Summer Camps 2025 Form

Summer Camps 2025 Form

Use this form to register your learner for summer programming at The Kaleidoscope Discovery Center. Have more than one learner? Submit the first, then refresh the form to submit for more.
Your Name (person completing this form)*

First NameLast Name
Your Email*
example@example.com
Your Phone Number*
Please enter a valid phone number.
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Name*

First NameLast Name
Student Birthdate*

MonthDayYear
Date
Student Grade *
(what grade they'll be in for fall)
May we use photos of this student for our marketing purposes?*

Yes, that's fine.No, I don't consent to this.
Student's phone number (if different than the one you listed for yourself)
Please enter a valid phone number.
Student's address (if different than the one you listed for yourself)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student's Additional Emergency Contact Name

First NameLast Name
Student's Additional Emergency Contact Phone Number
Please enter a valid phone number.
Student's Additional Emergency Contact Email
example@example.com
If this student has any allergies, needs special accommodations, or if there is anything else we should know, please list it below.
NO LUNCH OR SNACKS WILL BE PROVIDED. Please pack your learner(s) with a lunch & snacks every day they attend. A refrigerator will be available to store lunches & snacks.*

Yes, I understand. My student(s) will bring a lunch & snacks.

Summer Camps 2025 Form

Camp Selections