"*" indicates required fields Registration for Summer Camp Complete registration and submit $50.00 per child (non-refundable) registration fee. STUDENT INFORMATIONChild's Name* First Last Preferred Name, if differentDate of Birth* MM slash DD slash YYYY Age as of June 1*Select Week(s)* June 8-12 – Masters of Music: Composers & Their Creations June 15-19 – Treasures of the Earth: The Story Written in Stone (Rocks & Agates) July 7-10 – Life Beneath the Waves: The Hidden World of the Ocean (Theater Camp – week 1) July 13-17 – Sacred Stories; Journey Through Genesis & Joshua (Theater Camp – week 2) July 20-24 – The Smallest Engineers: Insects (Theater Camp – week 3) July 27-31 – Little Chefs & Kitchen Creations (Theater Camp – week 4) Individual Day Scheduling – Add dates in next section Individual Dates:PARENT INFORMATIONParent Name First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail Signature of Parent/GuardianDate MM slash DD slash YYYY APPLY FOR ANOTHER CHILD?* Yes No STUDENT #2 INFORMATIONChild's Name First Last Preferred Name, if differentDate of Birth MM slash DD slash YYYY Age as of Sept 1Select Week(s)* June 8-12 – Masters of Music: Composers & Their Creations June 15-19 – Treasures of the Earth: The Story Written in Stone (Rocks & Agates) July 7-10 – Life Beneath the Waves: The Hidden World of the Ocean (Theater Camp – week 1) July 13-17 – Sacred Stories: Journey Through Genesis & Joshua (Theater camp – week 2) July 20-24 – The Smallest Engineers: Insects (Theater camp – week 3) July 27-31 – Little Chefs & Kitchen Creations (Theater camp – week 4) Individual Day Scheduling – Add dates in next section Individual Dates:Date MM slash DD slash YYYY
