Summer Academy Registration "*" indicates required fields A medical waiver & emergency contact form is also required for each camper. Please provide copies of immunization records and a complete physical for each child NOT currently enrolled at Wakefield Country Day School.Participant's Name* First Last Grade Entering 2022-2023 School Year* Date of Birth* Month Day Year Parent/Guardian Name* First Last Cell Phone*Work PhoneAddress* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Alternate Email Camp Selection: Please select all that apply* (July 11-15) All About Robots (July 11-15) LEGO Camp (July 11-15) Basketball Camp (July 18-22) Robotics and Intro to Coding (July 18-22) Film and Photography Camp (July 25-29) Exploring Nature (July 25-29) Animation Basics (Aug. 1-5) Exploring Nature and Fun with German Each camp is $325. Please add the total number of camps to the quantity field below.Payment Method* Online Full Day On Campus Session* Price: $325.00 Quantity: Total Credit CardCard Details Cardholder Name
