Course Registration Form

UrbanHope Summer Camp Registration Form - 2025

Week 1: July 14th - 18th - Our summer camp only cost $10 per child for the entire week. They run from 12pm to 4pm, from 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*
Phone Number
Emergency Contact*
Health Card #*
Allergies & Medications:*
Additional Comments
Should be Empty:

UrbanHope Summer Camp Registration Form - 2025