Elementary Summer Camp 2020
This is an interest form, not an enrollment form. Enrollment is not guaranteed until you receive a confirmation notice. Once a confirmation notice is received, you will be asked to approve your schedule and pay our one-time $30 activity fee.

We will have a firm start date as soon as the Governor and Public Health Department provide direction on when it is safe to do so. We will have new COVID-19 policies and procedures for children, youth and families participating in our programs, as it relates to maintaining the safety of our participants and staff.

Contact Tanya Walker, GCC Elementary Program Manager and enrollment@goodmancenter.org or 608-204-8034 for more information.
Child's Last Name *
Child's First Name *
Child's Date of Birth *
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DD
/
YYYY
Child's School *
Priority is given to children attending Emerson and Lowell Elementary Schools
Child's Grade (as of May 2020) *
Required
Parent/Caregiver First Name *
Parent/Caregiver Last Name *
Full Mailing Address *
Email Address
Phone Number
Free or Reduced Lunch Qualification *
Goodman has a commitment to serving 75% or more of families who qualify for free or reduced lunch.
Household Size
Answer only if you qualify for Free or Reduced lunch or tuition assitance
Monthly Income before taxes
Answer only if you qualify for Free or Reduced lunch or tuition assitance
City/County funding or Scholarships
Clear selection
I would like my child to attend program on the following days (2 days/week minimum) *
Required
Does your child require one-on-one care for self help skills or behaviors? If yes, please include a short description of needs. *
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