LEGACY QUEENS SUMMER CAMP 2026 REGISTRATION FORM

Legacy is excited to welcome your child to the 2026 Summer Camp Season. This is the first step to enrolling your child! Please complete this form carefully by reading and reviewing all parts and questions!!

- Legacy Office of Membership Management & Programs

General Information

PreK. If your child will be four years old during camp, they will be placed in the Yellow Group. An additional $40 will be added to the session. This is a smaller cohort and requires additional staffing!

Broken Sessions: Going on vacation? Won't need consecutive two weeks, no problem! Click each session that has the dates your child will attend. No Worries, OMMP staff will sort all that out as we get closer to camp, at least by May 15, 2026.

Services: If your child typically receives speech or SEITT services and you may need accommodations during camp, please contact us first before completing this application.

Camp Shirts: Use this form to purchase additional shirts. Legacy provides one shirt for free. You can purchase shirts closer to camp as well, but for organizational purposes, we suggest ordering them today.

Deposits: Your deposit is applied toward your selected sessions.

For Example:
If your child attends 4 sessions, the deposit is split evenly ($62.50 per session).
If your child attends 2 sessions, $62.50 is applied to the first session and the remaining $187.50 to the second.

Tip: Please put an email that you check regularly.

Next: You will receive an email to sign the Membership Agreement. Missing this slows evveerrything....

Last: Once you receive the email from Procare with instructions to get on... Download the PROCARE App to your device. Once downloaded, your child is secure in camp! You can use ProCare messages at any time to communicate with the Membership Office!

Note: It takes 1-2 business days to fully process and review your application.

Oh!: Unfortunately, there are no refunds.

Additional Questions? Email us: membership@legacyafterschool.com

Follow us on Instagram! www.instagram.com/legacyyouthorg

Child's Full Name*

First NameLast Name

Date of Birth*

Date

Gender*

MaleFemale

Grade Entering in Fall 2026*

Child's School*

Was Your Child Enrolled in Legacy After School Programs During the 2025-2026 School Year?*

YesNo

Did Your Child Attend Legacy Summer Camp In The Past?*

YesNo

Does your childs school need an After School Program?*

YesNoNot Applicable

Primary Parent/Guardian Full Name*

First NameLast Name

Relationship to Child*

MotherFatherLegal GuardianOther

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Primary Phone Number*

Please enter a valid phone number.

Secondary Contact Phone Number ( Work)

Please enter a valid phone number.

Primary Email Address*

example@example.com

Parent/Guardian Full Name

First NameLast Name

Relationship to Child

FatherLegal Guardian

I Want This Guardian To Have Permissions On My Childs Account.

YesNo

Phone Number

Please enter a valid phone number.

Email Address

example@example.com

Authorized Parent/Guardian Full Name #1*

First NameLast Name

Authorized Pick Up #1 Phone Number*

Please enter a valid phone number.

Authorized Parent/Guardian Full Name #2

First NameLast Name

Authorized Pick Up #2 Phone Number

Please enter a valid phone number.

Select Summer Camp Sessions*

Session 1: June 29 - July 10, 2026: $325Session 2: July 13 - July 24, 2026: $325Session 3: July 27 - August 7, 2026: $325Session 4: August 10 - August 14, 2026: $300

Select the sessions you will need EXTENDED 8AM-5:45PM.

Session 1: June 29 - July 10Session 2: July 13 - July 24Session 3: July 27 - August 7Session 4: August 10 - August 14

Early Dismissal Plan- I am requesting that my child be dismissed on non trip days:*

Early Dismissal: 2:30-2:40 PMEarly Dismissal: 4:30-4:40 PMGeneral Dismissal: 5:15-5:45 PMOther

Select Club Add On Programing*

Is your child fully toilet trained?*

YesNo

Does your child require assistance in the bathroom? Note: your child must be independtly able to use the bathroom with minimal assistance.*

No, my child is independentYes, needs reminders onlyYes, needs significant assistance

Has your child had any bathroom accidents in the past 3 months?*

NoYes, occasionallyYes, frequently

Has your child attended any Summer Camp Program in the Past?*

Yes, and they loved itYes, mixed feelingsNot yet — this is a firstWe’re all learning together

Does your child have any behavioral concerns we should be aware of?*

NoYes

If yes, please describe behavioral concerns

Has your child been diagnosed or recieve with any of the following services concerns? (Select all that apply)*

If applicable, please provide additional details about your child's diagnosis or support needs

To Best serve your child. The Legacy Office of Membership Management requires that you upload your child's IEP and or any documents that will provide support and understanding of your child while in programs.

New York State Law and NYC Dept of Health Code requires all children to have a physical and immunizations stamped and dated within the calendar year of camp. If you have your childs physical, please upload it now so it can be processed. Note: your child will not be able to start camp without a valid physical.

Does your child have any medical conditions?*

NoYes

If yes, please describe the medical condition(s)

Does your child take any medications?*

NoYes

Does your child require the use of an epinephrine auto injector?*

NoYes

Does your child require the use of an asthma inhaler?*

NoYes

Does your child have any allergies?*

NoYes, food allergiesYes, medication allergiesYes, environmental allergies

If yes, list all allergies and describe any reactions or Medications. Note: Legacy is a nut free program and self administering site.

Legacy Accepts Select Child Care Vouchers and Child Care Assistance. Will You be using vouchers listed?*

I do not have a child care voucher.MTA LOCAL 1001199- CHILD CARE FUND

How did you hear about Legacy? ( Friend Name, Google, Instagram, Community?)*

Do you have any important comments regarding this registration to inform us of?

By completing this order, you are booking camp with a deposit for the child listed above. If you have a second child, please complete another application. Your first invoice payment will be due at least three weeks before the start of camp. *

2006 SUMMER CAMP DEPOSIT The deposit will be used to book sessions selected on the application.

$250.00

General Camper T-ShirtNote: Each camper will receive one camp shirt by default for free. This option is to purchase additional shirts. General Campers will be required to wear their shirt on trip days. We suggest ordering three shirts total for camp.

$20.00 QuantitySize

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

Queens Site Summer Camp 2026 Registration Form

Child Information

Primary Parent/Guardian Contact Information

Parent /Guardian Contact Information

Dismisal Process & Authorized Pick Up

Session Selection

Extended Day & Dismisal Plan Add-On Selection

Cooking & STEM Clubs Add-On Selection

Camper Independence

Behavioral and Developmental Information

Medical & Allergy Information

Parent Acknowledgments

FINALIZE SUMMER CAMP BOOKING

Payment Methods