Summer Camp Registration Form
Please fill out all the required information. We are looking forward to having your child(ren) in our summer camp!
Member Pricing
$100/week (half day) or $250/week (full day)
Non Member Pricing
$125/week (half day) or $300/week (full day)
Hours
Half Day is 9am-12pm. Full Day is 9am-4pm.
Deposit / Payment
There is a non-refundable deposit required to secure your child's spot. The deposit is $25 for half day camps and $50 for full day camps per kid for each week. This deposit will be applied to the total due. You will receive an invoice for the remaining balance due and it must be paid two weeks prior to the start of camp.
Back
Next
Participant Name
*
First Name
Last Name
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Gender
*
Male
Female
Prefer not to say
Other
T-Shirt Size
*
Please indicate if youth or adult size. Child must be registered prior to May 15, 2024 to guarantee receiving a t-shirt.
Any known medical conditions or allergies?
*
Back
Next
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Parent/Guardian E-mail
*
example@example.com
Mailing Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Back
Next
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Emergency Contact Relationship to Participant(s)
*
Parent
Family Member
Friend
Other
Back
Next
Will you be signing up any siblings?
*
Yes
No
How many additional siblings will you be signing up?
*
Please Select
1
2
3
4
5
Sibling 1 Name
*
First Name
Last Name
Sibling 1 Birth Date
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Prefer not to say
Other
T-Shirt Size
*
Please indicate if youth or adult size. Child must be registered prior to May 15, 2024 to guarantee receiving a t-shirt.
Any known medical conditions or allergies?
*
Sibling 2 Name
*
First Name
Last Name
Sibling 2 Birth Date
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Prefer not to say
Other
T-Shirt Size
*
Please indicate if youth or adult size. Child must be registered prior to May 15, 2024 to guarantee receiving a t-shirt.
Any known medical conditions or allergies?
*
Sibling 3 Name
*
First Name
Last Name
Sibling 3 Birth Date
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Prefer not to say
Other
T-Shirt Size
*
Please indicate if youth or adult size. Child must be registered prior to May 15, 2024 to guarantee receiving a t-shirt.
Any known medical conditions or allergies?
*
Sibling 4 Name
*
First Name
Last Name
Sibling 4 Birth Date
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Prefer not to say
Other
T-Shirt Size
*
Please indicate if youth or adult size. Child must be registered prior to May 15, 2024 to guarantee receiving a t-shirt.
Any known medical conditions or allergies?
*
Sibling 5 Name
*
First Name
Last Name
Sibling 5 Birth Date
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Prefer not to say
Other
T-Shirt Size
*
Please indicate if youth or adult size. Child must be registered prior to May 15, 2024 to guarantee receiving a t-shirt.
Any known medical conditions or allergies?
*
Back
Next
Optional Transportation
Pick-up and/or Drop-off is available for an additional $75/week per household. The price is for up to 5 miles, it is an additional $3/mile over 5 miles. Transportation costs will be added to the remaining balance due prior to the start of camp. For half day campers, pick up will be available for $40/week but drop off is not available.
Would you like us to Pick-up and/or Drop-off your child(ren) for Summer Camp?
*
No, I will provide transportion
Pick-up Only
Drop-off Only
Pick-up and Drop-off
Back
Next
Release and Waiver of Liability and Indemnity Agreement
Signature
*
Back
Next
Throughout the summer we will be taking pictures and videos of the kids while at camp. These may be used for art projects and activities. They may also be used for social media, website and advertising purposes. Your child’s photo will not be taken without your permission. Please select an option below to grant permission for us to use your child’s photo:
*
I grant permission for my child’s photo to be used for classroom activities, projects, website use, social media use and advertising purposes.
I grant permission for my child’s photo to be used only for classroom activities or projects. My child’s photo cannot be used for business purposes.
I do not grant permission for my child’s photo to be used at all.
Back
Next
Summer Camp Selection
Please select the week(s) you would like to register for and select the number of kids you are registering. A non-refundable deposit is required at the time of registration to secure your child(ren)'s spot. The deposit is $50/child for full day and $25/child for half day. Invoices for the remaining balance due will be sent at least one month prior to camp start and must be paid two weeks prior to camp start. Due to limited space, cancellations must be made at least one week prior to the start of the selected camp week to receive a refund. There will be no proration fees for any days a child participant cannot attend. There will be a $15 change fee for each change made to registrations.
Weeks Available:
*
prev
next
( X )
June 3-7
$
50.00
Quantity
Price
Full Day
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
$
50.00
Half Day
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
$
25.00
June 10-14
$
50.00
Quantity
Price
Full Day
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
$
50.00
Half Day
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
$
25.00
June 17-21
$
50.00
Quantity
Price
Full Day
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
$
50.00
Half Day
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
$
25.00
June 24-28
$
50.00
Quantity
Price
Full Day
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
$
50.00
Half Day
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
$
25.00
July 8-12
$
50.00
Quantity
Price
Full Day
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
$
50.00
Half Day
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
$
25.00
July 15-19
$
50.00
Quantity
Price
Full Day
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
$
50.00
Half Day
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
$
25.00
July 22-26
$
50.00
Quantity
Price
Full Day
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
$
50.00
Half Day
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
$
25.00
July 29-August 2
$
50.00
Quantity
Price
Full Day
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
$
50.00
Half Day
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
$
25.00
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
Submit
Should be Empty: