Session 3 2023 2/3 AM: Health Scientists Help Build Healthy Communities

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Session 3 AM: July 5-21

Age / grade level: 2/3

Teacher: Dr. Harcrow

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Teacher Bio:

Please fill out all information for each child's first registration. For additional registrations, you only have to complete the required information.

Note: This cost is for the registration fee only. You must pay the balance of the total camp cost by the first day of camp. Information will be provided in your receipt or you can pay here: SE2023 Summer Camp Balance. You should also receive an email a week prior to the start of camp with payment information. You may also pay in the office.

Student Name

Student age and grade (2022-2023 school year)

Parent / Guardian Name *

Parent Email

Parent Cell

Emergency Contact Name

Emergency Contact Phone Number

Does this student have any known allergies? If so, please list.

Does this student have any limits on physical activity? If so, please list.

Name of insurance

Insurance policy number

Policyholder's name

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Session 3 2023 2/3 AM: Health Scientists Help Build Healthy Communities

Educating Responsible Citizens of the World

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Telephone

Email

Session 3 2023 2/3 AM: Health Scientists Help Build Healthy Communities

Educating Responsible Citizens of the World​

Address

Telephone

Email

Educating Responsible Citizens of the World