Summer Academic Enrichment Application and Registration Form Household Information Parent/Guardian's Name * First Name Last Name Parent/Guardian's Phone Number * (###) ### #### Parent/Guardian's Email * Household's Permanent Home Address Address 1 Address 2 City State/Province Zip/Postal Code Country Participant Data Child's Name * First Name Last Name Gender & Pronouns * Child's Birthdate * MM DD YYYY Child's SSN * Please provide the child's social security number without the hyphens Child's Allergies/Medications/Conditions Please tell us about any special concerns for the child you are registering today. I will send emergency medication with my child Yes No Please contact me for more information Yes No Race/Ethnicity * American Indian or Alaskan Native Asian Black or African American Hispanic or Latino (a person of Cuban, Mexican, Chicano, Puerto Rican, South or Central American, or other Spanish culture, regardless of race) Native Hawaiian or Pacific Islander White Two or More Races School Information What elementary or middle school does your child attend? * This school is located in the following district: * Anoka-Hennepin Belle Plaine Bloomington Brooklyn Center Buffalo-Hanover-Montrose Burnsville Centennial Central Chisago Lakes Columbia Heights Delano Eastern Carver County Eden Prairie Edina Elk River Farmington Forest Lake Fridley Hastings Hopkins Inver Grove Heights Jordan Lakeville Le Sueur-Henderson Mahtomedi Minneapolis Minnetonka Mounds View New Prague Area North St. Paul-Maplewood Oakdale Northfield Orono Osseo Prior Lake-Savage Randolph Richfield Robbinsdale Rockford Rosemount-Apple Valley-Eagan Roseville Shakopee South St. Paul South Washington County Spring Lake Park St. Anthony-New Brighton St. Francis St. Louis Park St. Michael-Albertville St. Paul Stillwater Area Waconia Watertown-Mayer Wayzata West St. Paul-Mendota Heights-Eagan Westonka White Bear Lake Other/Private School If "other/private school" was selected, please specify the district. What grade did your child attend in the 2023-2024 school year? * 3rd 4th 5th 6th Is your child eligble for free or reduce-price lunches? * Yes No Proof of enrollment documentation. Please email proof of enrollment documentation to camps@theworks.org. Your camp registration won't be processed until documentation has been recieved. SUMMER CAMP INFORMATION Please review our camp policies at https://theworks.org/camp-policies/ Camp Dates + Camp Title Example: June 10-13, LEGO Engineering Aftercare Yes No Camp Dates + Camp Title Example: June 10-13, LEGO Engineering Aftercare Yes No Camp Dates + Camp Title Example: June 10-13, LEGO Engineering Aftercare Yes No Camp Dates + Camp Title Example: June 10-13, LEGO Engineering Aftercare Yes No The Works Museum Behavior Policy: * The Works Museum makes the safety and enjoyment of all campers a top priority. If the safety of staff, campers, or property is at risk, the camper will be removed from class immediately and sent home. If a behavior issue occurs, educators will redirect campers. If the behavior continues, campers will be removed from the classroom and parents will be called. Education staff, parent, and camper will work together to problem-solve the situation and create a behavior plan for the camper so s/he can return to camp. If behavior issues continue, the camper will be removed from class and sent home for the day. If it is determined that a resolution cannot be met, The Works reserves the right to remove a child from camp. My child and I agree to the behavior policy. May we use photos of your child for promotional purposes? * The Works Museum Photo Release: Photos taken during our camps may be selected for promotional purposes, including digital and printed media. If you choose to opt out of the this release, photos of your child will not be included in any of our camp photo albums. Yes, you may No, you MAY NOT Questions/Comments: THANK YOU!We will be in touch with you shortly. If you need immediate assistance, please call us: 952.888.4262Please email proof of enrollment documentation to camps@theworks.org.
