• This form has expired, please use the following form for 2025/2026

     

    2025/2026 Track Out / Day Camps

    Please note the 2025/2026 Trackout / Holiday registration will re-open on 9/4/2025

  • Have you previously registered your child for Track out, Holiday, Teacher Workday or any other Day camp before? (excludes Summer Camp 2023)*

  • Thank you!

    You do not need to re-register your child for Camp.

    Please use the following form for returning camper requests:

    Returning Camper Request

    Requests must be made at least 3 days prior to the requested days

    We will follow up via email with confirmation of your request and if we have availability to add your child to the requested days. 
    Please do not assume acceptance until you have received confirmation
    As a returning camper, your request is moved to the front of the processing list. 

  • Thank you! 
    You may continue with registration. 

    Requests must be made at least 3 days prior to the requested days to allow us time to process your request. 


    We will follow up via email with confirmation of your request and if we have availability to add your child to the requested days. 

    Please do not assume acceptance until you have received confirmation.

  • Camper's Information

  • NOTE -  Age out for this camp is 10 years old. If your child is older than 10 years old, please do not fill out this form and email us for more info - info@werockthespectrumcary.com 

     

     

  • Date of Birth*
     - -
  • Days of the week you would like your Child to attend*

  • Parents' Information

    Parent/Guardian 1
  • Format: (000) 000-0000.

  • Parent/Guardian 2
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Emergency Contacts/Authorized Pickup

    In a single parent/guardian household the primary person cannot be listed as the emergency contact. The second parent/guardian may be listed, however it is our preference to list someone not in the household. List the name of at least one person who can be contacted in the event of an emergency or illness if you cannot be reached. Any person listed should be able to assist in contacting you. At least one person listed must be within one hour of the center/home, able to take responsibility for the child in case the parent/guardian cannot be contacted and should be at least 18 years of age. The first emergency contact must live no more than 1 hour away and be over the age of 18.

  • Emergency Contact #1
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Medical / Health Information

  • Format: (000) 000-0000.
  • Is the Camper up-to-date on all immunizations?*
  • Does your child have any food, medication or environmental allergies?*
  • Allergies? Check all that apply*
  • 0/150
  • Does your child’s allergy/allergies require child care staff to monitor child for symptoms, take action if a reaction occurs, or give emergency medication to your child?*
  • If Yes, are any of these allergies potentially anaphylactic and require use of Epipen?*
  • Does your child have a special health or medical condition? Please include any special needs diagnosis here*
  • 0/150
  • Does the special health or medical condition require child care staff to perform a procedure, or perform child specific care such as: to monitor your child for symptoms or administer medication during child care hours?*
  • Is your child currently using any medication or food supplement that will be required to be administered while at camp?*
  • 0/150

  • Note: For Medication that we will need to administer, you will be required to fill out additional information on the medication as well as any required doctors instrcutions for OTC medication being used off label or above label dosing. 
    This will be sent you once your regirstation has been accecpted and the camp agreement form has been signed. 

  • Does your child have any dietary restrictions, including those for medical, religious or cultural reasons?*

  • NOTE: While we will not be providing food or snacks as part of Summer Camp, we need to know this information to ensure your child does not eat other children's food, or for severe allergies, we ask other parents not to send specific foods, eg. Peanut butter

  • 0/150

  • Communication & Social Skills

    This helps us identify the special needs of your child to place them appropriately
  • Communication - Please select ALL that apply*

  • Interactions with Others - Please select ALL that apply*
  • Response to Sounds - Please select ALL that apply*
  • Other Senses - Please select ALL that apply*

  • Emotions & Safety

    This helps us identify the special needs of your child to place them appropriately
  • Emotions - Please select ALL that apply*

  • Adaptive Skills - Please select ALL that apply*

  • Safety - Please select ALL that apply (Please be very honest here, this will not have any baring on acceptance into the program but helps us prep our staff accordingly)*

  • Behavior

    This helps us identify the special needs of your child to place them appropriately Please be very honest here, this will not have any baring on acceptance into the program but helps us prep our staff accordingly

  • Statement of Understanding

  • Date Signed*
     - -

  • After you click submit, an initial window will open with Jotform sign, just acknowledging that you are signing the registration form. 
    Once that is complete, you will be re-directed to Stripe's payment portal to pay for the registration. Once complete you will see a thank you page

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