2019 Summer Enrichment Camp Registration

 

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

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.

First Student

Student's Name *
Student's Name
Student's Birthdate *
Student's Birthdate
Address *
Address
Please share your student's primary residence.
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 attends.
Select your preferred camp site.
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 Name *
Parent/Guardian Name
Parent/Guardian Phone Number *
Parent/Guardian 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 any questions about our Summer Enrichment Camps, please contact Robbie at robbie@springforwardqca.org.

If you have more than one child you would like to enroll in Spring Forward Summer Enrichment Camps, please fill out additional forms 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 attends
Please select your preferred camp site
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.

Third 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 attends.
Please select your preferred camp site.
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.

Fourth 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 attends.
Please select your preferred camp site.
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.

Fifth 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 attends.
Please select your preferred camp site.
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, 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 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.