Summer Camp

    YORKTOWN STAGE THEATRE WORKSHOPS
    Summer Camp 2025
    Use separate form for each child.

    *Please check the checkbox to select the dates.

    WEEK 1

    JUN 30 - JUL 3

    Mon-Thr

    9:00am-3:00pm

    $359

    WEEK 2

    JUL 7-11

    Mon-Fri

    9:00am-3:00pm

    $359

    WEEK 3

    JUL 14-18

    Mon-Fri

    9:00am-3:00pm

    $359

    WEEK 4

    JUL 21-25

    Mon-Fri

    9:00am-3:00pm

    $359

    WEEK 5

    JUL 28 – AUG 1

    Mon-Fri

    9:00am-3:00pm

    $359

    WEEK 6

    AUG 4-8

    Mon-Fri

    9:00am-3:00pm

    $359

    WEEK 7

    AUG 11-15

    Mon-Fri

    9:00am-3:00pm

    $359

    WEEK 8

    AUG 18-22

    Mon-Fri

    9:00am-3:00pm

    $359

    Total Amount: $

    Child’s Name*:

    School District:

    Date of Birth*:

    (Format:mm/dd/yyyy)

    Age Today*:

    Grade (Fall of 2025)*:

    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:

    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*:

    (*Credit Card must be valid through September 2025)

    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 any week prior to 14 days before the 1st day of your registered week, you will receive a full refund, less a service charge of $75. This refund is not available for campers who have received discounts for weeks registered. There will be no refunds or credits for cancellations for any person after the dates noted above. Refunds and/or credits will not be available for any reason including, but not limited to sickness, vacations or family emergencies. 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.