Summer of Freedom Application
Our program operates Monday through Friday from 12PM - 4PM at Bartram's Garden (5400 Lindbergh Blvd, Phila PA 19143) beginning Tuesday July 6th, 2021 through Friday August 13th, 2021.

We will have a variety of workshops included but not limited to boating, biking, self defense, dance, fitness, meditation, podcasting, and science for young people entering grades 3 through 8.

Please take a moment to complete this short application, so we can offer your child the best experience possible.

If you have any questions please:
Email us at Contact@theecofoundation.com 
Text Brother Kyle at 215.313.2933

For more information about our organization please visit TheECOfoundation.com

Sign in to Google to save your progress. Learn more
Email *
What is your Child's FIRST Name?   *
What is your Child's LAST Name?   *
What is their Date of Birth? *
MM
/
DD
/
YYYY
How old are they now? *
Grade As Of Fall 2021? *
What is Their Parent/Guardian’s Name? *
What is Their Parent/Guardian’s Phone Number? *
Their Emergency Contact’s Name? *
Their Emergency Contact’s Number? *
Person Responsible for Pick Up (if applicable) *
Please List Any Dietary Restrictions *
Please List Any Medical Conditions *
Please List Child’s Superpower *
Please Select Any of These Topics That Interest Your Child *
Required
Do you consent to your child participating in all of The Summer of Soulcial Discovery activities including but not limited to boating, bike riding, fishing, dancing, group therapy, martial arts, playing in dirt, and eating food we prepare for them (with the exception of previously mentioned restrictions)? *
Do you consent to your child being  photographed and recorded (video or audio) for the purpose of documentation, artistic expression, and future promotion? *
Do you consent to your child having their temperature checked via a contactless thermometer? *
Do you agree to keep your child home if they are experiencing flu like symptoms? *
Do you agree to notify us if anyone the child has come in contact with someone who has contracted COVID-19? *
Do you consent to your child getting a free COVID-19 test? *
What is their shirt size?
Clear selection
Is there anything else you'd like us to know?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy