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The Accessible Scholastic Experience

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- Summer Camp
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Summer Camp Registration

Please complete the form to register your camper(s).

Parent/Guardian A, First Name

Parent/Guardian A, Phone

Parent/Guardian A, Last Name

Parent/Gaurdian A Email

Street Address

Parent/Guardian B, First Name

Parent/Guardian B, Phone

Parent/Guardian B, Last Name

Parent/Guardian B Email

Street Address B

Camper 1 Full Name

Date of Birth * required

Medications (please list name and doseage)

Allergies (please describe symptoms)

Which Summer Sessions will your child attend? * Required

Water: June 22-26th

Air: June 29-Jul 2nd

Earth: July 6-10th

Birds: July 13-17th

Insects: July 20-24

Wizarding July 27-31st

Reptiles:Aug 3-7th

Camper 2 Full Name

Date of Birth

Medications (please list name and doseage)

Allergies (please describe symptoms)

Which Summer Sessions will your child attend?

Water: June 22-26th

Air: June 29-Jul 2nd

Earth: July 6-10th

Birds: July 13-17th

Insects: July 20-24

Wizarding July 27-31st

Reptiles: Aug 3-7th

Camper 3 Full Name

Date of Birth

Medications (please list name and doseage)

Allergies (please describe symptoms)

Which Summer Sessions will your child attend?

Water: June 22-26th

Air: June 29-Jul 2nd

Earth: July 6-10th

Birds: July 13-17th

Insects: July 20-24

Wizarding July 27-31st

Reptiles: Aug 3-7th

Emergency Contact First Name

Emergency Contact Phone Number

Emergency Contact Last Name

Emercgency Contact Email

Relationship to Camper(s)

Approved Pickup First Name

Approved Pickup Phone Number

Approved Pickup Last Name

Approved Pickup Email

Relationship to Camper(s)

Approved Pickup First Name

Approved Pickup Phone Number

Approved Pickup Last Name

Approved Pickup Email

Relationship to Camper(s)

Approved Pickup First Name

Approved Pickup Phone Number

Approved Pickup Last Name

Approved Pickup Email

Relationship to Camper(s)

Payment Terms

A deposit of $30 per week per camper is due upon registration and fully refundable up until March 15, 2026. The remaining balances will be due on Mondays, two weeks before each camp session. For example, the payment for the camp starting on June 22nd will be due on June 8th. Invoice will be sent upon receipt of registration form.

I agree to the terms & conditions

Welcome, to The Accessible Scholastic Experience!

Oh no! We're full already. Please reach out via email if you would like to be added to our waitlist.

contact.us@aselearning.net

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