Busy Beavers Academy

Fill out the form completely to save your spot in Busy Beavers Academy summer camp! Registration includes a $15.00 non-refundable registration fee which can be paid online at the end of this registration form. Summer camp tutition is due before classes start.

Need help? Have questions? Contact us at info@busybeaversacademy.com or give us a call at (971) 301-4266.

Name of Child:

First NameMiddle NameLast Name

Nickname:

Date of Birth:

Gender:

MaleFemale

Is your child currently enrolled in another preschool program/Head Start?

NoYes - Name of Program:Other

Are you interested iN the AM art or PM science camp?

AM Art Camp (8:30-12)PM Science Camp (1-4:30)Either

Does your child have any allergies?

Does your child have any special concerns?

Parent/Guardian Name:

First NameLast Name

Relationship to Child:

ParentLegal GuardianFoster ParentOther:

Parent/Guardian Name:

First NameLast Name

Relationship to Child:

ParentLegal GuardianFoster ParentOther:

Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number:

Area CodePhone Number

Email:

example@example.com

Emergency Contact Information:

First NameLast Name

Relationship:

Phone Number:

Area CodePhone Number

Name of Individuals Authorized To Pick Up Child:

First NameLast Name

Busy Beavers Academy

Child Information

Family Information

Payment Information

Credit Card

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