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2023 Camp JYC Registration
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* Indicates required question
Camper's First Name
*
Your answer
Camper's Last Name
*
Your answer
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Gender
*
Campers will be assigned to the cabin area and will use restrooms/shower facilities of their biological (birth) gender.
Choose
Male
Female
Grade Completed in 2023
*
Choose
Pre-K
K
1
2
3
4
5
6
7
8
9
10
11
New Camper
*
Choose
Yes
No
Request one cabin-mate of the same gender
(not required; not guaranteed; N/A for Lil' Squirts Day Camp)
Your answer
Does the camper require a special diet?
*
Yes
No
Required
If the camper has special dietary restrictions, please list below.
Your answer
Parents' or Guardians' Names
*
Your answer
Parent Phone
*
Your answer
Parent Email
*
Your answer
How did you hear about Camp JYC?
Your answer
Early Registration
*
Is it before June 1st?
Choose
Yes
No
T-Shirt Size
*
Choose
YS
YM
YL
AS
AM
AL
AXL
AXXL
AXXXL
Teen Camp ($195 / $235)
For campers who have completed grades 7-11
July 9 -14
Discovery Camp ($195 / $235)
For campers who have completed grades 3-6
July 16-21
Adventure Camp ($195 / $235)
For campers who have completed grades 5-11
July 23-28
Lil' Squirts Day Camp ($90 / $130)
For campers who have completed grades PK-2 - No medical form necessary
July 31 - Aug 2
Choose your payment method
*
PayPal (includes 3.5% processing fee)
Check or Money Order payable to Camp JYC
Requesting full or partial sponsorship
Each overnight camper must bring a completed MEDICAL FORM, which includes obtaining a DOCTOR'S SIGNATURE.
*
This form will be collected AT CHECK-IN when you arrive at Camp JYC on the first day of your Camp week.
I have read and understand the above statement.
This does not apply to me - Lil' Squirts camper only.
Each overnight camper must bring a single sized mattress for their bunk.
I have read and understand the above statement.
This does not apply to me - Lil' Squirts camper only.
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