June Session Citizen Science Adventure Camp Application 2021
This camp is operated by Learning Endeavors, a Non-Profit Organization based on Maui:
Choose Camp Session or Sessions *
Camper's Full Name and "Nickname" if applicable *
Camper's Date of Birth *
Grade entering in Upcoming School Year 2021-22 *
Parent/Guardian Full Name *
Parent/Guardian Email *
Parent/Guardian Phone(s) *
Parent/Guardian Mailing Address *
This is an outdoor, active camp. Please rate your child's physical ability to engage in a moderate hike and physical exercise. *
Strong and Goes For it!
This camp will be taking place at Waihe'e Coastal Dunes and Wetlands Refuge on day 1, Kealia Ponds National Wildlife Refuge on day 2 and at the VFW in North Kihei on days 3 & 4. Dropoff/pick up locations will be shared after registration is complete. Check the appropriate box below. *
Please list any allergies and medications your camper may have.
Please provide an additional point contact in case of emergency. Full name, relationship, phone #. *
What type of medical coverage does your child have? (HMSA, Kaiser, other)
Please type your name below to "SIGN" if you give approval for Learning Endeavors to use photos of your camper or digital content created by your camper from the camp session for non-commercial, promotional and educational use only.
Camper T-Shirt Size (included in tuition) *
Please share with us any additional information about your camper we should know. Particular goals for this Summer? Does your child require any specific accommodations?
Registering a sibling? If so, submit an application for each child separately. Full tuition for 1st child, then receive $15 discount for additional sibling(s). Please name all siblings here, if this applies.
How did you hear about us?
Clear selection
Never submit passwords through Google Forms.
This form was created inside of Learning Endeavors. Report Abuse