Youth Summer Program Sign Up

Your spot in the Youth Summer Program will be reserved upon the completion of this form.
Session Selection *
Select which week/s of the Youth Summer Program your camper will attend.
Camper Information
Camper Name *
Camper Name
Camper Birthdate *
Camper Birthdate
Please list dietary restrictions, behavioral considerations, learning disabilities, and/or anything else we need to know in order to have a successful week with your camper!
List allergies, medications, injuries, and other necessary medical history we need to know.
Are you Registering A Sibling of this Camper? *
Fill out a separate form for any additional camper.
Parent/Guardian Information
Parent/Guardian Name *
Parent/Guardian Name
Parent/Guardian Phone Number *
Parent/Guardian Phone Number
Parent/Guardian Address *
Parent/Guardian Address
Emergency Contact Information
Use Parent/Guardian Information for the camper/s Emergency Contact *
If so, skip this section.
Emergency Contact
Emergency Contact
If different from Parent/Guardian information above.
Emergency Contact Phone Number
Emergency Contact Phone Number
I understand that tuition for this program is $625. *
A limited number of sliding scale financial aid spots are available. Indicate interest in these spots in the comments and questions section below.
Thank you!
We will be in touch within two business days to send instructions for payment, options for late pick up, and to field any potential questions. -C3 Team