The ReFresh Institute - Summer Day Camp Enrollment

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We are excited about hosting our new phase pilot summer day camp program. We look forward to serving your families. Please complete the form in its’ entirety below & with accuracy that we may serve you well this summer. Thank you!

Email *

Youth First & Last Name *

Parent/Guardian First & Last Name *

Phone Number *

Address *

Gender *

Female

Male

Prefer not to say

Other:

Enrolled Youth Grade Level *

Please select the grade level they will be entering in for the 2021-2022 School Year.

Does your child have a laptop/chromebook that they can bring for the program? *

Yes

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