ANCHORED Day Camp Registration
We will contact you for payment by email after receiving your registration. Payment must be sent within 2 WEEKS or registration will be cancelled.

A new form must be filled out for each child.

Email address *
Phone Number *
Your answer
Parent First Name *
Your answer
Parent Last Name *
Your answer
Home Address
Your answer
Child First Name *
Your answer
Child Last Name *
Your answer
What Grade is your child entering? *
Your answer
Please write out any allergies/sensitivities your child has if applicable:
Your answer
Does your child have any special learning needs/accommodations?
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Relationship *
Your answer
Emergency Contact Phone Number *
Your answer
Please write out the names of people you authorize to pick up your child from camp if it is not going to be you:
Your answer
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