Camp Registration

June 5-9, 2023
8:30-11:30 am
The Innovation School (1617 Michigan Ave, Bismarck)
For students entering *Preschool-5th grade
*Preschooler must be 4 years old & potty trained

Registration

* Indicates required field

Student Name *

First

Last

Date of Birth *

Grade Student Will Enter Fall 2023 *

Gender *

Male Female

Is your child enrolled at The Innovation School for the fall 2023 school year? *

Yes No

Parent Name *

First

Last

Phone Number *

Parent Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Emergency Contact *

First

Last

Relation to Child *

Phone Number *

Is your child able to participate in all activities of Little Makers STEAM Summer Camp? *

Yes No

List all allergies and the reaction that accompanies them. *

List any medications we should be aware of. *

List any other medical issues we should be aware of. *

Every effort will be made to locate a parent or guardian in case of emergency before any action is taken. I give my permission to The Innovation School to call an emergency team, doctor, or other medical person or organization for my child or to have my child taken to a hospital should the need arise. If we cannot be contacted, any expense incurred by The Innovation School will be accepted by the parent/guardian. *

I understand if we cannot be contacted, any expense incurred by The Innovation School will be accepted by the undersigned.

In lieu of a signature, please provide your date of birth as a digital signature. *

Today’s Date *

Click submit to take you to the payment page.

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