JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Registration - Panther Summer Camp 2024
Submitting the camp registration request does not guarantee enrollment.
Confirmation of placement will be provided via email.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Student Information
First Name
*
Your answer
Last Name
*
Your answer
DOB
MM
/
DD
/
YYYY
Gender
*
Male
Female
Other:
School Name
*
Your answer
T-shirt Size
*
Youth S (3-4 years)
Youth M (5-8 years)
Adult S (9-11 years)
Adult M (11+ years)
Adult L
Adult XL
Program Options
Full-Day Program - 9:00am - 4:00pm (Ages 3 to 12)
Half-Day Program - 9:00 - 1:00 (available for ages 3-4 only)
Program
*
Full Day - $250/week
Half Day Preschool - $160/week
Weeks of Summer Camp
Week 1
June 17-21
Week 2
June 24 - 28
Week 3
July 1-5
Parent Information
Contact #1
*
Name & Last Name
Your answer
Mobile
*
ex. +9955997080** (without spaces)
Your answer
Contact #2
*
Name & Last Name
Your answer
Mobile
*
ex. +9955997080** (without spaces)
Your answer
Additional Services @ Cost
Transportation
*
$50/week/child
No Transportation
Address
*
Your answer
Dietary Restrictions & Allergies
For any health conditions or serious allergies, please provide written notification to the health office at
maia-kumladze@tbilisi.qsi.org
Your answer
Field Trips
*
I hereby grant permission for my child to participate in all Panther Summer Camp field trips and activities.
Yes
No
Other:
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
