Summer Camp Registration Form

Information: This registration form is to enroll your child in our 2022 Summer Camp Program

Payments: Upon completion of this registration form, you will receive an email with instructions on paying. Please note that your registration is not complete and your child’s class spot is not reserved until the payment is made.

If you are registering multiple students, please complete one form per child

General Information

Student Name

First Name

Last Name

Student Grade

Parent/Guardian Name

First Name

Last Name

Add'l Parent/Guardian Name

Optional

First Name

Last Name

Email Address 1

Email Address 2

Optional

Phone Number 1

(###)

###

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Phone Number 2

Optional

(###)

###

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Class Preferences

Program Format

Summer Camp Registration Form

Curie Learning Atlanta