SUMMER EXTENDED LEARNING - Camp Get Connected 2021 Student Application
Please utilize the link to register your child for the summer camp.  We would love to have all registrations complete by May 15 in order to plan for staff assignments.  An information session will be scheduled during the month of May.

Camp Locations: Central Elementary School, Gaston Elementary, Willis Hare Elementary, Northampton High School and Conway Middle School
Camp Dates - Required Minimum of 30 Days.

K-8 SCHEDULE (30 days) 8:30am - 3:00pm
Week 1 - June 8-10 (3 days)
Week 2 - June 14-17 (4 days)
Week 3 - June 21-24 (4 days-Summer Retesting for EOGs and EOCs)
Week 4 - June 28 -30 (3 days)
OFF - Week of July 5 - 9
Week 5 - July 12-15 (4 days)
Week 6 - July 19-22 (4 days)
OFF - Week of July 26 - 29
Week 7 - August 2-5 (4 days)
Week 8 - August 9-12 (4 days)

9-12 SCHEDULE (30 days) 8:30am - 3:00pm
Week 1 - June 1 - June 4 (4 days)
Week 2 - June 7-10 (4 days)
Week 3 - June 14-17 (4 days)
Week 4 - June 21-24 (4 days-Summer Retesting for EOGs and EOCs)
Week 5 - June 28 -30 (3 days)
OFF - Week of July 5 - 9
Week 6 - July 12-15 (4 days)
Week 7 - July 19-22 (4 days)
Week 8 - July 26-28 (3 days)
Classes for credit and tutoring for students to fill COVID-19 learning loss gaps, recover failed credits, or get ahead in a tough subject.

We will offer connections to enhancement areas like career exploration, the arts, etc.

High School students will also be offered credit/course recovery offerings, at least one elective, preparation sessions related to College Admissions, WorkKeys and Career Advisement via personalized College and Post-Secondary Counseling.

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Please identify your role in completing this interest form. *
STUDENT INFORMATION
Student First Name *
Student Last Name *
School Currently Attending *
Students not in membership in Northampton County Schools prior to April 1 will be considered an out of district student.
Current Grade Level *
Please complete one form per child.  
Shirt Size *
If we are able to fund the t-shirts.  Students will not be allowed to keep shirts that are too small or too large, please select the true sizes.
CONTACT INFORMATION
Please complete with accurate information as this aides in Camp "Get Connected" reaching you for updates.
Mailing Address *
This is the address where you receive your mail
City *
State *
Zip Code *
Physical Address - BUS PICKUP/DROPOFF LOCATION *
This is the address where the bus will pick up your child.  Please make sure it is accurate DO NOT PUT SAME AS ABOVE.  You must put the accurate address in this filed on the form to allow data to transfer to the transportation department.
Physical City *
Please list the physical city/town if NOT listed above
State *
Physical Zip Code *
Student Email Address
If the student has a district email address. Please enter it here.
PARENT INFORMATION
Please complete the information concerning the parent.  If this information changes prior to the end of camp, please contact the site coordinator/principal or email faulknerg@northampton.k12.nc.us with: your name, the student name, and any changes.
Parent Last Name *
Parent First Name *
Parent Home Phone Number
Please include the area code  (XXX) YYY-ZZZZ  should be the format used when typing your phone number
Parent Cell Phone Number
Parent Email Address
Our motto is "Be Connected to Get Connected".  You must have an email address in order to register your child.  We will use this email address to update you with camp information.  If you have difficulty with obtaining an email address, please type "NEED HELP" in this box.
Emergency Contact Information (Name) *
Emergency Contact Phone Number *
ADDITIONAL INFORMATION
Does your child have any known allergies (include food, environmental, etc.)? *
Is there anything else about the child that you would like camp leaders to know? *
(i.e. medications, limitations, health related problems, etc.)
Student work as well as photo/video may be used during camp and published in the newspaper, camp website, district facebook page, billboards etc. to market district programs and to highlight the summer camp..  Do you grant us permission to publish photos and/or videos of your child?
Parent Preferred Number to Call During Camp Hours *
In the event that we must reach you during the camp hours, please list the number that is best for us to use and any specific notes. For example: "Please ask for the Drying Department when calling the office number."
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