REGISTRATION FOR CAMP 2024 IS NOW CLOSED. PLEASE EMAIL [email protected] TO INQUIRE IF WE CAN ACCOMMODATE YOUR CHILD PLEASE DO NOT FILL OUT A SUBMISSION HERE, AS WE MAY NOT BE ABLE TO HONOR IT. 1. Child/ren’s Information Child 1* First Name Middle Name Last Name Birth Date* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Gender* MaleFemale Grade entering Sep 2024* 3K/Nursery PLEASE NOTE. REGISTRATION IS VERY FULL FOR THIS GROUP. AN APPLICATION IS NOT A GUARANTEED SPOT (Must be toilet trained)UPK/Kindergarten PLEASE NOTE. REGISTRATION IS VERY FULL FOR THIS GROUP. AN APPLICATION IS NOT A GUARANTEED SPOTPre 1a/ PrimerFirst GradeSecond GradeThird GradeFourth GradeFifth Grade School Attending* Sessions* Entire Summer (June 27-August 20) $2000Session One (June 27-July 23) $1100Session 2 (July 24-August 20) $1200YISI Member Entire Summer-$1900YISI Member Session One $1050YISI Member Session Two $1150One Week ($350)Two Weeks ($700)Three Weeks ($1000) Hot Lunch * Full Summer ($250)Session 1 ($130)Session 2 ($140)Sack Lunch T Shirt Size* XSSMLXLAdult M Child 2 First Name Middle Name Last Name Birth Date 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Gender MaleFemale School Attending Grade entering Sep 2024 3K/Nursery PLEASE NOTE. REGISTRATION IS VERY FULL FOR THIS GROUP. AN APPLICATION IS NOT A GUARANTEED SPOT (Must be toilet trained)UPK/Kindergarten PLEASE NOTE. REGISTRATION IS VERY FULL FOR THIS GROUP. AN APPLICATION IS NOT A GUARANTEED SPOTPre 1a/ PrimerFirst GradeSecond GradeThird GradeFourth GradeFifth Grade Sessions Entire Summer (June 27-August 20) $1900 (Sibling Discount)Session One (June 27-July 23) $1100Session 2 (July 24-August 20) $1200YISI Member Entire Summer $1800 (Sibling Discount)YISI Member Session One $1050YISI Member Session Two $1150One Week ($350)Two Weeks ($700)Three Weeks ($1000) Hot Lunch Full Summer ($250)Session 1 ($130)Session 2 ($140)Sack Lunch T Shirt Size XSSMLXLAdult M Child 3 First Name Middle Name Last Name Birth Date 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Gender MaleFemale Sessions Entire Summer (June 27-August 20) $1900 (Sibling Discount)Session One (June 27-July 23) $1100Session 2 (July 24-August 20) $1200YISI Member Entire Summer $1800 (Sibling Discount)YISI Member Session One $1050YISI Member Session Two $1150One Week (350)Two Weeks (700)Three Weeks (1000) School Attending Grade entering Sep 2024 3K/Nursery PLEASE NOTE. REGISTRATION IS VERY FULL FOR THIS GROUP. AN APPLICATION IS NOT A GUARANTEED SPOT (Must be toilet trained)UPK/Kindergarten PLEASE NOTE. REGISTRATION IS VERY FULL FOR THIS GROUP. AN APPLICATION IS NOT A GUARANTEED SPOTPre 1a/ PrimerFirst GradeSecond GradeThird GradeFourth GradeFifth Grade Hot Lunch Full Summer ($250)Session 1 ($130)Session 2 ($140)Sack Lunch T Shirt Size XSSMLXLAdult M If you would like to register additional children, please contact us. Are you interested in Extended Care?* YesNo 2. Parent information Phone Number* Area Code Phone Number Address* Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Mother's info* First Name Last Name Occupation* Work Phone* Area Code Phone Number E-mail* Primary email Cell Phone* Area Code Phone Number Father's info* First Name Last Name Occupation* Work Phone* Area Code Phone Number E-mail* Cell Phone* Area Code Phone Number YISI Members* YesNo Marital Status* MarriedSingleDivorced/Separated How did you hear of us? MailerEmailFacebookNewspaper AdInternet SearchAttended PreviouslyOther 3. Emergency & Special Needs Information Emergency Contact (OTHER THAN PARENT)* First Name Last Name Phone Number* Area Code Phone Number Relationship* In order to create an effective and positive camp environment for everyone, please provide the following information for your child. All information will be handled with care and held in confidence Does your child have an IEP or 504 Plan?* YesNo Please email your child's IEP or 504 to the camp office Does your child receive any other services? * YesNo If Yes, please specify Other special considerations (Allergies, medical challenges, etc)* 4. Payment Information Being that Camp begins in under month, full payment is required at time of registration Lice Check* I Agree to a $10 Lice check per child (To be charged separately) Total $0.00 Payment* Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2024202520262027202820292030203120322033 Expiration Year Please contact the Camp office for special requests. I grant permission for my child to participate in all camp activities, including swimming and trips away from camp grounds (dates and destinations to be provided at a later date). I understand that if my application is not filled out completely or the required payments are not enclosed, my application will not be processed and will be returned. I agree to disclose any behavioral help my child receives during the school year, to ensure that Camp has the ability to accommodate my child's needs. I agree that my child may be photographed, and their pictures may be used in future camp promotional materials, including, but not limited to the brochure and the Gan YISI website. No camper will be permitted into camp without all forms completed (including medical and application) and all financial obligations satisfied. Gan YISI is not responsible for personal property brought to camp. If the Camper’s conduct is harmful to the best interests of Gan YISI Day Camp, the Camper may be dismissed at the sole discretion of the Director with no refund nor reduction of fee. I will settle my financial obligations to camp before camp starts Submit Should be Empty: This page uses TLS encryption to keep your data secure.