Wild Hearts Family Cooperative Summer Camp Application

SUMMER CAMP ADMISSIONS APPLICATION

please note enrollment for summer camps is limited, if we have space available after accommodated all of our current and incoming students, only then will we be able to offer enrollment to non-students. Our Wild Hearts Summer Camp operates as a parent-led cooperative program, meaning families play an active role in supporting the daily life of the camp. This structure allows us to offer a high-quality, community-centered program at a significantly reduced tuition rate, while still providing professional oversight and guidance.
Child's Name*

First NameLast Name
Child's DOB*

MonthDayYear
Date
Parent/Guardian 1 Name*

First NameLast Name
Parent/Guardian 2 Name (if applicable)

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred Household EMAIL ADDRESS:*
Preferred Phone Number*

Area CodePhone Number
AGE GROUPING

Please select your child's age group below:
Which camp will your child be placed in based on their age/eligibility?

TOTS CAMP (ages ~18 through 36 mos, must be independently walking or have a support aide or assistive device/equipment to ensure accessibility and safety)PRESCHOOL CAMP (ages ~3 through rising Kindergarten, must be using the toilet independently or have a support aide to assist with this skill until mastery is achieved)SCHOOL-AGE CAMP (ages ~rising 1st through 4th grade, must be using the toilet independently or have a support aide to assist with this skill until mastery is achieved)
ELIGIBILITY REQUIREMENTS

The following conditions are required in order to be eligible for enrollment in summer camp (based on the child's age/group placement)
my child is (or will be by the start of camp) using the toilet independently or has a support aide to assist with this skill until mastery is achieved *required for ages 3+ (for preschool and school-age camps)my child is (or will be by the start of camp) confidently walking or has a support aide/assistive device to ensure accessibility and safety *required for all agesmy child is developmentally capable of remaining with an assigned group of peers/teachers for the entirety of the day in an area that is not secured by a fence, or has a support aide to ensure safety *required for ages 3+ (for preschool and school-age camps); if your child struggles with elopement please contact us prior to applying
Please select the term during which you would like your child to attend
Enrollment Year Selection*
Session Attendance Selection
Days of Attendance Selection
Please note that 5-day enrollments will be given priority placement. 2 + 3 day applicants will be processed after February 15 if spots remain available.
Enrollment Priorities (please select all that apply; priority is given to applicants in the order listed here)

This child is the sibling of a currently enrolled studentMy child has previously attended camp, school or another Garden programOur family has visited the schoolI am willing to volunteer as an on-call sub throughout my child's enrollment term
Acknowledgement of Parent Responsibilities

Please carefully review the Wild Hearts Cooperative Community Handbook to learn more about the full volunteer responsibilities for all families participating in the Summer Camp Cooperative and sign to acknowledge full understanding of these responsibilities. Outlined below is the parent volunteer time committment based on days of attendance and enrollment sessions.
I have carefully reviewed the admissions information including the Co-Op Community Handbook and agree to all policies, terms and conditions provided within.*

Powered by Jotform SignClear
Please wait to be redirected to the payment link after submitting this form.
Should be Empty:

SUMMER CAMP ADMISSIONS APPLICATION

AGE GROUPING

ELIGIBILITY REQUIREMENTS

Acknowledgement of Parent Responsibilities