REGISTER | Junior Explorers

Child(ren) Name(s)

Child(ren) Grade (s) in September

Date of Birth

Address

Country/Region

Address

City

Zip / Postal code

Emergency Contact # 1 : Number / Name

Emergency Contact #2 : Number / Name

Allergies

Short answer

Medication needed on site (N/A)

Child's Physician

Child's Number

T-Shirt Size

Name of Parent or Tutor

Phone

Parent / Guardian Consent

I certify that I am the parent or legal guardian of the child listed on this registration form. I give permission for my child to participate in the Junior Explorers Enrichment Adventure Club program and all related activities during the camp session.

I understand that the program may include educational activities, outdoor play, water activities, field trips, and supervised group events. I acknowledge that reasonable precautions will be taken to ensure the safety of all participants.

I confirm that I am the parent or legal guardian of the child listed and give permission for my child to participate in the Junior Explorers Enrichment Adventure Club program and all related activities. I authorize staff to seek emergency medical care if necessary and agree to the program policies.

Signature

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ACADEMIC ADVENTURES THAT PROMOTE HANDS-ON ENRICHMENT, ENGAGEMENT, AND FUN!