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WAITLIST- YMCA Summer Camp Registration Form 2024
Participant Information
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* Indicates required question
Email
*
Your email
Child's Name (First and Last)
*
Your answer
Male/Female
*
Male
Female
A gender not listed here
Date of Birth
*
MM
/
DD
/
YYYY
Child's Age
*
Your answer
Grade Entering (next Fall)
*
Choose
Kindergarten
1st (First)
2nd (Second)
3rd (Third)
4th (Fourth)
5th (Fifth)
6th (Sixth)
DHS # (if applicable)
Your answer
Address: Street/City/ State/ Zip
*
Your answer
Parent 1/Guardian 1
*
Your answer
Parent 1/Guardian 1 Email
*
Your answer
Parent 1/Guardian 1 Cell Phone
*
Your answer
Parent 2/Guardian 2
*
Your answer
Parent 2/Guardian 2 Email
*
Your answer
Parent 2/Guardian 2 Cell Phone
*
Your answer
Parent 2/Guardian 2 Work Phone
Your answer
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