Sign Up Form Summer Camps

Summer Camp Student Sign Up Form

* Indicates required field

Student Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Student's Age *

Student's Date of Birth *

Student's current school *

Grade Level Entering in Fall 2026 *

Parent/Guardian Name *

First

Last

Relationship *

Parent/Guardian Phone Number *

Parent/Guardian Email (Please provide an email you check regularly) *

Is it ok to text this number? *

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!) *

Please add additional Information Here that may be helpful for staff to know to help your child have the best camp experience possible. *

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 Learning Center. I agree to be contacted by Achieve Learning Center to continue the registration process before sessions begin. I understand that filling out this form does not guarantee my child's admission into Achieve Learning Center programs. *