YPDC - Summer 2026 Enrollment

Summer Enrollment Form

Complete this form to register for camp, including guardian and camper details, attendance weeks, and agreement to terms.
What type of enrollment is this?
Parent/Guardian Information
Parent/Guardian Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter the parent/guardian's valid phone number.Format: (000) 000-0000.
Email Address
Please enter the parent/guardian's valid email address
Camper Information
Number of Campers
- Camper 1 Full Name
  
  First NameLast Name
- Camper 1 Person ID#
- Camper 1 Date of Birth
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Camper 1 Gender
- Camper 2 Full Name
  
  First NameLast Name
- Camper 2 Person ID#
- Camper 2 Date of Birth
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Camper 2 Gender
- Camper 3 Full Name
  
  First NameLast Name
- Camper 3 Person ID#
- Camper 3 Date of Birth
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Camper 3 Gender
- Camper 4 Full Name
  
  First NameLast Name
- Camper 4 Person ID#
- Camper 4 Date of Birth
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Camper 4 Gender
- Camper 5 Full Name
  
  First NameLast Name
- Camper 5 Person ID#
- Camper 5 Date of Birth
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Camper 5 Gender
- Camper 6 Full Name
  
  First NameLast Name
- Camper 6 Person ID#
- Camper 6 Date of Birth
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Camper 6 Gender

Enrollment Weeks
Please Select the Weeks of Attendance
Case Information
Case Name
Case ID Number
DCPP Office Location
Case Worker Email
example@example.com
Case Worker Name
Case Worker Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Enrollment Deposit
To reserve your camper’s spot for Summer 2026, a non-refundable deposit is required:

$155 paid online (includes a $5 processing fee)
or
$150 paid via Zelle

Your deposit will be applied toward your camper’s total summer tuition balance. Enrollment is confirmed once the deposit has been received.

We look forward to an amazing summer at Young People’s Day Camp! ☀️
Which payment option would you like to use?
Please submit your Zelle payment to Camp Director Kellie Orcutt at 908-510-0223 prior to completing this form. Please note that camper spots are not reserved until payment has been received and confirmed.

Camp Enrollment Deposit

YPDC North Enrollment Deposit

Camp Enrollment Deposit

$155.00

Total

Debit or Credit Card
Credit Card Number	Security Code
Expiration Month	Expiration Year

Tuition Information
Weekly tuition is $427.50 per child per week, which includes:
• Door-to-Door Transportation
• Daily Lunch / Snack
• Swimming 1–2x per week
• Field Trips
• Weekly Themes / Activities
• Camp Shirt & Bag
• And more!
SAR Information
FEIN #: 13-2873913
Resource ID #: 10002567
Service: Center Based Child Care – Summer Camp
Unit of Service: Weekly (1 unit per week of camp that the child is attending)
Rate per Service: $427.50

Please note: We bill weekly unless the beginning of a new month falls in the middle of a week. The only exception this summer is Week 1, which will be billed daily at a rate of $85.50 per day (Rate: $85.50 x 5 units/days).

A confirmation email, along with information regarding the SAR, will be emailed to you shortly after submission.
Enrollment Agreement
Enrollment in camp is limited. As the director incurs significant expenses upon registration, all fees must be paid in full by the conclusion of the camper’s stay (Summer 2026). No refunds will be issued. A completed and signed health form is required prior to attendance. For questions, contact Camp Director Kellie Orcutt at 908-510-0223 or kellie@ypdc.com.
I agree to the Enrollment Agreement
Should be Empty:

Summer Enrollment Form

Parent/Guardian Information

Camper Information

Enrollment Weeks

Case Information

Enrollment Deposit

Camp Enrollment Deposit

Enrollment Agreement