2026 Camper Enrollment Application

Returning Families Log In Here

or complete the Guest Application below.

Fill out the camper application below and click "Update Changes" at the bottom of the form to continue.

Last:

First:

Birthdate:

Street:

City:

State: Zip:

Home Phone:

Gender: Boy / Girl

Grade 2025-26: N (Preschool or not yet Kindergarten) K (Kindergarten) 1 2 3 4 5 6 7 8 9 10 11

School 2025-26:

Grade 2026-27: N (Preschool or not yet Kindergarten) K (Kindergarten) 1 2 3 4 5 6 7 8 9 10 11

School 2026-27:

Special Placement Requests: One Camper/Friend:

Grade Level (if different from above):

Toilet Trained? (Preschool Only) Yes / No

Does your child have an IEP or 504 Plan? Yes / No If so, we would appreciate a copy be provided to camp.

Allergies, Medications, or Medical Concerns:

Will your child require an Epipen at camp? Yes / No

Does your child receive any services during the school year (Speech, OT, PT, etc.), If so, please specify:

Choose your program!

<

Camp runs for 8 weeks from Monday June 29th to Friday August 21st, 2026
Week 1 will run Monday to Thursday and is a 4 day week.

Choose Which Weeks You Want - Check Each Week Requested

A minimum of 3 weeks is required.

Week 1: Mon Jun 29 - Thu July 2

Week 2: Mon Jul 6 - Fri Jul 10

Week 3: Mon Jul 13 - Fri Jul 17

Week 4: Mon Jul 20 - Fri Jul 24

Week 5: Mon Jul 27 - Fri Jul 31

Week 6: Mon Aug 3 - Fri Aug 7

Week 7: Mon Aug 10 - Fri Aug 14

Week 8: Mon Aug 17 - Fri Aug 21

Choose Your Add Ons!

If taking the bus, please see where transportation is available here.

AM Extended Hours (from 7:45am) $50/Week

PM Extended Hours (to 5:30pm) $50/Week (only available to PM campers)

Lunch Program $65/Week (Not available to AM campers)

AM Bus $110/Week

PM Bus $110/Week (Only available to Full Day campers)

Midday Bus (2 pm camp departure) $110/Week (Only available to Mini Day campers)

Mother or Guardian Contact Information:

Name:

Cell Phone:

Address (if different from camper):

Home Phone (if different from camper):

Business Phone:

Email Address:

Father or Guardian Contact Information:

Name:

Cell Phone:

Address (if different from camper):

Home Phone (if different from camper):

Business Phone:

Email Address:

Approve Release Form

I agree to all the conditions in the Release document below. (Click to enlarge)

Approve Enrollment Policies

I agree to all the conditions in the Enrollment Policies document below. (Click to enlarge)

3095 Purchase Street
Purchase, NY 10577

© by Purchase Day Camp