of Bergen, Morris, Passaic, Essex, Hudson & Rockland

Director: Nick Palermo 201-530-1255 or

Contact Us

Please feel free to contact us with any questions or comments. You may also like to fill out our pre-enrollment form so we may get your information accurately.

Phone:: 1-800-DAY-CAMP or 201-530-1255
Email:: lynn@ypdc.com

Pre-Enrollment Form

To pay for pre-enrollment please call us at 1-800-DAY-CAMP or 201-530-1255 with your credit card information.

Parents/Guardian Information

First Name:

Last Name:

Address:

City:

State/County:

Zip Code:

Home Phone:
Use format: XXX-XXX-XXXX

Cell Phone:
Use format: XXX-XXX-XXXX

Work Phone:
Use format: XXX-XXX-XXXX

E-Mail:

Children Information

Child 1

Name:

Birthdate:

Grade/Fall:

Address:

Child 2

Name:

Birthdate:

Grade/Fall:

Address:

Child 3

Name:

Birthdate:

Grade/Fall:

Address:

Dates Attending

Weeks Your Children Will Be Attending:
(Minimum 2 Week Enrollment Per Child Required)

6/28 - 7/01
7/06 - 7/09
7/12 - 7/16
7/19 - 7/23

7/26 - 7/30
8/02 - 8/06
8/09 - 8/13
8/16 - 8/20

Additional Comments and/or Information