Hopping Through History Registration Form

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Please complete this form to register for the 2-day virtual mini camp on March 31st and April 1st, 2021. The registration deadline is 11:59pm on Monday, March 22, 2021. Cost of program is $60 for SHS members and $70 for non-members. Once the registration form is submitted, you will receive an invoice via email. The invoice must be paid in full by March 23, 2021.

Reduced rates are available for those receiving food assistance (SNAP benefits). Please contact education@shakerhistory.org for more information.

Email *

Parent/Guardian Name *

Street Address *

Parent/Guardian Cell Phone Number *

Are you an SHS member? *

Yes

How many campers are you registering? (Sibling discounts available) *

Participant's Name and current grade (use same line separated by a dash [-] if registering more than one participant) *

Child(ren)'s grade bands and time slots (If registering more than one child, please select multiple) *special accommodations can be made for siblings who wish to participate together that might not be in the same grade band listed below* *

Grade 1-2 (9:00am-10:00am)

Grade 3-4 (10:30am-11:30am)

Grade 5-6 (1:00-2:00pm)

Required

Photo Release and Consent Form

I agree to take photos of my child participating in the Hopping Through History! Mini Camp for classroom purposes and use in promotional materials and digital marketing for the Shaker Historical Society. *

Yes

I allow photos of my child(ren) to be used in promotional materials and digital marketing for the Shaker Historical Society. *

Yes

After submission of this registration form, you will receive an invoice for the camp fees. Cost for the program is $60 for SHS members and $70 for non-members (cost is per participant and includes materials) . The balance is due in full by 11:59pm on March 23, 2021.

Supplies for the program are included in the cost of the program and must be picked up at Shaker Historical Society. Details will be included in your confirmation email. Please contact education@shakerhistory.org if you want to register but are unable to pickup the kit, or if you have additional questions or concerns.

I understand that although this is a virtual camp program, parent/guardian supervision is required. *

Yes

Required

I consent that all the above information is true and I agree to be contacted by the Shaker Historical Society regarding this program. *

Yes

Required

Send me a copy of my responses.

Submit

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