First Name

Last Name

Gender

MaleFemale

Email (Parent/Student age 13 or older)

How did you hear about our Summer Camps?

Phone Number (Parent/Student age 13 or older)

Date of Birth

Current Grade Level

3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeCompleted 12th Grade

T-shirt Size

YSYMYLYXLSMLXL

Race/Ethnicity

White/CaucasianBlack/African-AmericanHispanic/LatinoAsianNative Hawaiian/Pacific IslanderAmerican Indian/Alaska Native2 or more races/Mixed-raceOther

Submitting Application for:

Session 1Session 2Session 3Session 4Session 5Session 6

Session 7Session 8Session 9Session 10Session 11Session 12