Summer Camp Registration

Summer Camp 2025: 5 years old and up 9:00 am-12:45 pm

June 18-20, June 23-27, June 30-July 3, July 7-11, July 14-18, August 11-15, August 18-22 A minimum of 5 kids must sign up for the camp to take place.
To register by day please email bluegiraffedc@gmail.com or call 301-275-6768
Child Name*

First NameLast Name
Age
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Parent/Guardian Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Emergency Contact (Other than primary contact) *

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number
Medical Concerns; Allergies; Special needs: (physical; developmental; behavioral/emotional; sensory). This information helps our staff to do their best to accommodate all of our students particular needs.
Authorization for Medical Treatment in the event that parents/guardians named on this form cannot be reached, I authorize officials of the Blue Giraffe Education Center to consent on my behalf, to provide emergency treatment for my child I Agree*

I Agree
To register by day please email bluegiraffedc@gmail.com or call 301-275-6768