Student Information

Medical conditions, accommodations, food allergies, concerns, etc.​

Household Information

Primary Household - Parent/Guardian 1

Primary Household - Parent/Guardian 2

Secondary Household - Parent/Guardian 1

Secondary Household - Parent/Guardian 2

Which parent/guardian is the primary emergency contact for your student?​
Which parent/guardian is the secondary emergency contact for your student?​​​
Name, Address, Phone Number, Email Address​​

Early bird pricing valid through June 30, 2019.​​​​​​
After July 1, 2019​​​
I give constent for my child's image to be used in Summer Session promotions (e.g brochures, video, or the Camp Website)