Camp Registration PLEASE NOTE: All camps take place at our Medford location. Student InformationStudent's Name* First Last Student's Date-Of-Birth* Date Format: MM slash DD slash YYYY Student's Grade Level for the 2021/2022 School Year*Parent's Name* First Last Email* Enter Email Confirm Email Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent's Phone*Parent's Cell PhoneFood Allergies or Restrictions:Health or Medical Conditions we need to be aware of:Anything else you’d like us to know:Emergency Contacts1st Contact's Name* First Last Relation*Phone*2nd Contact's Name* First Last Phone*Relation*Release Form*I have read and agree to the terms outlined in the camp release form (pdf).CampsSummer Success AcademySummer Success Academy For incoming 2nd-8th Graders FULL SUMMER : June 22-August 19 JUNE: June 22-June 29 JULY: July 1-29 AUGUST: August 3-19 Adventures in Art2nd-8th graders Tues & Thursday- July 6th, 8th, 13th, 15th 2-4:30pm Enroll in Adventures in Art +$199 ($50 supply fee included)No ThanksSAT BootcampHigh School Students Tues, Wed, Thurs July 20-22nd. 2-5:00 PM Enroll in SAT Bootcamp +$189No ThanksLittle Einsteins Preschool Science CampAges 3-5 (fully potty trained) Tues, Wed, Thurs August 23-27 9-11:30am Enroll in Little Einsteins +$89No ThanksVirtual Book ClubWednesdays July 21-August 11 (4 weeks of club) 2-3PM via ZOOM Enroll in Virtual Book Club +$49No ThanksTotalIf you have a coupon code, enter it here. Grand Total $0.00 Clicking the link below will redirect you to PayPal to complete payment and registration. You are not registered until we receive your payment.CommentsThis field is for validation purposes and should be left unchanged.