UCCE Day Camp 2023

2023 UC Cooperative Extension Day Camp

Dates, Prices & Themes

Week 1: July 5-7	$90.00 (partial week due to holiday)	Interesting Insects
Week 2: July 10 - 14	$150.00 (full week)	Food and Farms
Week 3: July 17 - 21	$150.00 (full week)	Woods and Water
Week 4: July 24 - 28	$150.00 (full week)	Awesome Animals

Ages: 6 - 12

Registration is now OPEN!

1 child per registration

No partial weeks.

Scholarships available!

Scholarships must be received by June 1.

Camp is located at Ettl Hall, 1333 Butte Road, Yuba City, CA 95993

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Questions? Contact sutteryuba@ucanr.edu or 530-822-7515.

Camp sponsored by: The Center at Sierra Health Foundation and UC Cooperative Extension Sutter-Yuba

✻ = Required

County: ✻

Youth Last Name ✻

Youth First Name ✻

Preferred Name (e.g. nickname)

Birthdate (MO/DY/YEAR) ✻

Age ✻

Email ✻

Phone ✻

Address ✻

City, State, Zip ✻

School ✻

Grade ✻

Are you in a 4-H Club? ✻

Yes No

If Yes, which club?

About You

Gender: ✻

Woman/Girl Man/Boy Nonbinary Gender Identify Not Listed Prefer Not to Respond

Residence ✻

Demographics

(Information is for Funding Purposes Only - No identifying information will be given out)

Are you Hispanic or Latino ethnicity? ✻

Race ✻

American Indian or Alaska Native Asian Black or African American Native Hawaiian or Pacific Islander White Prefer Not to State

Emergency Contact Information - (Must be an adult other than Parent/Guardian)

First & Last Name ✻

Relationship ✻

Phone ✻

Email ✻

Parent / Guardian Information

Parent 1 First Name: ✻

Parent 1 Last Name:

✻

Parent 1 Phone ✻

Parent 2 Name (Optional):

Parent 2 Last Name (Optional):

Parent 2 phone (Optional):

Check box if:
Monthly household cash income is at or below 185% of the Federal Poverty guidelines or if your family qualifies for the CalFresh program. If yes, you can apply for a reduction or camp scholarship. Please contact Rene McCrory at the UCCE Sutter-Yuba Office at 530-822-7515 or rjmccrory@ucanr.edu to request a waiver. (Reference:https://www.fns.usda.gov/cn/income-eligibility-guidelines)

Yes, monthly house cash income is at or below 185% of the Federal Guidelines.

Does your child have need any special accommodations? ✻

Yes No

If Yes, please specify accommodations?

CAMP FORMS

Please read:

Code of Conduct - Member

Waiver of Liability

Photo & Information

I have read and agree to the Code of Conduct ✻

Yes No

I have read and agree to the Photo & Information ✻

Yes No

I have read and agree to the Waiver of Liability ✻

Yes No

Treatment Authorization and Health History form

Please download, fill out, and upload.

Is your child on regular medicines or will possibly bring meds to camp? If you click yes, please be sure to leave medicine in original container and bring all medicines to camp in a labeled plastic bag with instructions. ✻

Yes No

FOOD ALLERGIES and MEDICAL NEEDS

Does the camper have food allergies that requires a special diet? ✻

Yes No

If so, please list:

DAY CAMP T-SHIRTS
Please mark the size you need.
1 t-shit is included with your registration fee.

Additional t-shirts may be purchased for additional $10 each.

Size: ✻

I would like additional t-shirt/shirts ✻

I am registering for the following week/weeks: ✻

Week 1: July 5 - 7 $90.00 - Camp is full this week! Thank you. Week 2: July 10 - 14 $150.00 - Camp is full this week! Thank you. Week 3: July 17 - 21 $150.00 - Camp is full this week! Thank you. Week 4: July 24 - 28 $150.00 - Camp is full this week! Thank you.

I want to apply for a scholarship or fee reduction. Click HERE for application. Application DEADLINE is June 1st!

Yes No

(To pay by credit card, enter the amount you owe in the box below, and click "Submit Registration". You will then be taken to the credit card payment screen.)

Payment Type or Intent to apply for Scholarship ✻

Pay NOW by Credit Card Pay by check or money order to UC Cooperative Extension Office I am Registering Additional children/family member and want to pay once for all I want to hold my spot with a NON-REFUNDABLE $25.00 deposit I plan to apply for a Scholarship and holding my spot with a $25 NON-REFUNDABLE deposit

Credit Card Payment Amount here:

Upload your file