- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name
-
-
-
- Secondary Contact Last Name
-
-
-
-
-
- Secondary Contact Phone Number
-
-
-
- Secondary Contact Email
-
-
-
-
- Secondary Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name
-
-
-
- Secondary Contact Last Name
-
-
-
-
-
- Secondary Contact Phone Number
-
-
-
- Secondary Contact Email
-
-
-
-
- Secondary Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name
-
-
-
- Secondary Contact Last Name
-
-
-
-
-
- Secondary Contact Phone Number
-
-
-
- Secondary Contact Email
-
-
-
-
- Secondary Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name(Optional)
-
-
-
- Secondary Contact Last Name
-
-
-
-
-
- Secondary Contact Phone Number
-
-
-
- Secondary Contact Email
-
-
-
-
- Secondary Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name(Optional)
-
-
-
- Secondary Contact Last Name(Optional)
-
-
-
-
-
- Secondary Contact Phone Number
-
-
-
- Secondary Contact Email
-
-
-
-
- Secondary Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name(Optional)
-
-
-
- Secondary Contact Last Name(Optional)
-
-
-
-
-
- Secondary Contact Phone Number(Optional)
-
-
-
- Secondary Contact Email
-
-
-
-
- Secondary Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name(Optional)
-
-
-
- Secondary Contact Last Name(Optional)
-
-
-
-
-
- Secondary Contact Phone Number(Optional)
-
-
-
- Secondary Contact Email(Optional)
-
-
-
-
- Secondary Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name(Optional)
-
-
-
- Secondary Contact Last Name(Optional)
-
-
-
-
-
- Secondary Contact Phone Number(Optional)
-
-
-
- Secondary Contact Email(Optional)
-
-
-
-
- Secondary Contact Relationship(Optional)
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name(Optional)
-
-
-
- Secondary Contact Last Name(Optional)
-
-
-
-
-
- Secondary Contact Phone Number(Optional)
-
-
-
- Secondary Contact Email(Optional)
-
-
-
-
- Secondary Contact Relationship(Optional)
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name(Optional)
-
-
-
- Secondary Contact Last Name(Optional)
-
-
-
-
-
- Secondary Contact Phone Number(Optional)
-
-
-
- Secondary Contact Email(Optional)
-
-
-
-
- Secondary Contact Relationship(Optional)
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name(Optional)
-
-
-
- Secondary Contact Last Name(Optional)
-
-
-
-
-
- Secondary Contact Phone Number(Optional)
-
-
-
- Secondary Contact Email(Optional)
-
-
-
-
- Secondary Contact Relationship(Optional)
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference(Optional)
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name(Optional)
-
-
-
- Secondary Contact Last Name(Optional)
-
-
-
-
-
- Secondary Contact Phone Number(Optional)
-
-
-
- Secondary Contact Email(Optional)
-
-
-
-
- Secondary Contact Relationship(Optional)
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference(Optional)
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request
Parent On Duty (POD) Preference(Optional)
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name(Optional)
-
-
-
- Secondary Contact Last Name(Optional)
-
-
-
-
-
- Secondary Contact Phone Number(Optional)
-
-
-
- Secondary Contact Email(Optional)
-
-
-
-
- Secondary Contact Relationship(Optional)
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference(Optional)
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name(Optional)
-
-
-
- Secondary Contact Last Name(Optional)
-
-
-
-
-
- Secondary Contact Phone Number(Optional)
-
-
-
- Secondary Contact Email(Optional)
-
-
-
-
- Secondary Contact Relationship(Optional)
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference(Optional)
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request(Optional)
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name(Optional)
-
-
-
- Secondary Contact Last Name(Optional)
-
-
-
-
-
- Secondary Contact Phone Number(Optional)
-
-
-
- Secondary Contact Email(Optional)
-
-
-
-
- Secondary Contact Relationship(Optional)
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference(Optional)
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request(Optional)
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup(Optional)
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name(Optional)
-
-
-
- Secondary Contact Last Name(Optional)
-
-
-
-
-
- Secondary Contact Phone Number(Optional)
-
-
-
- Secondary Contact Email(Optional)
-
-
-
-
- Secondary Contact Relationship(Optional)
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference(Optional)
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request(Optional)
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup(Optional)
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs(Optional)
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name(Optional)
-
-
-
- Secondary Contact Last Name(Optional)
-
-
-
-
-
- Secondary Contact Phone Number(Optional)
-
-
-
- Secondary Contact Email(Optional)
-
-
-
-
- Secondary Contact Relationship(Optional)
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference(Optional)
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request(Optional)
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup(Optional)
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs(Optional)
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs(Optional)
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-
- NOTE: Please enter as much contact information as possible in case
- we need to contact you for application or during the camp week. The
- parent's first and last name must match the legal name on government
- issued ID
-
-
-
-
- Main Contact First Name
-
-
-
- Main Contact Last Name
-
-
-
-
-
- Main Contact Phone Number
-
-
-
- Main Contact Email
-
-
-
-
-
- Main Contact Relationship
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Secondary Contact First Name(Optional)
-
-
-
- Secondary Contact Last Name(Optional)
-
-
-
-
-
- Secondary Contact Phone Number(Optional)
-
-
-
- Secondary Contact Email(Optional)
-
-
-
-
- Secondary Contact Relationship(Optional)
-
-
- Father
-
-
-
- Mother
-
-
-
-
- Guardian
-
-
-
-
-
-
- Emergency Contact First Name
-
-
-
- Emergency Contact Last Name
-
-
-
-
-
-
-
- Emergency Contact Relationship
-
-
-
-
-
- Emergency Contact Phone Number
-
-
-
-
-
-
Parent On Duty (POD) Preference(Optional)
-
- NOTE: One shift required for each child enrolled in Overnight and
- ExplorAsian program. If you cannot serve POD, please select Paid
- Waiver. For all other program we encourage parents to help out.
-
- POD Preference
-
-
-
- Parent #1 as POD
-
-
-
-
-
- Parent #2 as POD
-
-
-
-
-
- I am willing to be a POD lead.
-
-
-
-
Roomate Request(Optional)
-
- Roomate Name
-
-
-
- If no roommate name is indicated, a roommate of the same gender and
- age category will be assigned. Roommate request will only be
- considered if both campers request each other. Ask your friend to
- put your name as their roommate request. Group request for Overnight
- Campers will NOT be accepted.
-
-
-
Medical Information
-
-
- For camper's immunization requirements, please refer to
- regulations
- from Mass Department of Public Health.
-
-
-
- Health Insurance Provider
-
-
-
- Insurance Subscriber's Name
-
-
-
-
-
- Primary Physician's Name
-
-
-
- Primary Physician's Phone
-
-
-
-
- I grant NECYSC permission to: (check box to grant
- consent)
-
-
-
- Accompany my child to the nearest hospital in case of an
- Emergency
-
-
-
-
-
- Secure medical treatment for my child if I cannot be reached
-
-
-
-
-
- Administer first aid in case of an injury
-
-
-
-
-
- Administer Tylenol/Ibuprofen/Benadryl/Tums to my child by
- the camp nurse if needed
-
-
-
-
- Apply Calamine lotion/Bacitracin/Sunscreen if needed
-
-
-
- NOTE: If consent is not granted for any of the above, please
- email us at
- registration@necysc.org
-
-
-
-
-
- Does your child have any allergies?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, to what? Please describe reaction and
- treatment.
-
-
-
-
-
- Initial to grant permission to treat allergic
- reactions
-
-
-
-
-
- Does your Physician's Health Form list an Epi-Pen as medication
- prescribed?
-
- If yes, do you understand that you MUST bring two Epi-Pens so
- that your child can attend camp? You must also fill out the
- NECYSC Medication Permission Slip for the Epi-Pens and submit
- along with other application forms.
-
-
-
- Yes
-
-
-
- No
-
-
-
- Does your child have any social/emotional concerns we
- should be aware of? If yes, please elaborate.
