2019 Imaginorium Rainbow Wizards Academy Registration
This is the registration for the Imaginorium Rainbow Wizards Academy, which will be held July 8-19, 2019 at the French American School in Providence, RI. This program is for students in middle school and high school, including those entering 6th grade and those who have just graduated high school. Those who are more than a year past high school should consider applying to be part of our staff.
Email address *
Student's Legal First Name *
Your answer
Student's Last Name *
Your answer
Name they prefer to be called *
Please spell this correctly as it is the name that will go on their nametag.
Your answer
Preferred pronouns *
Student's Age *
(at the time of camp)
Entering School Grade *
(or equivalent if home schooled)
What school do they attend?
This is optional, but it helps us know which of our students might already know each other.
Your answer
T-shirt size *
All students will receive an Imaginorium Academy T-shirt as part of registration. These are all standard adult sizes. If you need a different size, please list it under "other."
Extra T-shirt
Would you like to order more than one shirt? Some families like them for younger siblings or parents or for students to have more than one. Students and staff will only receive one free T-shirt, regardless of how many Imaginorium programs they participate over the summer. Extra shirts can be ordered for $10 each. List size and quantity.
Your answer
Wizarding Academy House *
If your child is new to our Wizarding Academy, which house do you think they would prefer? Rank from 1-4 with 1 being first choice. First choice is not guaranteed. Returning students stay in the same house, so please try to correctly list their house.
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Waverider (blue, narwhal, water, peace)
Windhorse (green, pegasus, air, love)
Stonedragon (gold, dragon, earth, strength)
Phoenixfire (red, phoenix, fire, hope)
Does your child want to be in the same house or class as any other camper (siblings, friends)?
We will do our best, but we cannot guarantee this.
Your answer
Would you describe your child as more *
Active
Attentive
What are some of your child's interests?
Identity *
This program is focused on LGBTQA+ issues, but is completely open to all, including to cisgendered heterosexual allies. It is just helpful for us to know who our students are in advance, at least inasmuch as we can know anyone based on labels. To your knowledge, does your child identify as any of the following?
Required
Parent(s) Name(s) *
Your answer
Parent E-mail address *
(required for confirmation and/or clarification of registration and other pre-camp information)
Your answer
Student E-mail address
(for camp information only)
Your answer
Mailing Address *
Your answer
City, State *
Your answer
Zip Code *
Your answer
Will the student be staying with someone else (grandparents, etc.) during camp? If so, list their names and contact information.
Your answer
Daytime Phone *
Where a parent or guardian can be reached in case of emergency
Your answer
Dismissal Options *
Pick-up
People who may pick up your child. License required for ID. Are there any custody issues we need to know about or any people who should NOT be allowed to pick up your child?
Your answer
FOOD ALLERGIES! *
Students bring their own lunch, but we eat camp snacks and sometimes have food-related projects in classes. It is very important for us to know specifics about food allergies and the severity of those allergies (For example, if a child is allergic to nuts, can they be in the same room with other kids eating peanut butter?). We may not be able to accommodate severe dietary needs and will ask for parents' help in providing appropriate snacks.
Your answer
Does your child have any other behavioral or health challenges? *
We seek to accommodate for all children's needs. Sensitivity to insect bites or summer heat, ADHD or ADD, autism or aspergers, etc. We can only meet your child's needs if we know what they are. Please explain what strategies may be most helpful for the staff who will be working with your child. If you believe your child may need one-to-one staff attention, please let us know.
Your answer
Insurance Provider *
In case of a medical emergency, we will attempt to contact you immediately, but if it is a true emergency we will transport your child to the nearest emergency facility.
Your answer
Program Fees *
Discounts
*Fees may be reduced by 10% per week based on any one of the following (one one discount per student, though, even if more than one applies).
Are you participating in our other Imaginorium program this summer?
Scholarship application
If you are unable to pay the full or discounted amount, you must apply for a partial scholarship. Please explain in as much detail as possible why you need this scholarship. All scholarship recipients are expected to provide some volunteer effort to the camp. How are you are willing to help with the camp (set-up, as a volunteer during camp, or clean-up)? Can you make any financial contribution? Could you pay half?
Your answer
How did you hear about our program? *
Your answer
Topical Medication
(Optional - Initial)
Your answer
Photo and Video Release *
(Initial) You may use photos and videos of my child on the web and in print to promote the Imaginorium Educational Collective. (We take care in how we share photos, especially of minors. It is VERY difficult to exclude children from photos, though it can be done if absolutely necessary. Talk to the Headmistress if you have concerns about how photos and videos are used.)
Your answer
Program Content *
(Initial) This program will be directed by a trained sexuality educator and will nurture the three "R's" of sexuality education: respect, relationship, and responsibility by helping children and youth gain self-respect and respect for others, build relationships with people of all genders and with many kinds of families, and understand their responsibilities regarding their own health and that of others. Program content will include explicit, age-appropriate educational content relating to sexuality, gender, and sexual health. Parents may reach out to staff about the curriculum at any time. By initialing here, I give permission for my child to participate in this program.
Your answer
Program Philosophy *
(Initial) I understand that the Imaginorium Educational Collective accepts and teaches diversity of race, religion, class, sexual orientation and gender identity and give permission for my child to attend this program.
Your answer
Permission *
By typing my name as an electronic signature, I represent that I am the Parent/Guardian of the child named in this registration. I grant permission for my child to participate in Rainbow Wizards Academy from 9 am - 3 pm. I agree and hereby do release and hold harmless all adult supervisors, from and for any and all liability which may arise for damages, loss or injuries, either to person or property, which my son/daughter may sustain while engaged in the activity conducted. I further agree to assume responsibility for any liability which may arise for damages, loss or injuries which may be caused by my son/daughter to the person or property of others. Should any injury occur, I grant permission for my son/daughter to receive treatment from an appropriate health care provider when the need for such treatment is immediate and when efforts to contact me (us) are unsuccessful. I also agree to pay and be responsible for all medical, hospital or other expenses which the Imaginorium or any/all supervisors may incur as a result of securing treatment.
Your answer
A copy of your responses will be emailed to the address you provided.
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