Hopping Through History Registration Form

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Please complete this form to register for the 5-day, in-person summer camp on June 27-July 1, 2022 every day from 9am to 12pm.

The registration deadline is 11:59pm on Monday, June 13, 2022. Cost of program is $175 for SHS members and $200 for non-members. Once the registration form is submitted, you will receive an invoice via email. The invoice must be paid in full by June 13, 2022.

Flexible, Pay-What-You-Can payment options are available. Please contact education@shakerhistory.org for more information.

Current CDC safeguards and precautions will be in effect for all in-person activities including summer camps and programs. All camp staff are fully vaccinated.

Email *

Parent/Guardian Name *

Parent/Guardian Cell Phone Number *

Preferred Email Address (if different than above)

Are you an SHS member? *

Yes

How many campers are you registering? (Sibling discounts available) *

What School(s) Does Your Camper(s) Attend? *

Camper's Name, pronouns (she/he/they), and grade as of September 2021. (use same line separated by a dash [-] if registering more than one participant) *

Photo Release and Consent Form

I agree to have photos of my child/their likeness participating in the Hopping Through History! Summer Camp taken for classroom purposes and use in promotional materials and digital marketing for the Shaker Historical Society. *

Yes

I allow photos of my child(ren) to be used in promotional materials and digital marketing for the Shaker Historical Society. *

Yes

After submission of this registration form, you will receive an invoice for the camp fees. Cost for the program is $175 for SHS members and $200 for non-members. The balance is due in full by 11:59pm on June 13th, 2022 via credit card or paper check.

Cost is per camper and includes materials and supplies. Please contact education@shakerhistory.org if you have additional questions or concerns or would like more information about the Pay-What-You-Can option.

I understand that this is an in-person camp at SHS, and my child will be required to wear a mask when around other participants and staff for everyone's health and safety. *

Yes

Required

I understand that small snacks will be provided to campers by staff. Please list below any food allergies your child(ren) has (if none, please answer "none" below). *

I consent that all the above information is true and I agree to be contacted by the Shaker Historical Society regarding this camp. *

Yes

Required

Send me a copy of my responses.

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