Application for Summer Camp

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Name of Camper

First

Last

Name in Chinese

(if applicable)

Gender

Date of Birth

Nationality

(For pick up card) A recent passport size photo of your child

Click or drag a file to this area to upload.

Address

Address Line 1

Address Line 2

City

State / Province / Region

Allergies

School currently attending

Language(s) Spoken at Home

Other Language Spoken at Home

Health concerns or allergies (please give details)

Preferred daytime contact number

Confirm Email

Name of Parent 1

First

Last

Contact number

Name of Parent 2

First

Last

Contact number