AURORA Summer Camp Registration

AURORA Summer Camp Registration

Summer Camp at Aurora Strategies will focus on brain boosting, language enrichment, and social skills development in a fun, active learning environment. Camp activities include 3 hours each day of intensive brain boosting activities. Our programs run in 2-week sessions from 9:00 AM - 3:00 PM and the cost of each session includes all field trips.

Please check the session(s) in which you are enrolling :
June 1 - 12
June 15 - 26
July 6 - 17
July 20 - 31

Child's Information

First Name :

Last Name :

Sex :
MaleFemale

Date of Birth (MM/DD/YYYY) :

Street Address :

City :

State :

ZIP Code :

Parent's Information

Mother's Information

Mother's Name :

Mother's Address (if different from child's) :

Mother's Daytime Phone (111-111-1111) :

Mother's Nighttime Phone (111-111-1111) :

Mother's Cell Phone (111-111-1111) :

Father's Information

Father's Name :

Father's Address (if different from child's) :

Father's Daytime Phone (111-111-1111) :

Father's Nighttime Phone (111-111-1111) :

Father's Cell Phone (111-111-1111) :

Emergency / Medical Information

Others to contact in case of emergency (Name / Phone # / Relationship):

Emergency Contact 1

Name :

Relationship :

Phone Number :

Emergency Contact 2

Name :

Relationship :

Phone Number :

Emergency Contact 3

Name :

Relationship :

Phone Number :

Others authorized for pick up (Name / Relationship)

Authorized Pick Up 1

Name :

Relationship :

Authorized Pick Up 2

Name :

Relationship :

Medical Information

Child’s medical conditions / Allergies :

Child’s primary physician :

Child’s primary physician phone :