Fall & Winter Day Camp Registration Form
Camp Dates and Themes (Kindergarten-5th Grade)

September 29 Museum Alive (2-3 FULL)

October 13 Spooky Science (K-1, 2-3 FULL)

November 20 Astronaut University (K-1, 2-3 FULL)

November 21 Superhero Science (K-1 FULL, 4-5 FULL)

December 18 Escape to a Galaxy Far, Far Away… (K-1, 2-3 FULL)

December 19 Get Your Game On (K-1, 2-3 FULL)

December 20 Insect Adventure (K-1, 2-3 FULL)

December 21 SHOCKING Science (K-1, 2-3 FULL)

December 22 Grossology (K-1 FULL)

December 27 Building Engineers

December 28 Robo-Academy

December 29 Culinary Challenge

January 2 Build with Blocks

Additional Information
Day camps are $40/day - includes lunch and materials.

This form, online or hard copy (PDF), must be completed in its entirety and submitted no later than one week before the camp date. Camps are limited in size; therefore, registration applications will be processed on a first come, first serve basis. Registration is complete and confirmed upon receipt of full payment.

Requests for cancellation must be received in writing to the Challenger Learning Center prior to camp start date. Full refunds will be allowed for written requests received two weeks in advance of the camp's start date. Half refunds will be allowed for written requests received one week in advance of the camp's start date. No refunds will be granted after the camp's start date. Please allow approximately 90 days for refunds to be processed, unless payment was received by credit card.

Camps will be conducted at the Challenger Learning Center on Kleman Plaza from 9:00 a.m. until 4:00 p.m., unless enrolled in extended care. Parents/guardians must designate on this registration form authorized individuals to pick up campers if parents/guardians are unable to do so. Parents/guardians and/or authorized individuals must accompany campers into the building and sign them in and out every day. Parents/guardians must always have photo ID with them and be listed as an authorized individual on the registration form. Challenger Learning Center is located at 200 South Duval St., on the corner of College Ave. and South Duval St.

Extended Care is available to accommodate busy schedules. Campers arriving earlier than 8:50 a.m. or departing later than 4:00 p.m. MUST be enrolled in the Extended Care. Campers enrolled in AM Extended Care may sign in as early as 7:50 a.m. For PM Extended Care, campers may be signed out any time before 6:00 p.m. to avoid a $1/minute late fee. AM Extended Care, 7:50 a.m. to 9:00 a.m., is $5/day. PM Extended Care, 4:00 p.m. to 6:00 p.m., is $5/day. You must indicate on the registration form that you plan to participate in Extended Care and include the cost in your camp payment. Extended Care campers will not be participating in extra camp activities during extended hours.

Lunch is provided daily. Lunch includes an entree (cheese or pepperoni pizza) and a healthy side. If preferred, your child may choose a corn dog, an all-beef hot dog or a vegetarian entree. You may provide your child with snacks, money to visit the concessions stand, and/or a lunch from home if preferred.

Camper pick-up/drop-off parking is available in the Kleman Plaza parking garage or at metered street spots. Bring your Kleman Plaza parking ticket into the CLC with you and CLC staff will validate tickets obtained within 30 minutes. Please note: you could be ticketed or towed for parking at the U.S. Post Office or in the loading zone on College Ave.

Camps are designed for the enjoyment and benefit of all campers enrolled. Our goal is to be educational as well as entertaining and campers are expected to abide by camp rules. With that as the objective, we anticipate that no camper is here who does not want to be here. Should any disciplinary problems occur, camp staff will contact the parent/guardian to discuss the child's behavior, possible remediation and/or picking up their camper. Please do not send any toys, books, electronic devices, etc. with the camper unless approved by a camp counselor. If items from home are brought, they may only be used during extended care, lunch and recess. The CLC is not responsible for lost/stolen/broken items brought from home.

Should you need additional information, please call (850) 645-7777, weekdays from 7:30 a.m. until 4:00 p.m. For content/curriculum, contact our Education Manager at (850) 645-7787.

Camper Information
First Name *
Your answer
Last Name *
Your answer
Gender *
Date of Birth *
Street Address *
Your answer
Zip Code *
Your answer
School Attending *
Your answer
Parent/Guardian Information
Parent/Guardian Name(s) *
Your answer
Email Address *
Your answer
Cell Phone *
Your answer
Work Phone
Your answer
Home Phone
Your answer
Pick-Up Authorization
If any individual(s) other than the parent/guardian(s) listed above are authorized to pick up your child from camp, please list their names and contact information below.

***Please note all parents and authorized individuals must present photo identification every time your camper is picked up.***

My child may be transported from the Challenger Learning Center by:

Authorized Individual(s) *
Your answer
Authorized Individual(s) Phone Number *
Your answer
Authorized Pick-Up Electronic Signature *
Your answer
Camp Selection
What grade is your child enrolled in school year 2017-2018?
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