Winter Wizarding School Registration Form

Winter Wizarding School Registration Form

Registration begins on November 13 for members and November 18 for non-members. This program is for kids in grades 2 - 5 or ages 7-11.
Camper Information
How many children do you wish to register?*
Child #1 Name*

First NameLast Name
Child's Age*
Child's Birthdate*

MonthDayYear
Date
What is your child's gender?
What pronouns does your child use?

They/ThemShe/herHe/himOther
Grade in school*
Child #2 Name*

First NameLast Name
Child's Age*
Child's Birthdate*

MonthDayYear
Date
What is your child's gender?
What pronouns does your child use?

They/ThemShe/herHe/himOther
Grade in school*
Child #3 Name*

First NameLast Name
Child's Age*
Child's Birthdate*

MonthDayYear
Date
What is your child's gender?
What pronouns does your child use?

They/ThemShe/herHe/himOther
Grade in School*
Child #4 Name*

First NameLast Name
Child's Age*
Child's Birthdate*

MonthDayYear
Date
What is your child's gender?
What pronouns does your child use?

They/ThemShe/herHe/himOther
Grade in School*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Parent/Guardian #1*

First NameLast Name
Cell Phone*

Area CodePhone Number
Home Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
Best Phone to Use During the Day*

CellHomeWork
Parent/Guardian Email (This is the email that will be used for primary communication.)*
example@example.com
Does your child have a Parent/Guardian #2?*

YesNo
Parent/Guardian #2 Name*

First NameLast Name
Cell Phone*

Area CodePhone Number
Home Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
Best Phone to Use During the Day*

CellHomeWork
Email
example@example.com
Emergency/Medical Information
In case of an emergency, parents/guardians will be contacted first. Please list the names & numbers of up to two additional people who can be contacted in case guardian(s) are unavailable.
Emergency Contact #1

First NameLast Name
Phone Number

Area CodePhone Number
Relationship to Child/Children
Emergency Contact #2

First NameLast Name
Phone Number

Area CodePhone Number
Relationship to Child/Children
Please list the people who are authorized to pick up your child/children from camp (changes can be made to your list later)*
Camp staff need to be aware of any medical issues (such as allergies or diabetes) as well as any physical, social or congnitive challenges that your child/children might have. All information will be kept confidential.
Would you like to explain any medical issues or challenges for your child/children?*

YesNo
Please do so here.
Child/ren's Physician
Phone Number

Area CodePhone Number
Membership Status
Are you a Member of Strawbery Banke Museum?*

YesNoI don't know
Is the child's parent/guardian on active duty in the military?

YesNo
Registration
For which program do you wish to register?*

Wizarding School Session I: February 17 - 21, 2025Wizarding School Session II: February 24 - 28, 2025
Camp runs from 9:00am - 3:00pm. Extended care is available from 8:00am - 5:00pm for $30 per day. Please check any days you may need extended care.

MondayTuesdayWednesdayThursdayFriday
Release and Consent
Please list the full name(s) for each child attending camp.*
I/We authorize Strawbery Banke Museum staff to arrange for emergency care for my/our minor child/children at a local hospital, as the staff deems necessary. I/We authorize hospital personnel to provide emergency medical treatment for my/our child/children.

I/We wish that my/our child/children participate in camp program(s) which is/are organized by Strawbery Banke Museum during the winter of 2025. I assume all the risks of injury and loss arising or resulting from my/our child's/chldren's participation, hereby releasing and holding harmless the Museum, its employees or agents from liability for any such injury or loss.

Unless otherwise informed, I/We allow our child to appear in photographs taken for use in Strawbery Banke Museum publications, publicity and social media. I also agree to allow photographs from camp to be available on a password protected site, to which only fellow camp families have access.
Please type your name(s) into the box below. By doing so, you are certifying that you are the parent and/or legal guardian of the minor participant(s) listed above, and you understand and are in agreement with the waivers indicated above.*
Payment
When you hit submit, you will be directed to the ticketing page to pay for your purchase. Your space(s) are not secured until payment is made. If you have trouble with payment, please email bcoppola@sbmuseum.org or call 603-241-1644 for help.
Should be Empty:

Winter Wizarding School Registration Form

Camper Information

Parent/Guardian Information

Emergency/Medical Information

Membership Status

Registration

Release and Consent

Payment