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Summer Camp Interests -Form Fill
Section One
Q1
Parent/Guardian Name
First Name
Q2
Parent/Guardian Name
Last Name
Q3
Parent/Guardian Phone Number
Q4
Parent/Guardian Email
Q5
Child/Camper Name
First Name
Q6
Child/Camper Name
Last Name
Q7
Date of Birth
Date
Q8
Gender
Female
Male
Q9
School
Q10
Grade
Q11
Are you interested in enrolling your child in this virtual summer camp?
Yes
No
Q12
What do you expect your child to learn from this summer camp?
Q13
What is your motivation on why you want to enroll your child in this summer camp?
Q14
What programs are you planning to enroll your child to?
Painting
Sketching
Cooking
Singing
Dancing
Acting
Chess
Sports
Academic Tutoring
Musical Instrument
Q15
What are the usual time of day you prefer your child to participate to?
Morning (7:00am-10:00am)
Afternoon (1:00pm-4:00pm)
Late Afternoon (4:00pm-7:00pm)
Q16
If physical summer camp will be an option, will you let you child participate?
Yes
No
Q17
Do you have the following equipment for virtual activities? Please select all that you have:
Internet connection
Desktop/laptop/mobile/smart phone
Web camera
Microphone
Headphone
Q18
We are open for any suggestions or feedback.
Q19
Registration Fee
Online Art Class 1$100.00
Quantity
Online Art Class 2$150.00
Quantity
Online Art Class 3$200.00
Quantity
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