Youth One-Week Camp Registration

Camper's Name *

Address *

Camper's Birthdate *

Camper's Sex *

Male

Female

Has the camper completed Kindergarten? *

Yes

No

Is your child a member of the Sewickley Valley YMCA? *

Yes

No

Will you be signing up for a membership when registering for camp? *

Yes

No

If you will be requesting financial assistance for camp, have you already submitted your application? *

Yes

No

I will not be requesting financial assistance

Parents / Guardian *

Phone Number *

Email *

Special Instructions / Allergies *

Proceed to registration *

Yes, I would like to proceed to select sessions and camps

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