Summer Camp Registration Summer Camp Registration 2023 Registration for Summer Camps at Hillcrest Academy. Please complete this form for each student you are registering. One form can be used to register a student for multiple camps. Step 1 of 4 25% Student Name* First Last Address* Street Address 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 Sex* Female Male Date of Birth* MM slash DD slash YYYY Grade in 2023-24 school year*Please select a grade belowKindergarten1st grade2nd grade3rd grade4th grade5th grade6th grade7th grade8th grade9th grade10th grade11th grade12th gradeSchool attending in 2023-24* Parent/Guardian InformationParent/Guardian Name* First Last Parent/Guardian Address is same as above* Yes No Parent/Guardian Address* Street Address City State / Province / Region ZIP / Postal Code Parent/Guardian Cell Phone*Parent/Guardian Email* Emergency Contact Person (other than Parent/Guardian listed above)* Emergency Contact Person Cell Phone Number* Camp RegistrationCamp Options* Basketball Camp Concerto Music Camp (6/12-6/16) Drum & Strum Music Camp (7/10-7/12) 15 camper limit Instrumental Music Camp (6/12-6/16) Soccer Camp Volleyball Camp Youth Theatre Camp (7/31-8/4) 25 camper limit Basketball Camp Options* 1st - 2nd Girls & Boys (6/22-6/23) 40 camper limit 3rd - 4th Girls & Boys (6/19-6/21) 40 camper limit 5th - 12th Boys (6/19-6/20 & 6/22-6/23) 40 camper limit 5th - 12th Girls (7/17-7/19) 40 camper limit Culinary Camp Options (6/19-6/21)* 3rd - 5th | 16 camper limit 6th - 8th | 12 camper limit Concerto & Instrumental Music Camp*What instrument do you play? Concerto & Instrumental Music Camp*What piece are you currently working on? Soccer Camp Options (7/10-7/12)* K - 4th 5th - 8th Volleyball Camp Options* 7th - 12th (7/17-7/20) 40 camper limit 4th - 6th (7/31-8/4) 40 camper limit T-ShirtsT-shirts are given out at basketball and volleyball camps. Please indicate what size of shirt your child needs. T-Shirt Size* Not Applicable- my child will not be attending a basketball or volleyball camp. Youth Small Youth Medium Youth Large Youth X-Large Adult Small Adult Medium Adult Large Adult X-Large Food AllergiesCulinary and Music Camps all provide snacks and/or use food during the camp.Please list any food allergies your child has. If your child isn't in culinary or music camp please state "N/A" or if your child doesn't have any please state "none".* Parent/Guardian ReleaseHillcrest Academy reserves the right to use and reproduce the likeness of campers.I hereby release Hillcrest Academy and the Hillcrest Academy Camp Staff from all claims resulting from injures sustained by the above while attending camp.*I am electronically signing my name by typing my full name below.