Clone of SLC Summer Camp Info Request

Student Registration

Summer Learning Camp
🌞 Camp Information
We’re excited to offer a fun and enriching Summer Learning Camp for our students!

📅 Camp Dates: June 1 – June 23

🕗 Schedule: Monday–Friday, 8:00 AM – 3:00 PM

(No camp on June 19 in observance of the Juneteenth holiday.)

💲 Cost: FREE for all participating students

🚌 Transportation: Bus transportation is available.

🍎 Meals: Breakfast, lunch, and a daily snack will be provided.

During camp, students will receive extra practice and support focused on strengthening grade-level reading and math skills — all while participating in engaging, structured activities in a supportive environment.

We look forward to a summer of learning and growth!
📝 Student Information
Student's Name*

First NameLast Name
Student's Current School*
Student's Current Grade Level (2025-26 School Year)*
Note: High School Summer Learning Camp is only available for rising 9th graders.
Student's Address

Street Address

Street Address Line 2

CityState

Zip Code
🚌 Transportation
Car RiderBus Rider
Car RiderBus Rider
What bus (if any) does your student normally ride during the school year?
🧑‍🧒 Parent/Guardian Contact Information
Parent's Name*

First NameLast Name
Parent's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent's Email
example@example.com
Relationship to Student
☎️ Emergency Contacts
Emergency Contact 1 Name*

First NameLast Name
Emergency Contact 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact 1 Relationship to Student
Emergency Contact 2 Name*

First NameLast Name
Emergency Contact 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact 2 Relationship to Student
🩺 Medical Information
YesNo
Are there any medical issues camp staff need to be aware of for this student? If so, please describe:
List any known allergies:
🖼️ Photo Privacy Notice
Yes, I give permission for my child’s photo to be used.No, I do not give permission for my child’s photo to be shared.
⚠️ Promotion Pathway Attendance Notice
Promotion Pathway Students: A 90% attendance rate is required for third grade students who plan to participate in Summer Learning Camp as part of their promotion pathway to 4th grade. This means students can only miss up to 2 days to meet the requirements of this promotion path. Students that miss more than 2 days will not be eligible for this promotion pathway.
🖊️ Parent Signature

I have read and understand the camp attendance requirements, schedule, and plan to enroll my student in Summer Learning Camp.
Parent Signature

Clear
Should be Empty:

Student Registration

🌞 Camp Information

📝 Student Information

🚌 Transportation

🧑‍🧒 Parent/Guardian Contact Information

☎️ Emergency Contacts

🩺 Medical Information

🖼️ Photo Privacy Notice

⚠️ Promotion Pathway Attendance Notice

🖊️ Parent Signature