ExperienceCraft Player Enrollment Form

1

Child's Name* This field is required.

First Name

Last Name

2

Child's Email* This field is required.Please share if your child is over 13 and prefers to be communicated with directly

example@example.com

3

Child's Phone Number* This field is required.

Please enter a valid phone number.

4

Do you consent to your child receiving program text?

YESNO

5

Child's Date of Birth* This field is required.

Date

6

Home Zip Code

7

Parent/Caregiver's Name* This field is required.

First Name

Last Name

8

Parent/Caregiver's Email* This field is required.

example@example.com

9

Parent/Caregiver's Phone Number* This field is required.

Please enter a valid phone number.

10

Do you consent to receiving program texts?

YESNO

11

Child's Gender Identity* This field is required.

12

Child's Race/Ethnicity* This field is required.

13

Which aspects of Excamps Online will the participant be engaging?* This field is required.

Minecraft & Discord

Discord activities only

14

What is the participant's Minecraft User Name?If he/she/they has one

15

What is the participant's Discord User Name?* This field is required.If he/she/they has one

18

Have you ever participated at one of our camps?* This field is required.

yes

no

19

Do you want to attend the Online Roblox Design Camp July 19-21, 5pm-8pm est?

YESNO

20

SignatureI acknowledge that I have read the ExperienceCraft release, and I understand what it means and what I am agreeing to by signing below.

Clear