2025 Summer Camp
Please use this form to register your child for our 2025 Summer Camp program for students in Nursery - Grade 2.
Camper's Information
Child's Name
*
First Name
Last Name
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Grade child will be entering in the Fall
*
Please Select
N
PK
K
1
2
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Information
Parent's Name
*
First Name
Last Name
Cell Number
*
Format: (000) 000-0000.
Parent's E-mail
*
example@example.com
Emergency Information
Emergency Contact's Name
*
First Name
Last Name
Relationship
*
Please Select
Mother
Father
Grandparent
Aunt
Uncle
Sibling
Babysitter/Nanny
Other
Phone Number
*
Format: (000) 000-0000.
Alternative Phone Number
Format: (000) 000-0000.
Does the camper have any allergies, chronic illness, or medical conditions? If yes, please describe.
*
Is the camper prescribed an inhaler? If yes, please explain any instructions.
*
Camp Selection (choose all that apply)
Week 1 (June 23 - June 27)
Week 2 (June 30 - July 3)
Week 3 (July 7 - July 11)
Week 4 (July 14 - July 18)
Week 5 (July 21 - July 25)
Week 6 (July 28 - Aug 1)
Week 7 (Aug 4 - Aug 8)
Submit
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