Summer Camp

    YORKTOWN STAGE THEATRE WORKSHOPS
    Summer Camp 2024
    Use separate form for each child.

    *Please check the checkbox to select the dates.

    WEEK 1

    JUN 27 - JUL 3

    Mon-Fri

    9:00am-3:00pm

    $279

    WEEK 3

    JUL 8-12

    Mon-Fri

    9:00am-3:00pm

    $279

    WEEK 4

    JUL 15-19

    Mon-Fri

    9:00am-3:00pm

    $279

    WEEK 5

    JUL 22-26

    Mon-Fri

    9:00am-3:00pm

    $279

    WEEK 6

    JUL 29 – AUG 2

    Mon-Fri

    9:00am-3:00pm

    $279

    WEEK 7

    AUG 5-9

    Mon-Fri

    9:00am-3:00pm

    $279

    WEEK 8

    AUG 12-16

    Mon-Fri

    9:00am-3:00pm

    $329

    WEEK 9

    AUG 19-23

    Mon-Fri

    9:00am-3:00pm

    $329

    Total Amount: $

    Child’s Name*:

    Date of Birth*:

    (Format:mm/dd/yyyy)

    Age Today*:

    Grade (Fall of 2024)*:

    Gender*:

    BoyGirl

    Sibling Discount $15

    Name of Primary Parent/Guardian*:

    Email Address*:

    (Confirmation of Registration will be sent by Email only.)

    Address of Primary Parent/Guardian*:

    Phone Nos. Primary Parent/Guardian*:

    Name of Other Parent/Guardian:

    Email Address:

    Phone Nos. Other Parent/Guardian:

    Prior YS Camper:

    Child To Be Placed With (Optional):

    (Only children of same grade will be placed together)

    Emergency Contact (to be called if Prime or Other Parent / Guardian cannot be reached):

    Name*:

    Phone*:

    Release Statement*: I hereby release the Executive Director and all employees of YORKTOWN STAGE from all claims of liability for any damages or injuries or illness which may be sustained while my child is in camp including illness from Covid 19. I hereby give permission for my child’s photograph to be used in Yorktown Stage’s Summer Camp publications, and for advertising and promotions. I hereby authorize YORKTOWN STAGE to charge my credit card below referenced, if any, for any and all charges incurred by me, relating to the extended care of my child, either before care or aftercare.

    Signature of Parent / Guardian*:

    Date*:

    (Format:mm/dd/yyyy)

    Type Name*:

    My child can be released to the following people:

    NAME:

    PHONE:

    NAME:

    PHONE:

    Credit Card Information:

    Card Type*:

    Card Number*:

    Expire Month*:

    Expire Year*:

    Sec. Code*:

    RELEASE OF MINORS: All campers are released at the end of the camp day to parent / guardians.
    NO CAMPER WILL BE ALLOWED TO LEAVE WITH A STRANGER.

    REFUND POLICY: If you cancel prior to 14 days before the 1st day of your registered week, for weeks 1-7 only, you will receive a full refund, less a handling charge of $45. If you cancel prior to July 26, for weeks 8-9 only, you will receive a full refund, less a handling charge of $45. There will be no refunds for cancellations for any person after the dates noted above. The Camp Director and/or the Executive Director have the right to dismiss any child for behavioral problems. Money will not be refunded for days missed due to dismissal or illness. NOTE: Your application cannot be processed unless completely filled out and signed, and all fees paid. Your medical form(s) must be submitted prior to the start of the camp week.

    NOTE:Your application cannot be processed unless completely filled out and signed. Your medical forms(s) must be submitted before the session starts. You will receive EMAIL confirmation of Registration. PLEASE remove spam filters. If not received, PLEASE call office at 914-962-0606.

    Please click on Submit only once. Your request is processing.