Summer Day Camp Registration

Your Email*
Child's Full Name*
Grade child is entering next school year (2022-2023)*
Location*
- Chaska
- Eden Prairie
Will your child be attending the 4-day or 5-day camp?*
- 4-Day
- 5-Day (Chaska Only)
Parent #1 Name*
(This is the first parent we will contact in case of an emergency)
Parent #1 Phone Number*
Parent #1 Alternate Phone Number
Parent #1 Email*
Emergency Contact/Parent #2 Name*
Emergency Contact/Parent #2 Phone Number*
Emergency Contact/Parent #2 Alternate Phone Number
Emergency Contact/Parent #2 Email*
Parent willing to chaperone a field trip? (If applicable)*
- Yes
- No
Primary Address of Child*
Street Address Address Line 2 City State ZIP Code
Secondary Address of Child
Street Address Address Line 2 City State ZIP Code
Child's Date of Birth*
Month
Day
Year
Years Playing Organized Hockey*
Medical conditions or allergies? (If yes, please explain)*
Anything we need to know academically, socially, or emotionally about your child? (If yes, please explain)*
Any days/weeks you know the child will not be attending camp?*
*Note: Due to staffing and facility costs, we will not be able to pro-rate tuition fees
Special requests to be paired in class with a friend or family member (Requests are not guaranteed)