Language
English (US)
Summer 2022 Registration Form
Adult Email Address (for registration communication)
*
example@example.com
How many participants are you registering today?
*
Please Select
1
2
Participant Name
*
First Name
Last Name
Second Participant Name
*
First Name
Last Name
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Camp Selection for: {part_1_name}
What camp(s) will {part_1_name} be participating in?
*
Young Speakers Camp (ages 8-10), Online, June 20-24 - $150.
Middle School Speakers Camp (ages 11-14), Online, June 27-July 1 - $150.
Debate Camp (ages 11-17), Online, July 18-29 - $300.
Would {part_1_name} be interested in attending camp in-person at our Richmond, CA office (if it became available)?
*
Yes, in-person would be preferred
Yes, but no preference either way
Maybe, it depends on other factors
No, but no preference either way
No, online would be preferred
Other (please elaborate)
Camp Subtotal for: {part_1_name}
*
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Camp Selection for: {part_2_name}
What camp(s) will {part_2_name} be participating in?
*
Young Speakers Camp (ages 8-10), Online, June 20-24 - $150.
Middle School Speakers Camp (ages 11-14), Online, June 27-July 1 - $150.
Debate Camp (ages 11-17), Online, July 18-29 - $300.
Would {part_2_name} be interested in attending camp in-person at our Richmond, CA office (if it became available)?
*
Yes, in-person would be preferred
Yes, but no preference either way
Maybe, it depends on other factors
No, but no preference either way
No, online would be preferred
Other (please elaborate)
Camp Subtotal for: {part_2_name}
*
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Registration for: {part_1_name}
Participant Name
*
{part_1_name}'s Date of Birth
*
-
Month
-
Day
Year
Date
What grade will {part_1_name} be in this fall?
*
Grade: 2022-2023 School Year
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
Other
What school will {part_1_name} attend this fall?
*
{part_1_name}'s pronouns are:
*
What best describes {part_1_name}?
*
White
Black, African American
American Indian or Alaska native
Asian Indian
Japanese
Native Hawaiian
Chinese
Korean
Guamanian or Chamorro
Filipino
Vietnamese
Samoan
Other Race (please specify)
Is {part_1_name}:
*
No, not of Hispanic, Latino or Spanish origin
Yes, Mexican, Mexican American, Chicano
Yes, Puerto Rican
Yes, Cuban
Yes, other Hispanic, Latino or Spanish Origin (please specify)
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Registration for: {part_2_name}
Participant Name
*
{part_2_name}'s Date of Birth
*
-
Month
-
Day
Year
Date
What grade will {part_2_name} be in this fall?
*
Grade: 2022-2023 School Year
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
Other
What school will {part_2_name} attend this fall?
*
{part_2_name}'s pronouns are:
*
What best describes {part_2_name}?
*
White
Black, African American
American Indian or Alaska native
Asian Indian
Japanese
Native Hawaiian
Chinese
Korean
Guamanian or Chamorro
Filipino
Vietnamese
Samoan
Other Race (please specify)
Is {part_2_name}:
*
No, not of Hispanic, Latino or Spanish origin
Yes, Mexican, Mexican American, Chicano
Yes, Puerto Rican
Yes, Cuban
Yes, other Hispanic, Latino or Spanish Origin (please specify)
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Next
Household Information
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Household Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Next
Agreements
Digital Signature
*
Clear
Signed by
*
First Name
Last Name
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Part 1 Subtotal
*
Part 2 Subtotal
*
Were you given a promo code for Summer 2022 Registration?
*
Yes
No
Promo code for {part_1_name}
*
Promo code for {part_2_name}
*
Discount - Part 1
*
Discount - Part 2
*
Registration Total
*
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Next
Please click the "Submit" button below to complete your registration.
Would you like to make a donation to The Practice Space?
*
Yes
Not today
How much would you like to donate?
*
The Practice Space is a registered 501(c)(3) Nonprofit
Total Checkout
*
Checkout Amount
*
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USD
Summer Camp 2022 - The Practice Space
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