Summer Camp Registration Form 2023

Summer Camp Registration Form 2023
Are you a member of Strawbery Banke Museum?*

YesNoI don't know
STOP!

An active membership is required to register for camps prior to January 16, 2023 at 10:00AM.

If you are not an active member but wish to renew or purchase a membership, you can Join or Renew now. Then come back and complete this form.

Submissions by those without an active membership will not be registered for camp.
STOP!

An active membership is required to register for camps prior to January 16, 2023 at 10:00AM.

If you have not renewed your membership with Strawbery Banke Museum in the last year, you are not an active member.

If you think you may be a member, you can text 603-241-1644. Please include the full name of the person the membership is under. If you are not sure, please send all the possibilities. Getting back to you will take time, but it is the fastest way to get an answer on your membership status. In the meantime, you can fill out this form. You have the option to save it at the bottom and return to it later.

To join or renew, please use the following link:

https://www.strawberybanke.org/join.cfm
Camper Information
Child #1 Name*

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

MonthDayYear
Date
What pronouns does your child use?

They/ThemShe/herHe/himOther
Grade entering in Fall 2023*
Child's T-shirt size (Each camp receives 1 free camp t-shirt)*

Youth XSYouth SYouth MYouth LYouth XLAdult SAdult MAdult LAdult XL
Would you like to register another child?*

YesNo
Child #2 Name*

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

MonthDayYear
Date
What pronouns does your child use?

They/ThemShe/herHe/himOther
Grade Entering Fall 2023*
Child's T-shirt size (Each camp receives 1 free camp t-shirt)*

Youth XSYouth SYouth MYouth LYouth XLAdult SAdult MAdult LAdult XL
Would you like to register another child?*

YesNo
Child #3 Name*

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

MonthDayYear
Date
What pronouns does your child use?

They/ThemShe/herHe/himOther
Grade Entering Fall 2023*
Would you like to register another child?*

YesNo
Child's T-shirt size (Each camp receives 1 free camp t-shirt)*

Youth XSYouth SYouth MYouth LYouth XLAdult SAdult MAdult LAdult XL
Child #4 Name*

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

MonthDayYear
Date
What pronouns does your child use?

They/ThemShe/herHe/himOther
Grade Entering Fall 2023*
Child's T-shirt size (Each camp receives 1 free camp t-shirt)*

Youth XSYouth SYouth MYouth LYouth XLAdult SAdult MAdult LAdult XL
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 contacts who will be called if parents/guardians cannot be reached.
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)*
Summer 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
Choose your Camps
Click the camps for which you are registering:*

History in Play: Growing Up Victorian, ages 9-11 (June 26 - 30, 2023) FULL Waiting list availableKids in the Kitchen Mini-Camp, ages 10 - 12 (June 26, 28 & 30, 2023)Daring Discoveries, ages 9 - 11 (July 10 - 14, 2023) Full Waiting list availableJr. Roleplayers: Industrial Era, ages 12 - 17 (July 10 - 21, 2023) Monday - Friday FULL Waiting list available.History Alive Session I, ages 6-8 (July 17 - 21, 2023) FULL Waiting list availableBuilding Detectives, ages 10 - 12 (July 24 - 28, 2023)DIY Inventions: Bright Ideas, ages 6 - 8 (July 24 - 28, 2023) FULL. Waiting list availableHistory Alive Session II, ages 6 - 8 (July 31 - 4, 2023) FULL Waiting list availableHistory at Play: Growing Up Colonial, ages 9 - 11, 2023) FULL Waiting list availableCelebrating the Past, ages 7 - 9 (August 7 - 11, 2023) FULL Waiting list availableJr. Roleplayers: Modern Age, ages 12 - 17 (August 7 - 18, 2022) Monday - Friday FULL Waiting list available
If needed, please clarify which children are doing which camps.
In order to be prepared to costume your child, please list your child(ren)'s height and pants size that you believe they will be at the time of camp. If you have multiple children please list names next to each answer (ex. John: 5'0', size 12-14)*
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 summer of 2023. 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.*
Summer Camp Payment - IMPORTANT

After hitting the submit button at the bottom of the page, you will be directed to the site where you can pay for summer camps. Your space is not secure until you have paid for camp. If you need help, instructions for paying are listed below.
Are you a member of Strawbery Banke Museum?*

YesNoI don't know
Do you have an online account at Strawbery Banke Museum?

YesNoI don't know
HOW TO PAY

1. Visit the Strawbery Banke Ticketing Site (you will be directed there when you click the SUBMIT button at the bottom of this page.)

2. If you are a Family member or higher, please log in to your SBM account. If you do not have an account, you will need to create one by clicking register in the upper right hand corner in order to receive your member discount.

3. Find the camps for which you would like to register (please check name and dates of camp) and choose the quanity (1 for one child, 2 for two children, etc.). NOTE: You will need to scroll through a few pages to see all the camp listings. Some camps have similar names.

4. When you have chosen all your camps, click the large "Register" button near the bottom of the screen and follow the instructions for payment.
HOW TO PAY

1. Visit the Strawbery Banke Ticketing Site (you will be directed there when you click the SUBMIT button at the bottom of this page.)

2. Find the camps for which you would like to register (please check name and dates of camp) and choose the quanity (1 for one child, 2 for two children, etc.). NOTE: You will need to scroll through a few pages to see all the camp listings.

3. When you have chosen all your camps, click the large "Register" button near the bottom of the screen and follow the instructions for payment.

4. When you check out there is an option to create an account for easy check-out in the future.
CREATING AN ACCOUNT

If you have been an active member in the last year, you would have received an email asking you to create an online account.

If you remember doing that, then after hitting the submit button, login to your account before you attempt to pay (see below for instructions on resetting a password)

If you do not have an account, you are most likely not a member. You can join or renew a membership to receive the 10% discount or you can proceed to pay for your camp following the onscreen instructions.

After registering, you will be able to create an account for easy checkout in the future. Creating an account is simple and free. Strawbery Banke values your privacy and does not share your information with any third parties.

You will receive a confirmation email once your registration is complete.
Going forward, use your email address and password to sign in.

RESETTING PASSWORD:
If you’ve forgotten your password, follow these steps to reset and regain access to your account.

Click the “sign in” text at the top right-hand side of the screen.

In the pop-up window, click on the text saying “Forgot your password?”

In the next window, enter the email address associated with your existing account.

Once a valid email is entered, an email with reset instructions will be sent to the associated account. If you do not receive the email, please check your junk email folder. If you still do not receive an email, the entered email address may not be associated with an Altru account and the user should “create an account” or contact Strawbery Banke Museum for assistance.
Should be Empty:

Summer Camp Registration Form 2023

Camper Information

Parent/Guardian Information

Emergency/Medical Information

Choose your Camps

Release and Consent