2021 Summer Camp Registration

If registering online, please use the form below. One camper per registration. If you have questions, please call 302-368-5703. If you have questions or are registering by email, please email the Director, Maureen Zieber, at director@ironhillsciencecenter.org

Name of Camper *

First

Last

Complete a separate registration form for each child.

Age and Birth Date of Camper *

Format request: 10 years old 3/12/2011

Name of Parent(s)/Guardian(s) *

Phone Numbers *

Full Address *

Email *

E-mail is used to send out confirmation of camp admittance. Your email address will remain confidential.

Name and Number(s) of Emergency Contacts

Size Shirt for Camper *

Youth Small
Youth Medium
Youth Large
Youth XLarge

Each camper will receive a white shirt with our logo on it.

Science Adventure Camps for 2021 (check all that apply) TUITION is $185.00 per week per camper. *

Insect Inspectors- August 2 to 6 (Ages 7-13)
Nature Rangers- August 9 to 13 (Ages 7-11)

Please note that CAMP TUITION IS $185.00 per week per camper. EXTENDED CARE $70/week (OR $30 FOR AM ONLY/ $40 FOR PM ONLY). Please complete a separate registration form for each child.

EXTENDED CARE

EXTENDED CARE $70/week (OR $30 for AM only/ $40 for PM only). This price is for one camper each week.

Illness and Health (space provided for additional information)

Please inform us of any other condition we should be aware of. This information is confidential and will enable us to better serve your child.

Immunization record: (You may substitute a photocopy of health card/record upon request) PLEASE NOTE: WE MUST HAVE COPY OF THIS AS PER STATE LAW. *

NOTE: you can obtain DE immunization records quickly at 1-800-282-8672. Make sure to email that information at director@ironhillsciencecenter.org

Health Authorization Release: I hereby give authorization for emergency medical care to be administered to my child, in the event that an emergency occurs and I am unable to be contacted in a timely manner. *

I agree
I DO NOT agree

Parental Release: I hereby attest that I am (we are) the legal parentguardian(s) of the above-named child and hereby consent to the child's participation in the activities during camp. I understand that activities during camp could result in physical injury to my child, but nonetheless I specifically request that he or she be allowed to participate in those activities. *

I agree

Payment *

We accept most credit cards with the exception of American Express.