2017 Summer Camp Registration
Camper Name
Your answer
Birthday and Age
Your answer
Home Address, City, State, Zip Code
Your answer
Interest in which of the following Groups
Required
Names of siblings in Kool Kidz Camps
Your answer
Which Preschool Camp would you like to sign up for?
(Only pertains to those signing up for preschool camps)
Which Science Camp are you signing up for?
What Engineering Camp are you signing up for?
What Art Camp are you signing up for?
Which Garden and Yoga Camp are you signing up for?
Which Lego Summer Camps are you signing up for?
Parent or Guardian's Name
Your answer
Relationship to child
Your answer
Address (if different from child's), City, State, Zip Code
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Work Phone
Your answer
Email
Your answer
Second Parent or Guardian's Name
Your answer
Relationship to child
Your answer
Address (if different from child's), City, State, Zip Code
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Work Phone
Your answer
Email
Your answer
Camper lives with
Your answer
Parental Status
Camper is allowed to leave with (list anyone and everyone allowed)
Your answer
Emergency Contact Name (someone other than a parent or guardian)
Your answer
Emergency Contact Phone Number
Your answer
Relationship to Camper
Your answer
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