Camp PAL 2026 Registration

Current date

MonthDayYear
Date
Camp PAL 2026
Epic Explorers

Session 1: Diving into the Deep Blue Sea June 30th - July 9th

Session 2: Mission to Space July 14th - July 23rd

Session 3: Arctic Expedition July 28th - August 6th

Tuesday - Wednesday - Thursday

TIME: 1:30 PM - 4:30 PM

Southern Boulevard Elementary School 192 Southern Blvd., Chatham, NJ 07928

YOU MUST REGISTER YOUR CHILD FOR AN ENTIRE TWO-WEEK SESSION; (additional single weeks will be allowed at the discretion of the Director)
Date of Registration

MonthDayYear
Date
Child's Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Age
Address*

Street Address

CityState

Zip Code
Parent/Guardian's name*

First NameLast Name
Email*
example@example.com
Cell phone*
Please enter a valid phone number.
Parent/Guardian's name

First NameLast Name
Email
example@example.com
Cell Phone
Please enter a valid phone number.
Emergency Contact Person (other than parent/guardian)*
Person(s) other than the parent authorized to pick child up from Camp PAL.*
Person(s) other than the parent authorized to pick child up from Camp PAL.
T-shirt size. (first t-shirt is free)*
Please note that wearing the Camp PAL t-shirt is not mandatory every day. We encourage campers to wear it on the first and last day of Camp PAL.
I would like to purchase an additional shirt for $10:

YesNo
How did you hear about Camp PAL?*

PHOTO/VIDEO RELEASE
For good and valuable consideration, the receipt of which is hereby acknowledged, I hereby consent to the photographing of my child and the recording of my child’s voice and the use of these photographs and/or recordings singularly or in conjunction with other photographs and/or recordings for advertising, publicity, commercial or other business purposes. I understand that the term “photograph” as used herein encompasses both still photographs and motion picture footage.

I further consent to the reproduction and/or authorization by Creative Speech Solutions, LLC to reproduce and use said photographs and recordings of my child’s voice.

I hereby release Creative Speech Solutions, LLC, and any of its associated or affiliated companies, their directors, officers, agents, employees and customers, and appointed advertising agencies, their directors, officers, agents and employees from all claims of every kind on account of such use.
Photo/Video Release Consent*
Parent/Guardian Signature*

Rows	YES	NO	List up to three current goals
Speech Therapy
Occupational Therapy
Physical Therapy
ABA (Applied Behavior Analysis)
Other

Rows	YES	NO	COMMENT
Single words
Simple phrases
Echolalia (eg. scripting, repeating adult speech)
Conversational
AAC (augmentative/alternative communication)
Other

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Camp PAL 2026