2020 Summer Camp Registration
Please fill in a SEPARATE FORM for each camper you are enrolling.
CAMPER INFORMATION
Camper First and Last Name *
Your answer
Age *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
School *
Your answer
Grade Completed as of May 2020 *
Your answer
What language(s) are spoken at home? What language(s) does your child speak? *
Your answer
PARENT INFORMATION
Parent First and Last Name *
Your answer
Address, City, State and Zip *
Your answer
Phone Number (where parent can be reached during camp hours) *
Your answer
Alternate Phone Number *
Your answer
Email Address *
Your answer
We sometimes use photos taken at camp for the purpose of promoting the school and/or summer camp. If you DO NOT wish for us to use your child's photo, please choose NO below. *
Required
UP-TO-DATE IMMUNIZATION RECORDS OR EXEMPTION FORMS ARE REQUIRED BEFORE YOUR CHILD MAY BEGIN CAMP.
Move and Play Camps
For ages 3 - 4, entering Preschool and Pre-K in the fall. All Move & Play campers must be able to use the toilet independently. We ask that children who have never been in a full day program sign up for at least 3 consecutive weeks of camp.
Please select one or more camps. Camps cost $230 per week
Imagine That Camps
For ages 5-6, entering Kindergarten - 1st grade in the fall.
Please select one or more camps. Camps cost $230 per week.
Discovery Camps
For ages 7 - 9, entering 2nd - 4th grades in the fall.
READING IS MAGIC: only for kids struggling with reading. Teacher referral is required.
Please select one or more camps. Camps cost $230 per week.
Exploration A Camps (also see Exploration B Camps below for alternate offerings)
For ages 10 - 15, entering 5th grade and up in the fall.
Please select one or more camps. Camps cost $230 per week. NOTE: Some camps have an additional activities fee, as noted
Exploration B Camps
For ages 10 - 15, entering 5th grade and up in the fall.
Please select one or more camps. Camps cost $230 per week. NOTE: Some camps have an additional activities fee, as noted.
Other Required Information
THIS INFORMATION IS NEEDED SO STAFF IS PREPARED TO GIVE THE BEST POSSIBLE CARE TO YOUR CHILD.

Please provide a medical/behavioral plan as applicable.
Does your child have any medical or other needs that require special attention? (severe allergies, medication, seizures, autism, behavioral challenges, asthma, diabetes, etc.) *
If yes, please describe.
Your answer
Has your child been assessed for any medical or behavioral needs? *
Does your child have any food restrictions that require special attention? *
If yes, please describe.
Your answer
PICK UP INFORMATION
The following individuals ONLY are authorized to pick up my child at SFSAS. I understand that if I wish any other persons (including other camp parents) to pick up my child I must personally hand a letter to the office requesting this change.
Name, PHONE #, Relationship to Child *
Your answer
Name, PHONE #, Relationship to Child *
Your answer
EMERGENCY CONTACTS
(Must be 2 individuals other than parents or guardians)
1. Name, PHONE #, Relationship to Child *
Your answer
2. Name, PHONE #, Relationship to Child *
Your answer
Medical Treatment Authorization
Submission of this form authorizes Santa Fe School for the Arts & Sciences to seek medical treatment and transportation for my child in case of a medical emergency. In the event of a medical emergency, 911 will be called and children will be transported to the nearest hospital, accompanied by a staff member.
Doctor's Name and Phone Number *
Your answer
Has your child had chicken pox. If yes, when? *
Your answer
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