Mrs. Smith's Science Camp 2018 Camper Registration
Camper's First Name *
Your answer
Camper's Last Name *
Your answer
Gender *
Grade in the 2017-2018 School Year *
Birthdate *
Your answer
Weeks Attending Camp: *
Required
T-shirt Size (Select one from the list) *
Address *
Your answer
Home Phone *
Your answer
Parent Email *
Your answer
Parent Secondary Email
Your answer
Parent 1 Name: *
Your answer
Parent 1 Cell phone number *
Your answer
Parent 2 Name
Your answer
Parent 2 Phone Number
Your answer
Emergency Contact Information *
Please include the name of the emergency contact (other than the parents listed above), as well as the phone numbers where we may reach them
Your answer
Allergies *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Maimonides School. Report Abuse - Terms of Service - Additional Terms