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 A shelter-in-place order is in effect for all Alameda County residents. City facilities are closed and non-essential meetings and events are cancelled.  Find more information here.

Participant Intake Application

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Please correct the field(s) marked in red below:

The following information needs to be completed for each class/camp registration.  The intake form is very comprehensive. Please describe your child’s special needs in detail on the application.

Camps Only - At this time, we are unable to accommodate campers with toileting issues, medical issues requiring protocols or those who are apt to elope.

 Returning participants do not need to fill out another intake form unless information has changed.


Participant Information:
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Participant Information:
Parent/Guardian Information #1 - must be available during camp hours
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Parent/Guardian Information #1 - must be available during camp hours
Parent/Guardian Information #2 - must be available during camp hours
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Parent/Guardian Information #2 - must be available during camp hours
Emergency Contact Information (other than parent/guardian):
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Emergency Contact Information (other than parent/guardian):
What types of programs are you most interested in? Check all that apply.
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What types of programs are you most interested in? Check all that apply.
Summer camps only. Which of the following weeks are you available? All camps are Monday through Friday with the exception of week 3 - there is no camp on Friday, July 3. Please check all that apply.
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Summer camps only. Which of the following weeks are you available? All camps are Monday through Friday with the exception of week 3 - there is no camp on Friday, July 3. Please check all that apply.
How did you hear about the Albany P.A.L.S. Program?
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Has your child enrolled in Summer PALS previously? If yes, what years?
Has your child enrolled in Summer PALS previously? If yes, what years?