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Elementary School Summer Camp 2024 Sign Up

Student first name

Student last name

Home address

Student gender

If selected "Other" please specify

Student date of birth

Student grade level (2023-2024 school year)

Student Race/Ethnicity * Required

African-American or Black

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Hispanic/Latinx

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East Asian

South Asian

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Bi/Multi-Racial

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Other

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T-shirt Size (Youth Sizes)

Any Dietary Restrictions? * Required

Yes

No

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Any Known Allergies or Medical Conditions? * Required

Yes

No

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Does your child require any special learning accommodations

Parent and Emergency Contact Info

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Email

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Student Information

Student First name*

Student Last name*

Home Address*

Gender*

Birthday*

Month

Day

Year

Grade Level*

Race/Ethnicity*

African American

American Indian or Alaskan Native

Hispanic/Latinx

Middle Eastern

East Asian

South Asian

Native Hawaiian or Other Pacific Islander

Bi/Multi-Racial

White

Prefer not to answer

Other

T-Shirt Size*

Youth sizes

Any Dietary Restrictions?*

Yes

No

Any Known Allergies or Medical Conditions?*

Yes

No

Does your child require any special learning accommodations?*

If nothing enter "none"

Semester*

Spring 2025

Parent/Guardian Information

First Name*

Last Name*

Email*

Phone*

Emergency Contact Name*

Emergency Contact Phone Number*

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Registration*

Student Ticket0

Free Registration

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