Sweet Roots Farm Camp Registration Form
Summer 2026
Attendee Information
Parent/Guardian's Name
*
First Name
Last Name
Email Address
*
example@example.com
Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Child's Name
*
First Name
Last Name
Birthdate
*
-
Month
-
Day
Year
Date
Emergency Contact
*
First Name
Last Name
Emergency Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Grade:
2
3
4
5
6
7
8
Does your child have any food or environmental allergies?
*
Yes
No
If yes, please describe:
Is there anything else we need to know about your child?
Are you registering more than one child?
Yes
No
Child's Name
*
First Name
Last Name
Birthdate
*
-
Month
-
Day
Year
Date
Grade:
2
3
4
5
6
7
8
Does your child have any food or environmental allergies?
*
Yes
No
If yes, please describe:
Is there anything else we need to know about your child?
Please list each person who is authorized to pick up your child(ren). Use this format: full name, relationship to child, phone number.
*
May we use photos/videos of your child(ren) for Mountain Roots Education materials (social media, website, etc)?
*
Yes
No
Please list dates for early drop off and/or late pick up (if any). Children can be dropped off as early as 8 am for $15/child and/or picked up as late as 4 pm for $15/child. Early drop off and late pick up can also be paid at a discounted weekly rate of $100/child, which includes extra morning and afternoon care on each day of camp. Please add payment for early drop off and late pick up to your cart by scrolling to the bottom of the list below.
Select your camp session(s) below. If you're registering more than one child, please change the 'quantity' under each session to 2.
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next
( X )
July 6-9 (Mon-Th)
$280.00
$
280.00
Quantity
1
2
3
4
5
6
7
8
9
10
July 6 & 8 (Mon & Wed)
$150.00
$
150.00
Quantity
1
2
3
4
5
6
7
8
9
10
July 13-16 (Mon-Th)
$280.00
$
280.00
Quantity
1
2
3
4
5
6
7
8
9
10
July 13 & 15 (Mon & Wed)
$150.00
$
150.00
Quantity
1
2
3
4
5
6
7
8
9
10
July 20-23 (Mon-Th)
$280.00
$
280.00
Quantity
1
2
3
4
5
6
7
8
9
10
July 20 & 22 (Mon & Wed)
$150.00
$
150.00
Quantity
1
2
3
4
5
6
7
8
9
10
July 27-30 (Mon-Th)
$280.00
$
280.00
Quantity
1
2
3
4
5
6
7
8
9
10
July 27 & 29 (Mon & Wed)
$150.00
$
150.00
Quantity
1
2
3
4
5
6
7
8
9
10
Aug 3-6 (Mon-Th)
$280.00
$
280.00
Quantity
1
2
3
4
5
6
7
8
9
10
Aug 3 & 5 (Mon & Wed)
$150.00
$
150.00
Quantity
1
2
3
4
5
6
7
8
9
10
Early Pick Up (Single Day)
$15.00
$
15.00
Quantity
1
2
3
4
5
6
7
8
9
10
Late Drop Off (Single Day)
$15.00
$
15.00
Quantity
1
2
3
4
5
6
7
8
9
10
Full Week Early Drop Off
$50.00
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
Full Week Late Pickup
$50.00
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
Each camp day starts at 9 am and ends at 3 pm. I understand Sweet Roots Farm Camp drop off and pick up times.
*
Yes
I have carefully read, understand, and voluntarily sign the above Mountain Roots Education Risk Release Form
*
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