Leadership Camp (PA) – Camper Registration


  • e.g. 123-456-7890
  • e.g. 123-456-7890
  • e.g. 123-456-7890
    Please select one
    Please select one
  • Education

  • Medical & Photo

  • Any pertinent health information, allergies, medications, etc.
  • I, the parent or guardian of the above-named applicant, hereby delegate authority to the Directors of the Leadership Camp to arrange whatever medical treatment they deem necessary for the above-named applicant during his stay at the camp. Also, I hereby authorize and consent to the use and reproduction by YSI staff or an authorized agent or assignee of any and all photographs/video taken of the above-named applicant for the purpose of promoting YSI programs, without any compensation to me. All film (and digital media), together with any prints, shall constitute property of YSI, solely and completely.

    Enter your name above to confirm both the medical and photo release, and your registration will be complete. If you type "no", then we will have to discuss other circumstances that can be agreed to for your son to attend the camp and the registration will not be complete until we can reach an agreement.
  • Miscellaneous

  • These are youth sizes.
    Parents should make transportation plans for their son to go to and from the Leadership Camp. In order to facilitate these plans, we help to connect parents who are interested in carpooling with other parents in their area.

    Mark 'yes' on this question if you would like your contact info (city, state, home phone number) to be shared and whether you would like to receive that of others. For those who mark 'yes,' we will send you this contact information starting about a month before the camp.
    A brief phone interview is required for any family who has not had a son attend the Leadership Camp before. A staff member will call you within two weeks of your submitting the registration form.
  • Who recommended this program to you?