YPDC - Home
About Activities Schedule Rates Contact
Menu Employment *News! Directions -
Young People’s Day Camp
Bergen, Morris, Passaic, Rockland, Essex & Hudson Counties
Contact Us
  Director
Dan McCabe 		Phone
201.530.1255
   
 

Contact
Phone 201.530.1255
 Email YPDCbergen@AOL.COM
Director Dan McCabe

   
  Pre-Enrollment Form
 

Parents/Guardian Information

 
First Name:
 
Last Name:
 
Address:
 
City:
 
State/County:
 
Zip Code
 
Home Phone#
 
Work Phone#
 
E-Mail
 

Child's Information

  
Name:
 
Birthdate:
 
Grade/Fall:
 
Address:
 

Child # 2 Information

  
Name:
 
Birthdate:
 
Grade/Fall:
 
Address:
 

Child # 3 Information

  
Name:
 
Birthdate:
 
Grade/Fall:
 
Address:
 

Additional Comments and/or Information

  
Comments: