Summer Camp Registration Name * First Name Last Name Phone Country (###) ### #### Email * Dates * June 28-July 2 July 5-9 SOLD OUT (select to add your child to the waiting list) July 12-16 July 19-23 July 26-30 Child's Name * *Please fill out a separate form for each child. First Name Last Name Child's Birthdate * MM DD YYYY What are your child's interests and favorite things? * * Favorite topics of conversation? Animals? Activities? Characters? Does your child have any allergies or dietary requirements? * Has your child been diagnosed with any conditions that we should be aware of, in order to best assist and create an accessible environment your child will thrive in? * Can your child swim? * Are you comfortable with them going to the pool with supervision? Must they use a floatation device? Child's English Level * Fluent Understands Some No English Experience Child's Italian Level * Fluent Understands Some No Italian Experience Is there any other information that you would like to tell us that may help us give your child the best experience at our camp? * Permissions * I agree to having trained first aid practitioners administer first aid to my child. In the instance that the camp staff believes, for whatever reason, that it is in my child's best interest to do so, I agree to pick up my child from camp early if necessary. My child is allowed in and around the pool when supervised by adults. Alternative Emergency Contact * First Name Last Name Alternative Emergency Contact Phone * Country (###) ### #### Relationship to the Child * I would like the Co-working Space weekly pass for the following weeks: June 28-July 2 July 5-9 SOLD OUT (select to add your child to the waiting list) July 12-16 July 19-23 July 26-30 Thank you!
