Park Shore Inquiry Form for Tours & Office Use

What Program(s) Are You Interested In?
Day Camp
Flexible Day Camp
Travel Camp Programs (Grades 6-9)
Toddler Day Camp Program
Extreme STEAM Science Kids Camp
Sports Track
Preschool School Program
Kindergarten
Toddler School Program
Preschool & Kindergarten After School Programs

Parent Information

First Name

Last Name

Email

Place of Work

Phone

Address
Street Address Address Line 2 City State ZIP Code

Child 1 Information

Child 1 Name

Child 1 Birthdate
Month
Day
Year

Grade Completed as of Coming June

Child 2 Information

Child 2 Name

Child 2 Birthdate
Month
Day
Year

Grade Completed as of Coming June

Child 3 Information

Child 3 Name

Child 3 Birthdate
Month
Day
Year

Grade Completed as of Coming June

Additional Information

How did you hear about us? Please check all that apply.
Google
Facebook
Instagram
Yelp
LongIsland.com
Mommy Poppins
Long Island Parent
Macaroni Kid
Living Huntington
Advertisement
Through your place of work
Friend/Relative
Park Shore Employee
Drove by
Other

Office Inquiry Form

LONG ISLAND SUMMER DAY CAMP PROVIDING AMAZING CAMP EXPERIENCES FOR OVER 65 YEARS

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