of Staten Island

Director: Keith Glauber 718-701-3600 or

Contact Us

Campers Eating Ice Cream

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 718-701-3600
Email:: keith@ypdc.com
Address:: 1075 Woodrow Road, Staten Island, NY 10312
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Pre-Enrollment Form

To pay for pre-enrollment please call us at 1-800-DAY-CAMP or 718-701-3600 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)

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
8/23 - 8/27

Additional Comments and/or Information