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 *

Parent/Guardian Name *

First

Last

Relationship *

Parent/Guardian Phone Number *

Days of Week and/or Time of Day (choose all that you are interested in or apply) *

Half Day Morning 8:00 a.m. - 12:00 p.m. Half Day Afternoon 12:00 p.m. - 4:00 p.m. Full Day 8:00 a.m. - 4:00 p.m. (only available for students 8 and up) Beginning Reading/Kindergarten Readiness Camp ONLY Monday/Wednesday 1:00-3:00 p.m. Beginning Reading/Kindergarten Readiness Camp ONLY Tuesday/Thursday 1:00-3:00 p.m. Beginning Reading/Kindergarten Readiness Camp ONLY Monday/Wednesday 2:00-4:00 p.m. Beginning Reading/Kindergarten Readiness Camp ONLY Tuesday/Thursday 2:00-4:00 p.m. Reading Skills Camp ONLY Monday/Wednesday Reading Skills Camp ONLY Tuesday/Thursday

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. 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. *