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Spring Break Science Camp 2024 Registration

Refund Policy: 100% refund only if written cancellation notice is received 30 days prior to camp beginning.

Camper's Information

First Name*

Last Name*

Date of Birth*

Age*

Sex*

Grade (Fall 2024)*

T-Shirt Size*

Does your child have food allergies or special learning conditions?*

To give your child their best camp experience, please let us know about your child's food allergies (i.e. peanuts, etc..) or special learning conditions (dyslexia, ADHD, autism, etc..). This helps us create an optimum learning environment.

Is there anything that you'd like to share with us about your child or their time at Camp?

Parent's Information

First Name*

Last Name*

Email Address*

Home Phone*

Secondary Phone

Address*

Address 2

City*

State*

Zip Code*

Emergency Contact Information (please list a different contact from parent/guardian listed above)

Emergency Contact First Name*

Emergency Contact Last Name*

Emergency Contact Phone*

Membership/Multiple Registration Information

Will you/Have you registered another child for Camp?*

Are you currently a member?*