Camper Name *

First Name

Last Name

Camper Birthdate *

MM

DD

YYYY

Camper Field Trip T-Shirt Size *

Youth XS

Youth S

Youth M

Youth L

Youth XL

ENTERING Grade for Fall 2025 (not CURRENT grade) *

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

Camper Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent Name *

First Name

Last Name

Parent Phone *

(###)

###

####

Parent 2 Name

First Name

Last Name

Parent 2 Phone

(###)

###

####

Tiered Registration *

Tier 1: - Guaranteed care - 3 days/week minimum - 1 week vacation (optional) Tier 2: - Care based on availability - No minimum requirement

Tier 1

Tier 2