Save & Return Account (optional)

CLICK HERE to setup an account or to return to your account for this form.

We recommend creating an account so that any information you enter will be saved so that you may complete it at another time.

All your information is securely stored, we will not give out your information to anyone.

2022 ONLINE APPLICATION FORM

Camper Information

Camper First Name *

Camper Last Name *

Camper Birth Date * +

Camper Street Address *

Camper Apt #

Camper City *

Camper State *

Camper Zip Code *

Gender *

Female

Male

Camper's t-shirt size *

Did you attend our camp last year? *

Yes

No

Current School *

School in September 2022 *

Grade in September 2022 *

Activities to avoid (please describe)

Does your child have a prescription for an Epipen?

Epipen information: *

Yes

No

Please list all known allergies here.

Allergies:

Does your camper receive any special education
services, have any special needs we should
be aware of, or an IEP? We want to help your
camper have a successful summer and all
information is kept confidential.

IEP *

Yes

No

Please describe services *

Choose and upload your medical form here (or email it to us after you register)

Please be sure to click 'upload' before proceeding.

I give permission for my child to sign him/herself out of camp at the end of the day AND from the bus stop by him/herself if they take the bus home on any given day (available for 6th - 8th graders only - written note or email also required).

Self Dismissal:

Y

* * * * *

*I understand that by checking this box and signing below, I am agreeing to provide proof that my child currently is, or will be, fully vaccinated, by submitting their vaccination card or other Manhattan Youth approved verification method before attending camp (fully vaccinated is currently defined by Manhattan Youth as having already received at least two vaccine doses for children 5 and older, and we reserve the right require a third dose/booster if available and time allows). The second dose must be received at least 14 days before their first day attending camp). If your child is not yet 5 years old, checking this box and signing below is also your agreement of the following to Manhattan Youth: That you fully plan to, and will get, Covid vaccinations for your registered child, including those vaccines that will be, but are not yet available to children under 5 years old, when they do become available.

Parent/Guardian Signature: *

clear

*You have two options for when to provide proof of full vaccination status to Manhattan Youth as follows: You may use the link below to upload vaccination card proof now, or, you may complete the rest of this registration form without uploading proof now and submit proof of vaccination to us as no later than April 1, 2022, unless to your child will not be eligible to become fully vaccinated until after that date, in which case you will submit proof as soon as possible.

Vaccine Upload Form