Summer Camp Registration Form

Scuola Italiana di Portland

Application for Admission

Summer Camp 2026

Imagination Week

Please complete one form for each child.

Second enrolled sibling can receive the discounted family rate.
Child's Name*

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
Gender

MaleFemaleOther
Please indicate your estimation of this child's overall level of Italian knowledge. No experience is necessary to enroll in summer camp.

Principiante (Beginner)Intermedio/a (Intermediate)Avanzato/a (advanced)
Parent 1 Full Name

First NameLast Name
Spouse if not child's parent

First NameLast Name
Parent 1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent 1 Home Number

Area CodePhone Number
Parent 1 Work Number

Area CodePhone Number
Parent 1 Cell Number

Area CodePhone Number
Parent 1 E-mail*
Parent 1 Employer and Title
Parent 2 Full Name

First NameLast Name
Spouse if not child's parent

First NameLast Name
Parent 2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent 2 Home Number

Area CodePhone Number
Parent 2 Work Number

Area CodePhone Number
Parent 2 Cell Number

Area CodePhone Number
Parent 2 Employer and Title
Parent 2 E-mail*
If parents separated, student lives with:
Are duplicate mailings necessary?

YesNo
Emergency contact #1 (name, address, phone)
Emergency contact #2 (name, address, phone)
Where did you learn about this program?
Signature Parent 1*

Clear
Signature Parent 2

Clear
June 15-19, 2026, 9:00am - 3:00pm
August 17-21, 2026, 9:00am - 3:00pm

This fun week is broken up into five exciting themes that explore a topic with crafts, songs, adventures, games, and free play at our school location in the Pearl - 1542 NW 14th Ave. There is something for everyone this week, from fairies to superheroes to animals and dinosaurs.

Cost: $375

Siblings receive a 30% discount on enrollment.* Scholarships available.
*To receive the 30% discount, please fill out a form for your first student and pay in full. Then fill out a second form for the second student and select the 30% off sibling rate.

**Scholarships are available! Please email info@scuola.us.
Payment Information

To receive the sibling discount of 30%, please take the following steps: (1) fill out a form for the first student, select the full price ($200), and complete payment, then (2) fill out a second form for the next child, select the sibling rate, and complete payment. Email info@scuola.us with any questions.
Mille grazie! For questions, please contact us at: info@scuola.us

Mailing address: Scuola Italiana di Portland 1542 NW 14th Ave, Portland, OR 97209
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Imagination Week - June 15-19$375.00

Sibling Rate -Imagination Week - June 15-19$262.50

Imagination Week - August 17-19$375.00

Sibling Rate - Imagination Week - August 17-19$262.50

Total $0.00
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Scuola Italiana di Portland

Please complete one form for each child.

Second enrolled sibling can receive the discounted family rate.

Payment Information