Staff Forms

Please Download and Fill Out The Forms Below

In compliance with the Department of Health, the forms below are mandatory and essential for the well-being and safety of our camp. These forms MUST be completed and signed prior to the first day of camp. If Park Shore does not have the completed and signed forms, we will not be able to permit you to start camp until they are signed and received. According to NYS Department of Health Regulations and the Suffolk County Department of Health, all staff members at day and resident camps must have on file a recently completed Health form with important contact information, documentation of physical exam (within the past 12 months), a documented vaccination record and written verification from your health care provider that you may attend and participate in all camp activities or a statement of activity restrictions, if pertinent. We ask that you supply us with a completed Health Form which includes contact information, your physician’s signature, stamp, and evidence of physical exam. We appreciate your immediate attention to this matter and look forward to an amazing fun-filled summer. Thank you for your cooperation. If you have any questions, please call our office at (631) 499-8580.


Pre-Camp Health Screening Form

Please complete the health verification form below in addition to getting a rapid Covid-19 test with a negative result before your child begins their session. If you have any questions or need assistance in finding a place for the rapid test please call our office at 631-499-8580. Thank you for your cooperation in helping us keep our campers and staff safe.

Health Verification Form

Health Forms

2022 Medical Authorization Form

2022 Physical Exam & Immunization Form

2022 Health Information Form

Re-Entry Form

How to Submit Forms

  1. FAX: 631-499-6917
  2. Email: dawn@parkshoredaycamp.com
  3. Drop Off
  4. Mail


Visit Us

450 Deer Park Road

Dix Hills, NY 11746

Tour Hours

M-F: 10am - 4pm

S-S: 11am - 2pm (February - June)

Learn More About

Park Shore Perks