STEAM Summer 2021 Registration Form

Olive | Berkeley Summer Registration

Thanks for your registering in Olive Children | Berkeley Academy Summer Camp 2022. The camp dates are from June 13 to August 4, bi-week sessions. Please fill out the field as it indicated.

Please select session(s) your child would like to attend.

	6/13- 6/24	6/27 - 7/8	7/11 - 7/22	8/25 - 8/5
Please Select

Please select Full Day/AM/PM your child would like to attend? *
Does your child need extended care? *
Student General Information
Campus you would like to attend *
Berkeley Academy: 43475 Ellsworth St; Olive SJ: 34700 Fremont Blvd
Please select your child's grade level? *
Student Full Name *

First Name Last Name
Birth Date

Month Day Year
Gender *
Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Parents General Information
Mother Full Name *

First Name Last Name
Mother Email Address *

Confirmation Email example@example.com
Mother Phone Number *

Area Code Phone Number
Father Full Name *

First Name Last Name
Father Email Address *

Confirmation Email example@example.com
Father Phone Number *

Area Code Phone Number
Summer Camp 2022 Registration *
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Registration Fee It is not refundable.
$ 50.00

Total

$ 0.00
Should be Empty:

Olive | Berkeley Summer Registration