2019 CM Kids' Choice Summer Camp: Registration
Dates available:
July 8 - 12 |  9:00am - 5:00pm
July 15 - 19 | 9:00am - 5:00pm

Space is limited to 20 students per weekly session. Extended care (to 6pm) available.

Questions: please contact Amanda at amanda@classroommatters.com.

Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Pronouns *
Birthdate *
MM
/
DD
/
YYYY
School *
Your answer
Grade Level as of Fall 2019 *
Parent/Guardian #1: Name *
Your answer
Parent/Guardian #1: Phone # *
Your answer
Parent/Guardian #1: Email Address *
Your answer
Parent/Guardian #2: Name *
Your answer
Parent/Guardian #2: Phone # *
Your answer
Parent/Guardian #2: Email Address *
Your answer
Emergency Contact #1: Name *
Your answer
Emergency Contact #1: Phone Number *
Your answer
Emergency Contact #2: Name
Your answer
Emergency Contact #2: Phone Number
Your answer
Allergies/Medical Conditions *
Your answer
Who is approved for pickup? *
Your answer
Does your child have any special needs or learning differences? If so, please elaborate. *
Your answer
Which week(s) will your child be attending camp? *
Required
Weekly Schedule (in order to secure a space in the camp, you must commit to paying the weekly enrollment fee, even if your child does not attend all 5 days) *
Required
Is there anything else you'd like us to know about your child?
Your answer
Payment *
Required
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