Summer Camp Detailed Registration Form 2026

Mathnasium Summer Camp Registration 2026
Child's Information
Child's Name #1

First NameLast Name
Birth Date

MonthDayYear
Grade
Gender
Which Camp Option do you Choose?
Camp Week(s) - use Ctrl to select multiple weeks
Drop-In Day 1
Drop-In Day 2
Drop-In Day 3
Drop-In Day 4
Drop-In Day 5
Child's Name #2

First NameLast Name
Birth Date

MonthDayYear
Grade
Gender
Which Camp Option do you Choose?
Camp Week(s) - use Ctrl to select multiple weeks
Drop-In Day 1
Drop-In Day 2
Drop-In Day 3
Drop-In Day 4
Drop-In Day 5
Child's Name #3

First NameLast Name
Birth Date

MonthDayYear
Grade
Gender
Which Camp Option do you Choose?
Camp Week(s) - use Ctrl to select multiple weeks
Drop-In Day 1
Drop-In Day 2
Drop-In Day 3
Drop-In Day 4
Drop-In Day 5
Parent/Guardian Information
Guardian #1

First NameLast Name
Cell Number
Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Guardian #2

First NameLast Name
Cell Number
Format: (000) 000-0000.
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
Please list individually who has permission to pick up your child:
Full Name

First NameLast Name
Relationship
Full Name

First NameLast Name
Relationship
Full Name

First NameLast Name
Relationship
Does your child(ren) have any allergies, food allergies, dietary restrictions, chronic illness, or medical conditions? If yes, please describe. If no, please mark NONE.
Is your child prescribed an inhaler or require an EpiPen? If yes, please explain any instructions. If no, please mark NONE.

Mathnasium Summer Camp Policies
Camp Fees For Option 1: Each Monday-Friday week is $700, paid in advance. You will receive an invoice with your selected weeks.

For Option 2 - Each Drop-In Camp Day is $175/day. You must specify your desired days ahead of time to set up individual Camp Days. All invoices MUST be paid prior to the start of camp.

Cancellation Fee 100% will be refunded up to 3 weeks prior to the camp start date. 50% will be refunded up to 2 weeks prior to the camp start date. No refunds will be given 1 week or less prior to the camp start date.

Opening Hours We are open from 9:00 am to 3:00 pm daily. Parents may drop off and pick up as needed. Planned activities are from 9:00 am to 3:00 pm each day. Please pack a lunch, water bottle, and extra snacks for your child every day of camp. If your child(ren) has any food allergies, please make sure you let us know by indicating what they are.

Pick Up CAMP CLOSES at 3:00 p.m. SHARP, in preparation for our afternoon classes. Please make sure all students are picked up by 3:15 pm as we prepare for afternoon sessions.
Initial
Photo, Voice, Website, Video Permission Waiver I/We hereby consent to allow the use of voice, video, image or likeness in photographs and/or video of my child by Mathnasium of Redwood City. I understand this waiver is in effect until I provide, in writing, a cease order. I/We also agree to forego any right or entitlement I/We might have to any compensation or fees.
Behavioral Agreement It is our expectation that children will behave well. Being respectful, appropriate interactions and learning self-control is part of a process. At Mathnasium of Redwood City, we work to promote positive, healthy relationships with self and others. Please discuss our expectations with your child and have them verbally acknowledge to you that they know what is expected and will do their best to cooperate fully with Mathnasium staff.
UNACCEPTABLE BEHAVIORS INCLUDE: • defying authority or deliberately disrupting the group • assaulting another person by a verbal or physical threat or action • fighting or wrestling • stealing the property of another person or of Mathnasium • deliberately destroying or damaging the property of another person or of Mathnasium • possessing firearms, knives or any other dangerous object which could cause injury to any person • harassing, bullying or intimidating any other child or staff members in any way • use of inappropriate or “foul” language.
We want each child to suceed and grow We will work with parents to develop an action plan to reduce or eliminate unhealthy behavior. If the action plan does not produce the desired results, a conference will be requested with parents and other staff members to determine next steps. Mathnasium of Redwood City does reserve the right to terminate a child’s enrollment in the program if there is an inability to resolve problematic behaviors.
Informed Consent and Acknowledgement I hereby give my approval for my child’s participation in any and all activities prepared by Mathnasium of Redwood City during the selected camp. In exchange for the acceptance of said child’s candidacy by Mathnasium of Redwood City, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Mathnasium of Redwood City and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions. In case of injury to said child, I hereby waive all claims against Mathnasium of Redwood City including all instructors and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event.
Emergency Medical Care In the event that I/we cannot be reached in an emergency, I/we give permission to Mathnasium of Redwood City to call 911 to hospitalize and/or get the proper treatment for my child(ren) as named above.
Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature
Date

MonthDayYear
Date
Should be Empty:

Mathnasium Summer Camp Registration 2026

Mathnasium Summer Camp Policies