Course Registration Form

UrbanHope Summer Camp Registration Form - 2026

August 24th - 28th | Our summer camp only cost $10 per child for the entire week | 12pm to 4pm | Monday to Friday
Student's Name

First NameMiddle NameLast Name
Student's Name

First NameMiddle NameLast Name
Student's Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Mobile Number
Format: (000) 000-0000.
Phone Number
Format: (000) 000-0000.
Emergency Contact
Format: (000) 000-0000.
Health Card #
Allergies & Medications:
Additional Comments
Should be Empty:

UrbanHope Summer Camp Registration Form - 2026