QCSD Academic Summer Camp Online Registration
In order to fully complete online registration, please have emergency contact and medical information handy.

Email address *
Last Name of Student *
Your answer
First Name of Student *
Your answer
Student Mailing Address (Street or PO) *
Your answer
Student City *
Your answer
Student State *
Student Zip Code *
Your answer
Student Home Phone Number *
Your answer
Student Date of Birth *
MM
/
DD
/
YYYY
Grade entering into this fall *
What school does your child attend currently? *
Your child's teachers LAST NAME: *
Your answer
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