2026 Registration Form
Dates: Week 1: July 20 - 24, 2026 / Week 2: July 27-July 31, 2026 (Monday - Friday | 10:00am - 3:00pm)
Location: Lincoln Memorial United Methodist Church - 641 Masten Avenue, Buffalo, NY  14209
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Please select the dates in Week 1: July 20 - July 24 that  youth will be attending Camp (If not attending full week select all the dates that youth will be attending.) *
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Please select the dates in Week 2: July 27 - July 31 that  youth will be attending Camp (If not attending full week select all the dates that youth will be attending.) *
Required
Camper Information
Camper Name *
Gender Identity:
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Nickname
Birthdates & Age
Parent/Caregiver Name *
Street Address/ City, State, Zip Code *
Please provide the best phone number that you can be reached: *
Email Address *
Emergency Contact
Contact Name & Relationship to Camper
Contact Numbers
The following Adults (18 or older) have permission to pick up your child from Camp Peaceprints:
1. Name & Phone # 
2. Name & Phone # 
Allergies/Medical Concerns

We cannot administer any medication during this program. Please do not send anything (pain relief, cough medication, etc.) with your child. 

Please list any allergies (food and environmental) and treatment: *
Please provide other information you believe would be helpful for us to know about your child: *
Do you or your child have a skill or interest you would like to share with Camp Peaceprints? 
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If yes, what?
Lunch and snack are provided each day.  We will be swimming on Tuesdays and Thursdays.
Can you provide transportation for field trips?
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If you can you provide transportation for field trips, how many could you transport in addition to driver?
I give permission for my child’s photograph to be used in promotional materials, websites, television, and newspapers. *
Camp cost is $100/week or $20/day.  Please make checks payable to: "WNY Peace Center."
Please let us know if you need scholarship assistance.
If you are not able to pay the $100/week or $20/day, what amount could you pay?
Could you donate scholarship money?  If yes, how much would you be able to donate?
Other donations - i.e., food, art supplies, etc.
Total Payment Made
** Please note: No electronic devices permitted at Camp Peaceprints. Your child will have access to a Director’s cell phone if needed.**
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