Student Information Required

Only one student can be enrolled at a time. Additional students in the same household must pay and fill out the Student Information form separately. This form is required for students to fully register.

Which class are you opting for? (Required)

Child's first and last name (Required)

How old is your child? (Required)

What grade are they in? (Required)

What school does the student attend? (Required)

Does the student receive any special services at school (504 Plan, SLP, Special Education, etc)? (Required)

If you answered “Yes” - which services?

What’s your main goal for your child attending Camp Cranium? (Required)

If we have to contact a guardian or parent during Camp Cranium, who should we contact and what is their relation to the child? (Required)

What is the above listed person’s cell phone number? (Required)

Please list an alternate emergency contact. (Required)

Are there any allergies (food or otherwise) that we should be aware of? (Required)

Are there any medical conditions we should be aware of? (Required)

Would you like to share anything else?

A Division Of: