Summer 2019 Kids on Campus Registration

 

Summer will be here before we know it! Enroll your student in Spring Forward’s Kids on Campus and give them a camp experience they’ll never forget! Weekly activities include field trips, literacy intervention, daily enrichment in various departments at Augustana College, and daily breakfast and lunch. Rock Island students who will be in 6th or 7th grade in the 2019-2020 school year are eligible to attend Kids on Campus. If you have a child entering 1st through 5th grade, check out our Summer Enrichment Camps!

Fill out the form(s) below to register your student(s) for Spring Forward Summer Enrichment Camps. Please note that all form fields are required. If you have any questions about this form or our programming, contact Spring Forward’s Program Manager, Robbie McIntyre at robbie@springforwardqca.org.

Student's Name *
Student's Name
Student's Birthdate *
Student's Birthdate
Address *
Address
Please share your student's primary address.
Gender *
Please select your student's gender. We use this information for reporting and funding purposes.
Please select your student's shirt size.
Please select the school your student will attend in the 2019-2020 school year
Please select the school your student attended in the 2018-2019 school year if it is different from the one they will attend in the 2019-2020 school year.
Student's Grade *
Please select the grade your student will be starting in the 2019-2020 school year.
Please enter your student's classroom teacher from the 2018-2019 school year.
Please select your student's ethnicity. We use this information for reporting and funding purposes.
Language(s) Spoken at Home *
Please select all languages that are comfortably spoken in your home.
If your preferred language was not listed, please share it here.
Parent/Guardian's Name *
Parent/Guardian's Name
Parent/Guardian's Phone Number *
Parent/Guardian's Phone Number
Please share the best phone number to reach your student's parent/guardian.
Does your student have permission to walk home at the end of program? *
Does your student receive ESL services at school? *
Does your student have medication that will need to be administered during program? *
If your student takes medication at home, or if you answered 'yes' to the previous question, please explain here. If your student does not take medication, please enter 'None'.
Does your student have any allergies? *
If you answered 'yes' to the previous question, please explain here. Include any necessary treatment information (EpiPens, etc.) If your answered 'no' to the previous question, please enter 'None'.
Does Spring Forward have permission to photograph your child during camp activities? *
Spring Forward Learning Center (SFLC) may photograph your child for means of publication purposes. The photographs could be used in publication to create positive press for the organization. Photos might also be used in various brochures describing and promoting the program in a positive way. In no way will the photos be used in any illegal misrepresentation of your child. Spring Forward Learning Center does take pictures of the programs and participants during the normal course of programming, special events, as well as any function pertaining to Spring Forward. By selecting 'yes' you are agreeing to allow Spring Forward or its agent to take pictures of your child and use them for publicity.

If you have more than one child you would like to enroll in Spring Forward’s Kids on Campus, please fill out an additional form below.

Second Student

Student's Name *
Student's Name
Student's Birthdate *
Student's Birthdate
Gender *
Please select your student's gender. We use this information for reporting and funding purposes.
Please select your student's shirt size.
Please select the school your student will attend in the 2019-2020 school year.
Please select the school your student attended in the 2018-2019 school year if it is different from the one they will attend in the 2019-2020 school year.
Student's Grade *
Please select the grade your student will be starting in the 2019-2020 school year.
Please enter your student's classroom teacher from the 2018-2019 school year.
Please select your student's ethnicity. We use this information for reporting and funding purposes.
Does your student have permission to walk home at the end of program? *
Does your student receive ESL services at school? *
Does your student have medication that will need to be administered during program? *
If your student takes medication at home, or if you answered 'yes' to the previous question, please explain here. If your student does not take medication, please enter 'None'.
Does your student have any allergies? *
If you answered 'yes' to the previous question, please explain here. Include any necessary treatment information (EpiPens, etc.) If you answered 'no' to the previous question, please enter 'None'.
Does Spring Forward have permission to photograph your child during camp activities? *
Spring Forward Learning Center (SFLC) may photograph your child for means of publication purposes. The photographs could be used in publication to create positive press for the organization. Photos might also be used in various brochures describing and promoting the program in a positive way. In no way will the photos be used in any illegal misrepresentation of your child. Spring Forward Learning Center does take pictures of the programs and participants during the normal course of programming, special events, as well as any function pertaining to Spring Forward. By selecting 'yes' you are agreeing to allow Spring Forward or its agent to take pictures of your child and use them for publicity.