2023 West Greene Summer Camp K-6 Registration
Please fill out the online registration form below to register your child for the West Greene Summer Learning Program. If more than one student will be attending please make sure to fill out a separate form for each student.

Students must attend all day 9:00AM to 1:30PM (grades K-6). Breakfast and Lunch will be provided. Program cost is free.

Space is limited and is available on a first come first serve basis. You will receive an email confirmation within 3 days upon receiving your online registration to confirm your spot is held.  Registrants will receive official confirmation of enrollment once all forms are received.

• Dates: June 20, 2023 - July 13, 2023, (4-week program, 3 days a week: Tuesday, Wednesday, and Thursday)
  ***July 4th: NO SCHOOL***
• Time: 9am-1:30pm
• Location: West Greene Elementary
• Face-to-face instruction with certified teachers
• Hands-On Exploration of our World around us
• Integrated STEAM activities daily
• Pre and Post assessments in ELA and Math
• Transportation will be provided by the district for West Greene students (if needed).
• Technology will be provided by the district for West Greene students
• Several Guest Speakers will be joining us ( Possible examples: Bee Keepers and Park Rangers)
• Field trips outside of the classroom may include:  
         -Exploring our natural resources on our WG campus
         -Embarking on a field trip to a local Alpaca farm
         -Traveling to Ryerson Station State Park (We invite our parent/guardians to join us!!)

Detailed Field Trip Forms will be provided once registered.
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Email *
Contact Information
Legal Parent/Guardian(s) Name *
Primary Phone Number *
Please list the number in which you can best be reached in case of an emergency.
Alternate Phone Number *
Please list a second number, that we can use to reach you in case you cannot be reached at the primary phone number. If the number is for another family member, please indicate their name along with the number.
Street Address *
City *
State *
Zip Code *
Student Information
Student's First Name *
Student's Last Name *
Gender *
School Child Attends *
Grade Entering in 2023-2024: *
Transportation *
Transportation will not be door-to-door.  We will have designated pickup and dropoff areas throughout the district.
Breakfast *
Lunch *
Photo Release
Please complete the information below:  
Your child's picture may be taken for the local newspaper or for special program presentations. Kindly give us permission or decline permission to include your child in pictures by indicating your response below. *
Required
Medical Form Release
Emergency and Medical release information for Summer Learning Program. Please complete all information below in order to successfully register for the Summer Learning Program. Please mark all fields that DO NOT apply with N/A.
Parent/Guardian Name
Please indicate if the information is different from the above contact information.
Allergies *
Medications *
Medical Conditions *
Dietary Restrictions *
Emergency Contact *
In case of an emergency, please contact (other than parent).
Physician/Physician Phone Number *
In case of an emergency, please contact (other than parent).
Handicap Accessibility *
Required
Handicap Accessibility *
If "Yes" was selected above, please explain requirements below.
End of Summer Camp Send-Off:
Ryerson Station Field Trip:  July 13 
Would a parent/guardian be available to join us at Ryerson Station State Park on our last day of camp?  
 *
Summer Learning Program Policy Information
BEHAVIOR POLICY - The Summer Learning Program reserves the right to remove disruptive students from the program. In this unlikely event, the parent(s) will be required to pick up their student immediately.

TECHNOLOGY POLICY - Personal electronic devices (iPods, iPads, Kindles, Nintendo, etc.) are not permitted during the Summer Learning Program, unless otherwise noted by the instructor. Cell phones are the ONLY exception however they must remain stored in the student's backpack, etc. only to be used in a case of emergency. If a student is using technology inappropriately the item will be kept aside by an instructor for the remainder of the day. Multiple infractions will result in the student being dismissed from the Summer Learning Program.
A copy of your responses will be emailed to the address you provided.
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