JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Camp Ignite Registration 2024
Welcome to Sage School and Camp Ignite! We can't wait for another fun summer!
Please fill out this form for pre-registration. A payment link will be sent separately and registration is not complete until payment is made.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Student Name (First Last )
*
Your answer
Student Current Age (##)
Your answer
Parent(s) Name(s)
*
Your answer
Primary Address - Street, City, State, Zip Code
*
Your answer
Primary Contact 1 Name
*
Your answer
Primary Contact 1 Phone Number
*
Your answer
Primary Contact 1 Email
*
Your answer
Secondary Contact 2 Name
Your answer
Secondary Contact 2 Phone Number
Your answer
Secondary Contact 2 Email
Your answer
Emergency Contact information
*
Your answer
Does your child have allergies?
*
Yes
No
If yes, please provide all allergies, symptoms to watch for, triggers, and how to respond.
Your answer
Does your child take medication?
*
Yes
No
If yes, will Sage need to administer medication? Please explain. (A form will be emailed sparely authorizing us to store and administer medication if that is the case.)
Your answer
Does your child have important medical information or a diagnosis which impacts school or camp?
*
Yes
No
If yes, please share and explain how we can take best care of your child.
Your answer
Rising Grade Level (2024-2025)
*
First
Second
Third
Fourth
Fifth
Reading Level
*
On Grade Level
1 Year Below Grade Level
2 Years Below Grade Level
Above Grade Level
Math Level
*
On Grade Level
1 Year Below Grade Level
2 Years Below Grade level
Above Grade Level
Is your child Dyslexic?
*
Yes
No
Unknown
Does your child have additional diagnosis other than Dyslexia, like ADHD, Articulation, or Language? Explain
*
Your answer
Has your child have any history of misconduct in school or sports? If yes, explain.
*
Your answer
What is the primary goal of your child attending Camp Ignite?
*
Academic
Social
Just for Fun
Childcare
Creative Outlet
All of the Above
Is there anything you'd like us to know about your child?
Your answer
Will your child be staying for aftercare? 1:00-3:00pm (Additional $200 over the $500 for 8:00am-1:00pm
*
Yes
No
Please list all adults authorized to pick up or check out your child. List first and last name on their license.
*
Your answer
If the registration is approved, the primary contact will receive a link via email for payment. Payment must be received by May 15, 2024. There is limited space in each grade and will not be reserved until payment is complete.
*
I understand.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Sage School.
Report Abuse
Forms
