China's Weekend Summer Camp Registration

China's Weekend Summer Camp

Registration Form
All registrations are received and reviewed on a first come, first served basis. Upon filling all open spots, all additional submissions will be added to our waiting list.
Weekend Summer Camp Registration
Expected Start Date

MonthDayYear
Grade Level
Select your child's grade level at time of registration.
SaturdaySunday
Student Information
First Name*
Last Name*
FemaleMale
Birth Date*

MonthDayYear
Health Care/Insurance #*
Please type the name of your child's medical insurance carrier and their insurance number. This information will be shared with medical professionals in case of emergencies.
Doctors Name*

First NameLast Name
Doctors Phone Number*

Area CodePhone Number
Parent/Guardian Information 1
Full Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home*

Area CodePhone Number
Cell

Area CodePhone Number
Work

Area CodePhone Number
E-mail*
Parent/Guardian Information 2
Full Name

First NameLast Name
Home

Area CodePhone Number
Cell

Area CodePhone Number
Work

Area CodePhone Number
E-mail
Other Infomation
YesNo
YesNo
YesNo
If yes please list, including any food or drug allergies.
Does your child have any medical conditions?
Does your child require any medication? If yes, please list these medications and when they should be administered.
YesNo
Please list the people authorized to pick up your child and their relationship.
ex: Mary Jones: Grandmother
Does your child have any siblings who will also attend Camp?*
If yes, what is their name, age(s)?
Emergency Contact - Other than Parent/Guardian

Type NA in required fields if no emergency contact available.
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home*

Area CodePhone Number
Cell

Area CodePhone Number
Work

Area CodePhone Number
All registrations are received and reviewed in a first come, first served basis. Upon filling all open spots, all additional submissions will be added to our waiting list.
You will only need to register on this form the first time.
If paying cash, skip to the submit button below.

My Products

Summer Camp Saturday Fee$40.00

Registration fee is PER child.

Number of Students Registering
Item subtotal:$0.00

Summer Camp Sunday Fee $40.00

Registration fee is PER child.

Number of Students Registering
Item subtotal:$0.00

Total $0.00

Payment Methods

Credit Card

Cash App Pay

Should be Empty:

China's Weekend Summer Camp

Weekend Summer Camp Registration

Student Information

Parent/Guardian Information 1

Parent/Guardian Information 2

Other Infomation

Emergency Contact - Other than Parent/Guardian

You will only need to register on this form the first time.

If paying cash, skip to the submit button below.

Payment Methods