iDiscover 2018 Summer Camp: Youth Registration Form
Welcome to the Kindling Intellectual Development Program iDiscover 2018 Summer Camp youth registration form. Here you can sign up your child, a family member, or a youth for our annual summer camp program. This year, we are happy to host a total of 50 campers.

CAMP DETAILS:

When: June 18th - 22nd, 2018 from 8:00 AM to 3:00 PM
Where: The First Congregational Church of Riverside:
3504 Mission Inn Ave. Riverside,CA, 92501
Cost: FREE
Meals: Breakfast, lunch, and snacks provided

ACTIVITY HIGHLIGHTS:

- Fun and Educational Activities
- Special Guest Speakers
- Art, Music, and Dance
- Field Trip(s)

DEADLINE TO APPLY: Saturday June 2nd, 2018 at 11:59 PM

For any questions or concerns, please email kid.program.ucr@gmail.com

Name of Camper *
First and Last
Your answer
Age *
Unfortunately, we will not be accepting campers UNDER THE AGE OF 5 AND OVER THE AGE OF 13. This is to keep the camp itinerary cohesive and comprehensive for the majority.
Your answer
Gender *
Has this camper attended any KID Program summer camp in the past? *
Has this camper attended any type of summer camp in the past? *
Grade *
Your answer
Youth T-Shirt Size *
Please provide us with your Camper's T-Shirt Size
Guardian / Emergency Contact - Name *
This person will be contacted in case information is needed or an emergency arises.
Your answer
Guardian / Emergency Contact - Relationship to Camper *
Your answer
Guardian / Emergency Contact - Phone number *
This person will be contacted in case information is needed or an emergency arises.
Your answer
Guardian / Emergency Contact - Email Address
Optional. This will be used to send updates and reminders about the camp.
Your answer
Additional Notes:
Please take a moment to add any information we should know about the camper. For example, medication needs, allergy information, etc.
Your answer
Will the Camper be attending the entire summer camp? *
*WHEN: Monday June 18th, 2018 through Friday, June 22nd, 2018 from 8:00 AM to 3:00 PM each day. We prefer if the child attends the entire camp.
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