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Summer Camp Student Sign Up Form
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Indicates required field
Student Name
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First
Last
Address
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Line 1
Line 2
City
State
Zip Code
Country
Student's Age
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Student's Date of Birth
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Student's current school
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Grade Level Entering in Fall 2023
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Parent/Guardian Name
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First
Last
Relationship
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Parent/Guardian Phone Number
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Parent/Guardian Email (Please provide an email you check regularly)
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Camp Choices (please choose all that apply)
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Academic Readiness Camp
CSI Math Camp
I would like to add early drop off..
I am interested in group tutoring.
Is it ok to text this number?
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Yes
No
Please thank the wonderful person who referred me by giving them $25 off their camp fee! (Type their name below, so we can thank them!)
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Preferred Dates (please check all that you are interested in or apply)
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June 5th - 8th
June 12th - 15th
June 19th - 22nd
June 26th - 29th
July 10th - 13th
July 17th - 20th
July 24th - 27th
July 31st - August 3rd
August 7th - 10th
Length of Week (Camp Hours are 8:30-12:30 daily)
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Full Week (Monday-Thursday)
Monday/Wednesday
Tuesday/Thursday
Other
My child is currently in the following programs
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Sports
After School Enrichment
Fine Arts (Music, Art, Theater)
504
IEP
SRP (Reading Specialty Program)
SCSS
OT
Counseling
Youth Group or Church Programs
Tutoring
AP Classes
Dual Enrollment Classes
Other (please add information in the notes section below)
T-Shirt Size
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Youth Small
Youth Medium
Youth Large
Youth Extra Large
Adult Small
Adult Medium
Adult Large
Adult Extra Large
I am interested in learning more about other services Achieve offers. (Please check all that apply.)
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Teacher Monitored Digital Learning Programs
Academic Assessment
Occupational Therapy Assessment
Parenting Classes
In-Person Private School Program
Virtual Private School Program
SAT/ACT/TSI/Military Test Prep
NCAA School Program
Please add additional Information Here that may be helpful for staff to know to help your child have the best camp experience possible.
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By typing my name below, I acknowledge that I have completed this form fully and accurately. I also acknowledge that I am beginning the sign up process for services at Achieve. I agree to be contacted by Achieve to continue the registration process before sessions begin. I understand that filling out this form does not guarantee my child's admission into Achieve's programs.
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Home
Home School
Tutoring
Music Lessons
Camps
Parents
About
Contact
Calendar
Forms
Store
Employment