2024 Summer Camp Registration Form
Please fill out one form per camper per camp session.
Camper's Information
Personal & Health & Contact
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
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Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
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2015
2014
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2012
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1920
Year
Age (at time of camp)
Please Select
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18+
Grade (entering this fall)
School my child attends
List Any Allergies and Dietary Restrictions
Will student need to take medications while at camp?
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent / Guardian Information
(All correspondence and and invoices will be sent to this person)
Name
First Name
Last Name
Email
example@example.com
Cell Phone
-
Area Code
Phone Number
Work Phone
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
Relationship with the Camper
Emergency Contacts and Authorized Pick Up Persons
Program Information
There are three camp choices: 8 am until 12:30 pm (Session 1), 12:30-5:00 (Session 2), or 8 am - 5 pm (Session 3/Full Day). Students may be picked up early, however, camp fees are not changed. All camps require a $25 non refundable registration fee per camp. Each Camp fee is $90 per week (Sessions 1 or 2) or $140 for the Full Day option. Registration fee is due upon registration and the remaining balance is due the first day of camp. Limited spacing available for each camp.
Select Camp Week/Theme
*
Camp Olympics - June 10-14, 2024 SOLD OUT
Find the Artist in You - June 17-21, 2024 SOLD OUT
Physical Science - June 24-28, 2024
America the Beautiful - July 1-5, 2024 (4 days - Closed July 4)
Weird Science - July 8-12, 2024 LOW AVAILABILITY
The Music Maker - July 22-26, 2024
I Can Be A Chef - July 15-19, 2024 SOLD OUT
Gaming Camp - June 3-7, 2024 SOLD OUT
My Child Will Attend
*
Session 1: 8 am - 12:30 pm $90
Sessions 2: 12:30 pm - 5 pm $90
Full Day Session 8 am - 5 pm $140
My Products
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next
( X )
Registration Fee per Camp
$
25.00
There is a $25 registration fee
Quantity
1
2
3
4
5
6
7
8
9
10
Camp T-Shirt
$
20.00
Camp T-Shirts are available at an additional cost. Please indicate quantity next to the size you wish to order. T-Shirt orders are due at time of registration.
Size
Quantity
Price
Youth XS
1
2
3
4
5
6
7
8
9
10
$
20.00
Youth S
1
2
3
4
5
6
7
8
9
10
$
20.00
Youth M
1
2
3
4
5
6
7
8
9
10
$
20.00
Youth L
1
2
3
4
5
6
7
8
9
10
$
20.00
Youth XL
1
2
3
4
5
6
7
8
9
10
$
20.00
Adult S
1
2
3
4
5
6
7
8
9
10
$
20.00
Adult M
1
2
3
4
5
6
7
8
9
10
$
20.00
Adult L
1
2
3
4
5
6
7
8
9
10
$
20.00
Adult XL
1
2
3
4
5
6
7
8
9
10
$
20.00
Adulth XXL
1
2
3
4
5
6
7
8
9
10
$
21.00
Adult XXXL
1
2
3
4
5
6
7
8
9
10
$
21.00
Total
$
0.00
Credit Card
Liability Waiver
I agree to the following LIABILITY WAIVER: The undersigned being the lawful parent and/or guardian of the above child(ren) hereby consent to the participation by the child(ren) in all activities conducted by Wittmann Learning Center and to the participation of the child(ren) in all events related to said activities. The children that participate in activities and adventures with Wittmann Learning Center are consistently well supervised, however, accidents do happen. The undersigned assumes all risk of injury or harm to the child(ren) associated with participation in Wittmann Learning Center's activities and adventures and agrees to release, indemnify, defend, and forever discharge Wittmann Learning Center and its subsidiaries, vendors, staff, employees, and agents of and from all liability, claims, demands, damages, costs, expenses, actions and causes of action in respect of death, injury, loss or damage to the child(ren), howsoever caused, arising by reason of or during the child(ren)'s participation in attendance and activities at Wittmann Learning Center.
Signature: By placing your signature, you understand and agree to the liability waiver above. You also agree to make payment for camp by the first day of camp.
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: