Live Online Camp Registration

Child's Full Name*

First Name

Last Name

Child' Birthday*

Child's Age at Time of Camp*

Child's Gender*

Parent 1 Full Name*

First Name

Last Name

Parent 1 Cell/Home Phone*

Parent 1 Work/Day Phone

Parent 2 Full Name

First Name

Last Name

Parent 2 Cell/Home Phone

Parent 2 Work/Day Phone

Parent's Email*

Best Email To Send Workshop Links & Codes To

Home Address*

Street

City

State

Zip Code

Emergency Contact Person*

First Name

Last Name

Cell Phone

If you already know who will be present in the home with your child during their Virtual Workshops, please enter their information here:

Full Name

Cell Phone

Please select each week that you would like to register your child for~

Week 1: June 14 – June 18

Please select your number of workshops per day for Week 1~

Partial Day: 1 Workshop Per Day ($100)