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Camper Information

Parent/Guardian Information

Choose your camp and session(s) below

Camp Wind-in-the-Pines

For 6-12 year olds
Please note that there are no partial weeks or sessions.
Each week at Camp Wind-in-the-Pines cost $230.00. Each session is one-week long.

Sessions cannot be prorated.
*No camp July 4, 2013

Counselor-in-Training (CIT) Program

For 13-15 year olds
Please note that there are no partial weeks or sessions.
Each week in the CIT program cost $115.00.

Sessions cannot be prorated.
*No camp July 4, 2013


Worcester: 1 Salem Square
Drop-off: 7:30 - 8:25 a.m. / Pick-up: 4:30 - 6:00 p.m.

Westborough: 15 Grove Street
Drop-off: 7:30 - 8:10 a.m. / Pick-up: 4:45 - 6:00 p.m.

Pick-up List

Anyone picking up a camper must provide a photo ID and be listed below

List up to 3 other people (other than parent/guardian) that are authorized to pick-up the camper or should be contacted in case of a medical emergency or emergency pick-up:

Emergency Medical Release

In case of an emergency, I understand every effort will be made to contact me or the emergency contact persons listed above. In the event that we cannot be reached, I hereby give permission to the physician listed on the form to hospitalize, secure proper treatment and to order anesthesia or surgery for my child.

Allergies and Medication

The Permission to Administer Medication form must be filled out and given to the Camp Director on the first day of each camp session. Medications must be accompanied by the original physician’s prescription with clearly written directions. If your child has other special needs (language, learning disability, speech, hearing, food allergies, etc) please contact the Camp Director at 508-767-2505 ext. 3019 prior to June 17 or at 508-892-9814 after June 17.

Medical Release
I authorize the YWCA as agent for the undersigned to consent with respect to said minor, to an x-ray examination, anesthetic, medical, dental or surgical diagnosis or treatment, and hospital care which is deemed advisable by, and is to rendered under general or special supervision of, any physician or surgeon licensed under the provisions of the MA 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 YWCA is not responsible for costs incurred for medical care.


I give permission for sunscreen to be administered and/or applied to my camper as deemed necessary by the camp staff.

Backpack Search
I agree that any camp participant's belongings may be searched outside the participant's presence for drugs, alcohol, weapons or other forbidden objects.

Lost or Stolen Items
Campers are asked to leave any valuables, electronics (mp3 players, digital cameras, etc.) at home. The YWCA and its employees are not responsible for lost or stolen items.

I give permission for my child's photograph to be taken for use by the YWCA Central Massachusetts in program brochures, annual report, website, and other promotional materials and for release to local newspapers.

I have read, understand and agree to the terms of this application.

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