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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

Q9

School

Q10

Grade

Q11

Are you interested in enrolling your child in this virtual summer camp?

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?

Q15

What are the usual time of day you prefer your child to participate to?

Q16

If physical summer camp will be an option, will you let you child participate?

Q17

Do you have the following equipment for virtual activities? Please select all that you have:

Q18

We are open for any suggestions or feedback.

Q19

Registration Fee