-
-
-
-
-
- Does your child wear any of the following:
-
-
-
- Glasses
-
-
-
-
-
- Contact lenses
-
-
-
-
-
- Hearing Aids
-
-
-
-
-
- Is your child taking any medication?
-
-
-
- Yes
-
-
-
-
-
- No
-
-
-
-
-
- If yes, will the camp need to administer the medication
- to your child during camp? Please explain
- dose/frequency/other note; If no, please explain why
- medication is not needed at camp
-
-
-
-
-
- Are there any activities your child should not take part
- in? If yes, please elaborate.
-
-
-
-
- In case of medical emergency: I understand every effort will be
- made to contact parents/guardians of campers. IN THE EVENT THAT
- I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION FOR THE
- FOLLOWING: THE PHYSICIAN SELECTED BY THE CAMP DIRECTOR MAY
- SECURE PROPER TREATMENT FOR, HOSPITALIZE, ORDER AND ADMINISTER
- MEDICATIONS AND ANESTHESIA, PERFORM X-RAYS, SPECIAL PROCEDURES
- OR SURGERY IF DEEMED NECESSARY BY HIM/HER FOR MY CHILD.
-
-
-
- PARENT/GUARDIAN SIGNATURE (Type in full name)
-
-
-
-
-
-
-
All Persons authorized For Child Pickup(Optional)
-
-
- NOTE: Please list names for all persons including parents that
- are authorized to pick up your child(ren). We will only release
- your child(ren) to the authorized persons listed.
-
-
-
- Names of authorized persons
-
-
-
-
-
Supplemental Information for CITs/Counselors/RAs(Optional)
-
-
- Supplements for the Counselor/CIT/RA application are required
- and can be found on the website
-
-
-
- Please follow the instruction to complete it and email it by
- application deadline when applicable.
-
-
-
-
Supplemental Information for CITs/Counselors/RAs(Optional)
-
-
-
- NOTE: The camp fee: $1800 for ExplorAsian, $1800 for Overnight,
- $900 for Day Camp and $1100 for CIT.
-
-
-
-
- Camp Fee: ($)
-
-
-
- Parent On Duty (POD) Waiver Fee: ($)
-
-
-
-
- Voluntary Donation (tax deductible receipt will be mailed
- after camp): ($)
-
-
-
-
-
-
- TOTAL: ($)
-
-
-
-
-
-
- I am also applying for financial aid. I will submit 50% of
- my payment to hold my application. Please download and
- submit the financial aid application form for consideration.
- Use original amount for the Camp Fee field and 50% amount
- for the TOTAL field.
-
-
-
-
-
Additional Information(Optional)
-
-
-
-
- Check if you want us to contact you to place ads in Camp
- Book
-
-
-
-
-
-
- Check if you don't want to publish name/address/phone in
- camp week-book
-
-
-
-
-
-
- Check if you want to publish name/city/phone in day camp car
- pool list
-
-
-
-
-
-
- Check if you want to be added in next year camp Committee
- candidate list
-
-
-
-
- Where did you hear about us?
-
-
-
- Were you referred by anyone?
-
-
-
-
-
Important Documents
-
-
- Please access and read our documents on camp rules form via the
- hyperlinks below and acknowledge consent by checking the boxes
- below.
-
- By clicking the Submit button below I certify that I have read
- and understand
- NECYSC Camp Information
- and the information provided on this application form is
- accurate to the best of my knowledge.
-
-
-
-
- NOTE: After you submit this application, please make sure you
- see a confirmation page. Write down your confirmation number. In
- order to complete the registration process, you must print and
- fill out the required forms on the
- Download Forms page
- and mail them along with your check to "NECYSC, P.O.BOX 615,
- Weston, MA 02493" as soon as possible. Please make sure to write
- your camper's name and confirmation number on the check. The
- application priority is based on the latest postmark date of
- receipt of the check and
- ALL required information. Contact
- registration@necysc.org
- if you have trouble to complete online application.
-
-
-
-
-
-
-
- {% if form.errors %}
-
-
- Oops! There was an error processing your form. Please check the form for any errors and try again.
-
-