YWCA Child Enrichment Summer Camp 2024 Enrollment Form 
L Please enter in all data carefully in each respective field. Email confirmation will be sent once your applications have been accepted and approved. 

If you have more than 1 child you would like to register, please complete one response form and submit a new one for each additional child. 

Email cedirector@ywcaswil.org for any questions! 
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Email *
Is your child currently enrolled in YWCA any of the following YWCA Programs?  *
Required
Name of Child *
Pronoun Preference
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Child's Race/Ethnicity  *
Child Birthdate  *
MM
/
DD
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YYYY
Child Age *
Grade Completed: Children must have completed Kindergarten to attend Summer 2024.  *
Allergies/Medical Conditions  *
Please indicate any restrictions for play indoors/outdoors.  *
Program Option: Camp Weeks are from June 3rd - August 9th. 
 *
Attended Weeks - please select all weeks your child will be in attendance. 
Summer Camp Vacation Week:  Each child is entitled to one week vacation (absences where you are not charged) per calendar year. Full time students receive 5 days, part time students receive 3 days. If your child surpasses the number of eligible vacation days, you will be charged according to your child's schedule. Please provide the week of your vacation below if applicable. 
If you selected part time, please indicate which days of week your child will be attending.  *
Required
Please indicate if you will be paying Private Pay, CHASI, or DCFS. 
( 100% payment required until CHASI/DCFS approval)
 *
Household Size *
Annual Household Income received by all household members. (please indicate DTD if you do not wish to provide income amount)  *
Assistance Programs Utilized. Check all that apply.  *
Required
Child Shirt Size  *
Does your Child have an IEP or 501 plan? If yes, please email a copy to CE Director so we may better serve your child in our program.  *
Site Attending  *
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