Join the Wait List for
MCRC's PA Day Camp - January 2024
Fill out this form to join the wait list for MCRC's PA Day Camp on January 22, 2024.
If a space becomes available, you will be contacted by MCRC staff.
Camp Name
Camp Program Id
Parent Information
Parent/Guardian First Name
Parent/Guardian Last Name
Parent/Guardian Email
Street Address
Town/City
Postal Code
Home Phone
Mobile Phone
Work Phone
Child's Information
Child's First Name
Child's Last Name
Child's Date of Birth
Child's Age Group
Please select...
Infant
Toddler
Preschool
JK/SK
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Does your child have Anaphylaxis
Yes
No
Does your child have Asthma
Yes
No
Does your child have any special needs
Yes
No
Does your child have any other medical conditions?
Yes
No
Please Provide Additional Details
Contact Information