Summer Camp 2008 | Registration

Camper Information

Name

Summer/Fall 2008 Grade

Birth Date/Year

Parent/Guardian Information

Name(s)

Address

Phone Number(s)

Email Address

Names and phone numbers of up to 3 people who may be picking up your camper

Museum Membership Number

Become a Museum member during registration and receive the discounted member rate.

Emergency Information

Name of Emergency Contact

Relationship to Child

Phone Number(s)

Primary Physician

Physician Phone Number

Camper Allergies (including peanuts and bees)

Camper Medications

Special Behavioral Considerations

Payment Information

Credit Card Number (Visa or Mastercard)

Expiration Date

V-Code (3-digit number on signature side of credit card)

Helpful Hints

Have this information ready and available before you go online to avoid being timed out.

Please fill out a separate registration form for each child.