Summer Camp Registration - YWCA Carlisle & Cumberland County

To add your child to the waiting list for our summer camp, please fill out the form below, indicating the weeks and times you are interested. You can also call our office at 717-243-3818 to have your child added to the waiting list

Summer Camp Registration 2026

Camp Registration (Complete to be added to the waitlist)

Our summer program is open to students turning at least 4 by September 1, 2026 through student exiting first grade. To attend summer camp, students must be daytime potty trained with only occasional accidents (exceptions may be made in certain documented cases related to medical needs or developmental delays. Please contact the preschool director for more information.) A $25 deposit is due per week to guarantee your child’s spot in that week of camp. This deposit will be applied to your child’s weekly tuition, with the remainder of the payment due one week prior to each week of camp. Deposit fees are non-refundable.

Select all weeks you would like to register your child for below:

Weekly Tuition: $120 per week for 9:00 am-1:00 pm and $155 per week for 9:00 am-3:00 pm

Week of June 8: Nature and Gardening

9:00 am-1:00 pm

9:00 am-3:00 pm

WAIT LIST ONLY

Week of June 22: Camping & the Great Outdoors

9:00 am-1:00 pm

9:00 am-3:00 pm

WAIT LIST ONLY

Week of August 3: Ocean Exploration

9:00 am-1:00 pm

9:00 am-3:00 pm

WAIT LIST ONLY

Week of August 10: Arts & Crafts

9:00 am-1:00 pm

9:00 am-3:00 pm

WAIT LIST ONLY

Child's Information

Child's Name(Required)

First Last

Preferred Name to be Called/Nickname

Preferred Name For Labeling Items

Child's Age(Required)

Child's Birthdate(Required)

Child's Gender(Required)

Highest Grade Completed by the Time of Camp

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Demographics - please select all that apply(Required)

African American/Black

Asian American/Pacific Islander

Hispanic/Latinx

Native American

White/Caucasian

Prefer not to answer

Primary Language Spoken at Home(Required)

Other Languages

(Optional)

Does your child have any special needs or does your child receive any therapies/support services from the Capital Area Intermediate Unit (CAIU) for early childhood intervention? NOTE: A copy of the child's IFSP will be required prior to starting school.(Required)

Yes

A copy of the child’s IFSP is required prior to school starting. Please list all support services your child receives:

May we contact your child's therapist(s)?

Yes

Has your child exhibited any barriers to learning (including anxiety, language skills/speech, running away, aggression, physical limitations, social limitations, etc.)?

Is this your child's first experience in a school setting or group?(Required)

Yes

Is this your child's first time away from parent/guardian or direct member of your family (like grandparents, relatives, etc.)?(Required)

Yes

Parent/Guardian Information

Parents/Guardians Name(Required)

First Last

Phone

Employer

Work Phone

Additional Parent/Guardian Info (if applicable)

First Last

Phone

Address (if not the same as parent/guardian listed above)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employer

Work Phone

Emergency Contacts - In the event that parent/guardian cannot be reached, please list 2 emergency contacts for your child.

Name of Emergency Contact #1(Required)

Emergency Contact #1 Phone(Required)

Emergency Contact # 1 Address

Name of Emergency Contact #2(Required)

Emergency Contact #2 Phone(Required)

Emergency Contact # 2 Address

People Authorized to Pick Up My Child - Photo ID required at time of pick up

Pick Up Person #1

Pick Up Person #1 Phone

Pick Up Person # 1 Address

Pick Up Person #2

Pick Up Person #2 Phone

Pick Up Person #2 Address

Pick Up Person #3

Pick Up Person #3 Phone

Pick Up Person #3 Address

Please list any additional approved pick-up persons, phone numbers, and addresses

Is there anyone who legally cannot have any contact with your child (such as attending class/school events, volunteering, etc.). If so, please list them by first and last name in the box below.

Child's Health Information

Please list any allergies or medical conditions.

Please list any additional dietary resrictions.

Please list any prescriptions to be kept at school (doctor's form required).

Does your child have an EPIPEN?

Yes

Doctor's Name

Doctor's Phone #

Doctor's Office Address

Is your child covered by insurance?(Required)

Yes

Primary Health Insurance Provider:

Insurance Provider Phone #

Insurance Identification #

Insurance Group #

Dentist's Name

Dentist's Phone #

RELEASE INFORMATION

I understand that, in the event of an emergency involving my child, it may be necessary for a staff person or other representative of YWCA Carlisle to administer basic first aid to my child and/or transport my child to a hospital, physician's office or other health care facility. I hereby consent to the treatment and/or transportation of my child under such circumstances, and release YWCA Carlisle, its employees, director and agents from any claim arising out of or related to such treatment or transportation, except in the case of gross negligence. I will bear all expenses incurred in transportation and medical treatment.(Required)

My electronic signature below indicates my consent. (Consent is required to enroll in Little Wonders Summer Camp. If you cannot consent, regrettably, your child will not be able to attend our preschool. Please contact the Preschool Director with any questions).

Name Date

Additional Releases - Please check any and all boxes that apply:(Required)

1. I give permission for my child to be photographed for classroom use ONLY including displays, projects, activities, and special events (will not be used for social media or online - only within classroom group).

2. I give permission for my child’s photo to be used on the school website, on all YWCA Carlisle & Cumberland County social media accounts, marketing materials, and other school promotions, both print and electronic (including, but not limited to YWCA Carlisle’s annual report), understanding my child’s name will not be displayed.

3. REQUIRED - I understand that my deposit is non-refundable, even if my child does not attend camp as registered.

4. REQUIRED - I hereby agree to abide by the YWCA Little Wonder’s camp fee policies, including paying a late pick up fee of $1.00 per minute after 5 minutes late, paying my balence of camp tuition by one week prior to the week of camp attendance, and that my child cannot attend camp for any unpaid dates until payment has been made. I understand that my child’s spot in the camp is only guaranteed by completion of tuition payment one week prior to camp and that non-payment by 3 days prior to the first day of the camp week can lead to my child’s spot being released to others on the waiting list for that week.

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Summer Camp Registration 2026

Camp Registration (Complete to be added to the waitlist)

Select all weeks you would like to register your child for below:

Child's Information

Parent/Guardian Information

Emergency Contacts - In the event that parent/guardian cannot be reached, please list 2 emergency contacts for your child.

People Authorized to Pick Up My Child - Photo ID required at time of pick up

Child's Health Information

RELEASE INFORMATION