7-11 Summer Camp 2023

Summer Camp 2023

Play wild!
Students will get outside, make friends, and learn more about Kentucky's diverse ecosystem through hiking, games, and fun activities. Classes are lead by park rangers, naturalists, and environmental educators.

Camp takes place 9am-12pm Monday, Wednesday, and Friday over a 9 day period. This is a drop off day camp, not overnight.

Ages: 7-11

When:

June 19, 21, 23, 26, 28

Location: A different Lexington, KY park each day

Cost: $285 per student per session

Please fill out one registration form per student. Thank you!
Student Information
*A separate registration form must be completed for each child
Child's Name*

First NameLast Name
Age*
Gender*

MaleFemale
T-shirt size
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Siblings:
If you are signing up siblings together for the same session, please enter Sibs5 for the promo code at checkout on both registration forms in order to recieve 5% off. Please list sibling if applicable:
Sibling's Name
Parent/Guardian Information
Parent/ Guardian Contact's Name*

First NameLast Name
Relationship*
Phone Number*

Area CodePhone Number
E-mail*
example@example.com
If we have a time-sensitive question/ emergency, what's the best number to text you at?*
All important communications will happen via email, but if we need to ask you a time-sensitive question or have an emergency that forces us to evacuate the park (inclement weather, injury, etc.) we will send you a text.
List people who are allowed to pick your child up from class (besides parent/guardian on this form)
Emergency Contact Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*

Area CodePhone Number
E-mail
example@example.com
Child Information
Does your child have any allergies, chronic illness, or medical conditions? If yes, please describe.*
Is your child prescribed an inhaler? If yes, please explain any instructions.
What do you want your child to gain from this class?
Is there any other information that you would like to share with us about your child?
Ex: Any medical, learning, behavioral, or emotional challenges that may affect their ability to participate in this program? How does your child interact with other children, adults?
How did you hear about Rugged Research?*

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Confirmation

BY AGREEING AND ENTERING MY NAME BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Name of Parent/Guardian:*

First NameLast Name
Date*

MonthDayYear
Date

My Products

Summer Camp$285.00

June 19, 21, 23, 26, 28 9am-12pm

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Subtotal $0.00Tax $0.00Total $0.00

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