CUSE Youth Summer C.A.M.P = Community, Adventure, Memories, and Play (CYC) Registration Application
Event Duration: July 7th, 2025 - August 15th, 2025
Monday through Friday 8:30am - 5:30pm
Address: 401 South Avenue Syracuse, NY 13204
Contact Us: (315) 671-5837 or receptionist@smnfswcc.org  
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Child Full Name (must complete separate application for additional children) *
Child Age on July 7, 2025 *
Child Date of Birth *
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Parent/Guardian First Name *
Parent/Guardian Last Name
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Street Address *
City, State *
Zip Code *
Phone Number
*
Email *
Emergency Contact Name *
Relationship to the Child *
Emergency Contact Phone Number *
How will your child(ren) get home?  *
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Child(ren) Shirt Size *
Can Your Child Swim? *
Dietary restrictions/Food Allergy *
Required
Any Allergies/Medication/Health Conditions: *
Required
If So, Will Child Have Treatment On Hand? *
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Child Current School *
Child School Next School Year *
 Welcome to Syracuse Community Connections CUSE Youth Summer C.A.M.P = Community Adventure Memories and Play (CYC)

Summer programming will begin on Monday, July 7th through Friday, August 15th. Monday through Friday from 8:30am to 5:30pm.

Once registered, all youth will be assigned to age-appropriate groups. As a group your child will participate in various scheduled social, recreational, and educational activities on and off site. Youth will be required to remain in their assigned group under the supervision of their group leader during the course of this summer camp. Please make sure that your child(ren) arrive no later than am each morning to avoid delay in their daily schedule or off-site activities. Timely arrival is important as a strict program schedule will be followed.

Breakfast and lunch will be served to youth on a daily basis. A menu will be provided for your viewing. If you or your child is not in favor of the meal menu, we ask that you provide them with lunch. No child will be allowed to go to the store during program hours (no exceptions).

Breakfast will be served:            Monday- Friday            8:30am - 9:30am
Lunch will be served:                  Monday- Friday           12:00pm - 1:00pm
Snack will be served:                  Monday - Friday            4:00pm - 4:30pm

Participants are prohibited from wearing flip-flops and sandals except during swimming sessions. Please send your child to camp with sneakers every day. For outdoor activities we ask that you provide your child with sunscreen to prevent sunburns and rashes. Please label your child's belongings. 

Staff will not be responsible for children who leave the building without permission (parents will be called and child suspended). Staff will not be responsible for the supervision of youth prior to 8:30am. Please do not leave your child(ren) unattended on SCC premises. All children must be picked up by 5:15pm. SCC has the right to contact police officials if child is not picked up by the agreed time (emergency will be considered and circumstances beyond your control).  

Code of Conduct
Rules:
  • Identification is required to enter the building
  • NO children under the age of 5 years old allowed in the facility unsupervised by an adult
  • All pants must be worn at waist height
  • All children must be dressed appropriately (up to the discretion of staff)
  • Absolutely NO sleeping on the premises 
  • Absolutely NO disrespect toward staff will be tolerated (After 3 infractions, you will be barred from the building until further notice)
  • No loitering on the premises
  • No soliciting on the premises
  • No drug sales anywhere in or around the building (parking lot included)
  • No gambling anywhere in or around the building
  • All youth should be picked up by 5:15. Otherwise SCC has the right to call DSS
  • No foul language
  • No defacing property
  • No one under the influence of drugs or alcohol will be allowed in the building
  • No weapons of any kind
  • No horseplay or fighting
  • No smoking in or on the property
  • No running in the building (excluding the gymnasium)
  • No threatening or intimidating peers, staff, or guests
  • No stealing , destroying, misusing, or defacing anyone's property
  • Must comply with all safety regulations
  • Report to management of all suspicious, unethical, or illegal activity 
  • Must give proper advance notice when unable to report to program on time
  • Children who do not attend camp regularly (95% attendance) will not be allowed to go on trips.

I have fully read and understand the rules and expectations listed above. I have read and explained the importance of abiding by the code of conduct to my child(ren). If my child does not adhere, I understand that my child's privileges( field trips, activities, and enrollment) can be revoked. I have also been informed that there are cameras on the premises. 
*
Required
CUSE Youth Summer C.A.M.P (CYC) Hold Harmless Agreement & Registration Form
1) I hereby give permission for my SON(s)/DAUGHTER(s)/SELF, to participate in the CUSE Youth Summer C.A.M.P (CYC) on the registration form. 2) I recognize, understand, and acknowledge that, as in all activities, there is always the inherent risk of injury up to and including death. 3) I recognize, understand, and acknowledge that any and all rules, policies, guidelines, and safety procedures are established for the safety and protection of all participants 4) I agree that my SON(s)/DAUGHTER(s)/SELF will be expected to comply with all rules, policies, guidelines, and safety procedures; We will comply with directives from ALL staff and administration of CUSE Youth Summer Camp (CYC). 5) I certify, to the best of my knowledge, that the current physical condition/health of my SON(s)/DAUGHTER(s)/SELF, is satisfactory for participation; I will notify staff immediately should the mentioned condition changes at any time within the duration of camp and provide proof of a current physical examination upon request. 6) I recognize failure to comply with the mentioned items could result in immediate suspension and/or dismissal from the program. 7) The staff and/or sponsors have my permission to have a Physician and/or Emergency Medical Service (EMS) treat and/or transport my SON(s)/DAUGHTER(s)/SELF, if needed, at any time during participation in the program. 8) In consideration of participation of my SON(s)/DAUGHTER(s)/SELF in the class/program(s) listed on the registration form , I, the undersigned, do hereby agree to hold harmless and indemnify CUSE Youth Summer C.A.M.P (CYC), it's agents, servants, and employees against any claims for and on account of any and all injuries sustained by my SON(s)/DAUGHTER(s)/SELF as a result of participation in the mentioned class/program, including, but not limited to, claims on the account of negligence by CUSE Youth Summer C.A.M.P (CYC), its agents, servants, employees, or subcontractors. 9) The staff and/or sponsors have my permission to photograph my SON(s)/DAUGHTER(s)/SELF. I understand that said photographs may be used in future promotional flyers, brochures, web pages, or press releases. 10) I certify my SON(s)/DAUGHTER(s)/SELF can communicate/ understand directives from staff/instructors. 

I have read, understand, and accept the "Hold Harmless Agreement & C.A.M/P (CYC) Registration Form" policies. I am 18 years or older and responsible for the participant(s). *
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