Kindercamp Registration Form           August 2021
Families, please complete the registration form for Kindercamp taking place August 9-20th, 2021 from 8:00-12:45pm. This program will also be fully in- person on the HPE campus.

School breakfast and lunch will be provided, free for all students.

We will be following the Ready Schools Safe Learners guidance, but will update you with any changes as the summer school start date approaches.

More details about the program are yet to come. Deadline for registration is July 16th, 2021.

If you have any questions, please contact Emily Collins (Kindercamp Principal) at emily_collins@rsd.k12.or.us
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Email *
Kindercamp, Summer 2021
Student first and last name: *
Student's date of birth: *
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Parent/guardian #1 first and last name and current phone number: *
Parent/guardian #2 first and last name and current phone number:
Mailing address (including city and zip code): *
Email for parent/guardian #1 you will be checking during Kindercamp: *
Email for parent/guardian #2 you will be checking during Kindercamp:
What language(s) do you most often speak at home? *
Which of the following would you use to describe your child's race/ethnicity? (Check all the apply) *
Required
If other, please describe:
Prior preschool experience: *
If yes, please list name of preschool:
Names and phone numbers of those authorized to pick up your child (in addition to parents/guardians listed above): *
In the case of an injury or health emergency, 911 will also be contacted.
My child's transportation plan will be (Check all that apply): *
Bus
Parent/Guardian
Morning
Afternoon
If known ahead of time, please specify the dates and times (morning, afternoon, or both) your child will be riding the bus during Kindercamp. *
Are there any planned absences in the month of August we should know about? If so, please list dates below. *
Does your child have any medical conditions including food allergies or intolerances that we should be aware of? *
Please specify the physical address for morning bus pick-up, if applicable:
Please specify the physical address for afternoon bus drop-off, if applicable:
Does your child have any medical conditions including food allergies or intolerances that we should be aware of? *
If yes, please explain:
Does your child currently have a Rainier City Library card? *
I give permission for my child to ride the bus to and from the Rainier City Library for a field trip during Kindercamp.   *
Parent/guardian signature: *
*
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A copy of your responses will be emailed to the address you provided.
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