SPUSD SPRING CAMP 2019
DATES: Monday-Thursday, April 1-4, 2019
HOURS: 6:15am-6:00pm
SITE: Marengo Elementary School
ADDRESS: 1400 Marengo Ave., South Pasadena, CA 91030
Contact us at 626-441-5810, ext. 1125 OR extday@spusd.net
Email address *
Camper's Name (Last name first) Each camper will need to be registered individually. *
Your answer
Camper's Birthdate *
Your answer
School Camper Attends *
Is your child in any SPUSD Extended Day school year program? *
Camper's Grade in School *
Camper's Home Address *
Your answer
Camper's Home Phone *
Your answer
Medical/Dietary Concerns for Camper *
Your answer
Parent/Guardian #1 Name *
Your answer
Parent/Guardian #1 Address *
Your answer
Parent/Guardian #1 Contact Number *
Your answer
Parent/Guardian #2 Name
Your answer
Parent/Guardian #2 Address (if different from #1)
Your answer
Parent/Guardian # 2 Contact Number
Your answer
Emergency Contact #1 (not a parent/guardian) *
Your answer
Emergency Contact #1 Phone Number
Your answer
EC #1 Authorized to pick up camper? *
Emergency Contact #2 (not a parent/guardian)
Your answer
Emergency Contact #2 Phone number
Your answer
EC #2 Authorized to pick up camper?
Please read the statements below and check the box if you agree to the policies. *
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A copy of your responses will be emailed to the address you provided.
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