Camper Application 2021

Terms and Conditions

Camp will provide all program supplies, two daily snacks and admissions and transportation for all trips.
I grant permission for my child/children to participate in all camp activities, including trips which take place off campus. (dates and destinations to be provided at a later date)
I agree to pay the Lice fee of $10 for the summer. If your child is not present during any scheduled in camp lice checks, your child cannot return to camp without a note from a reputable Lice checking company. ( Only with the approval of YISI Day Camp)
All sessions with outside professionals (OT,PT etc.) must be coordinated by the professional with the camp office a minimum of one day before the services are to be provided. Camp will not be responsible for fees incurred from changes not coordinated with the camp office.
I agree that my children may be photographed, and their pictures ay be used in future camp promotional materials, including, but not limited to the brochure and the YISI website
If the camper's conduct is deemed inappropriate or harmful to other YISI campers or staff members, the camper may be dismissed at the sole discretion of the Director with no refund nor reduction of fee.
In the event that YISI is forced to resort to legal means to collect any outstanding amount due, we agree that we are obligated to pay YISI's reasonable attorney's fees plus any cost of the court incurred by YISI in the collection or enforcement of the debt.
I agree to follow all YISI COVID protocols put in place by camp including protocol changes which may be implemented and put into effect throughout the summer as put forth by DOH.
I will adhere to any protocols that may change throughout the duration of the summer.
All parents are responsible for checking with camp for updated travel protocols before traveling. Parents are required to inform camp of any travel outside the tri-state area that their child/ren will take during the weeks camp is in session. Campers must abide by DOH quarantine guidelines for travel. No refunds or credits will be issued for quarantine related to traveling.
There will be no quarantine refunds if your child/children bunk must quarantine.
There will be no refunds issued should your child be required to quarantine due to personally testing positive for COVID or by having direct exposure.
If camp protocols are not adhered to, YISI reserves the right to remove a child from camp with no refunds offered.
I agree that myself and my child/children will adhere fully and entirely to CDC and DOH guidelines regarding COVID including but not limited to mask wearing and quarantining.

I have read and agree to the Terms and Conditions outlined above

I paid a $100 PreRegistration Fee in-person.

Mother's Information

Mother's Name

Mother's Cell Phone*

Mother's Work Phone

Mother's Home Phone

Mother's Email*

Payment Information

Cardholder Name*

Card Number*

Expiration Month*

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January
February
March
April
May
June
July
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September
October
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Expiration Year*

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2021
2022
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2027
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2050
2051

CVC*

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Young Israel of Staten Island

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Camper Application 2021

Terms and Conditions

Camper Information

Mother's Information

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Payment Information