Form

Palisades Park Recreation

Summer Camp 2026 Pre-Registration Form
This form is meant to collect information on your intention to register your child for Palisades Park Recreation Summer Camp 2026. When you submit this information you will be contacted via email to complete the registration process by attending one of the in-person sessions to provide the necessary forms & signatures, as well as submitting payment in full. Your child will not be able to attend unless the completed forms & full payment have been received prior to the first day of camp. Forms & payment will not be accepted after Sunday June 28, 2026.
Camp Attendee Information*

Child's First NameChild's Last Name
*

Street Address

Street Address Line 2

CityState

Zip Code
Child's Date Of Birth*

MonthDayYear
Date
Gender*
School*
Parent/Guardian Contact Information*

First NameLast Name
Relationship To Child*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Emergency Contact (If Different Than Above)

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact - Relationship To Child
Should be Empty:

Palisades Park Recreation