STEAM Camp Registration Number of Children *Select1 Child - $1502 Children - $3003 Children - $4504 Children - $600Child 1Child 1's First Name *Child 1's Last Name *Child 1's Nickname/Preferred Name *Child 1's Date of Birth *Child 1's Grade Level *Child 2Child 2's First Name *Child 2's Last Name *Child 2's Nickname/Preferred Name *Child 2's Date of Birth *Child 2's Grade Level *Child 3Child 3's First Name *Child 3's Last Name *Child 3's Nickname/Preferred Name *Child 3's Date of Birth *Child 3's Grade Level *Child 4Child 4's First Name *Child 4's Last Name *Child 4's Nickname/Preferred Name *Child 4's Date of Birth *Child 4's Grade Level *Parent/Guardian InfoParent/Guardian's First Name *Parent/Guardian's Last Name *Parent/Guardian's Phone *Parent/Guardian's Email Address *Emergency Contact's First Name *Emergency Contact's Last Name *Emergency Contact Phone *Additional InfoList any dietary restrictions or allergies your child has here. *List any other information pertinent to your child's care here. *Payment & ConsentTotal Being Charged$Credit / Debit Card *Liability Waiver *I, Parent/Guardian listed above, give consent for my child, name listed above, to participate in Kennedy Pond Conservancy's day camp activities. I understand and accept that there are inherent risks involved. Therefore, I release Kennedy Pond Conservancy, its staff, and volunteers from any liability for injuries or damages that may occur during the camp. I grant permission to Kennedy Pond Conservancy and its affiliates to use photographs, video recordings, or other media of me taken before, during, or after the Event for promotional, marketing, or other lawful purposes, including but not limited to social media, websites, advertisements, and publications, without compensation or approval rights. I acknowledge that I've read and understood this waiver.Submit
