Pathfinder Country Day Camp Enrollment Form 2024
Pathfinder's Online Enrollment System for 2024.  Please check for availability,  nbsummercamp@msn.com
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Email *
How did you hear about Pathfinder? *
Camper First & Last Name *
Child's Birthday *
MM
/
DD
/
YYYY
Check One *
Required
Camper age (June 2024) *
Years & Months
September 2024 Grade *
Gender *
Parent/Guardian Name *
Cell Phone # *
Home Phone # *
Winter Mailing Address *
Street/Apt#,City,State,Zip
Parent Contact #1 *
Email, Cell #, Work #
Parent Contact #2 *
Email, Cell #, Work #
Emergency Contact #1 *
Name, Cell #, Work #
Emergency Contact #2 *
Name, Cell #, Work #
Permission to Pick Up Child #1 *
Name?  Relationship to Child?  Does camper know this person?
Permission to Pick Up Child #2 *
Name?  Relationship to Child?  Does camper know this person?
Summer Street Address *
House #, Street Name, Town: MTK AMG EH  
PATHFINDER DOES NOT PROVIDE TRANSPORTATION  Parent Drop Off/Parent Pick Up Only
Camper Swim Ability *
Fishing: Children ages 8 years - 11 years only
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Insurance Company *
Policy Number & Policy Contact Phone Number *
Group Number *
Relationship to Participant/Primary Card Holder *
Food Allergies? *
Required
Animal/Insect/Other Allergy? *
Required
Does your child have asthma?
List medications required at camp.
*
Required
Dietary Restrictions *
Required
Medical Forms: Current physical, including a copy of child’s immunizations, is mandatory prior to children beginning camp. All physicals must be dated within a 12 month period of attendance. Children who are not immunized must have a written letter of explanation for the health office file.
Campers Last Well Check by a Licensed Medial Personal? *
Date (__/__/__)
Activity Restrictions *
Children who are not immunized must have a written letter of explanation for the Suffolk County Health Department.
Mandatory to attend camp: Well-Check Within 12 Months/Copy of Camper Immunization Record
Email this document to nbsummercamp@msn.com With the subject title being the child's First and Last name then immunization record
Permission to Photograph Child for Advertising Purposes *
Please place my child with friends. Children are grouped by age, grade and gender. 
Names of children placed together.
*
Full Season Dates
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Weekly Options: 5 days / week 
Consecutive weeks
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Weekly Options: 4 days / week  
Consecutive weeks, please.
Sibling Discount: 2nd, 3rd & 4th Additional Sibling
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Camper Begin date?  End date?  *
Tuition Includes: Backpack, T-shirt, Friday Cookouts, Professional Shows, Events Calendar, Friends and Fantastic Summer Days!
The payment is due in full. The camper enrollment form must be completed. which will secure camper space for summer 2024. 
Please follow below instructions to submit enrollment form correctly.
1. Submit payment  in full (payment link below)
2. Credit card must match billing/address information.
3. Return to this form to finalize Terms, Conditions, Medical Information below.
Click link above, enter Credit card payment information and tuition amount. Below: Camper Tuition Amount
Tuition is due in full upon registration. Please check with the camp director for camper availability.  Pathfinder may process the credit card for balance, additional weeks or extra days the child attends camp. *
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