Camp Registration

Camp Registration
Parent Name*

First NameLast Name
Parent Email Address*
example@example.com
Parent Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Additional Adults Approved for Pickup from Camp
Please let us know first and last names, thanks!
How Did You Hear About Us?
Camper Information
Name*

First NameLast Name
Get Moving!Get Creative!Get Outside!
Grade*
Their rising grade for Fall 2025 (next year!)
Current School*
Any Allergies or Medication?*
If so, please let us know!
- Name
  
  First NameLast Name
- Get Moving!Get Creative!Get Outside!
- Grade
  Their rising grade for Fall 2025 (next year!)
- Current School
- Any Allergies or Medication?
  If so, please let us know!
- Name
  
  First NameLast Name
- Get Moving!Get Creative!Get Outside!
- Grade
  Their rising grade for Fall 2025 (next year!)
- Current School
- Any Allergies or Medication?
  If so, please let us know!

Waivers and Forms

By selecting singing in the box below, you agree to our Activity Release Form; please click to review it. Thank you!
Your Signature

Clear
Photo Release*
I give my permission to use my student(s) photos in promotional materials for Willows Academy and for Summer at Willows emails/social media posts.

Please Choose Your Camp(s)

June 9-13

$275.00 How Many Campers?

June 16-20

$275.00 How Many Campers?

June 23-27

$350.00 How Many Campers?

Enter coupon

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Camper Information