO Day Camp is not
responsible for any lost or stolen items.
Register online @ www.cyocamp.org
Parent/Guardian Name ________________________________
Parent/Guardian Signature _____________________________
Camper’s Signature ____________________________________
Date ____________________