Summer Camp 2026 Ages 12-16 Enrollment Form

Teen & Tween Summer Camp Registration Ages 12–16

We are starting with two camp options and may add additional weeks based on interest. There is a section below where you can share your availability and let us know if you’re interested in additional dates.
Camper Name*

First NameLast Name
Birth Date*

MonthDayYear
Age of Camper as of June 1, 2026*
Grade (FALL 2026)*
Name of School (for Fall 2026)
Parents and Guardians

Information
Name of Parent or Guardian 1*

First NameLast Name
E-mail of Parent or Guardian 1*
example@example.com
Phone Number of Parent or Guardian 1*

Area CodePhone Number
Address of Parent or Guardian 1*

Street Address

Apartment

CityState

Zip Code
Name of Parent or Guardian 2

First NameLast Name
Email of Parent or Guardian 2
example@example.com Please double check for accuracy.
Phone Number for Parent or Guardian 2

Area CodePhone Number
Parent/Guardian 1 and 2 have same address.
Address of Parent or Guardian 2

Street Address

Apartment

CityState

Zip Code
NoYes (please elaborate below)
If yes, please provide details below, including:
- Specific diagnoses or challenges
- Any strategies, tools, or accommodations that help your child succeed
- Anything else you feel would help us create a positive and supportive environment

Camps to choose from

Select which camp you'd like to register for
Select this camp
M-F 1pm-4pmI need to register for selected days
Selected Days

If you selected “specific days” above, please list the days you would like your student to attend.
Details:
I would be interested in additional Teen & Tween camp weeks (ages 12–15)I would be interested in additional Tween camp weeks (ages 10–13)I am interested in specific dates not currently offered (please list below)I am interested in different camp themes (please list below)
If you selected any of the options above, please share details (dates, themes, ages, etc.):

Emergency Form Submission

Please click here to download the required Emergency Form.

We must have your physical signature directly on this form (typed signatures or completed Google Docs are not accepted).

This form provides us with important medical and contact information for your child. We carry a copy with us during all off-site adventures, such as trips to the beach or park, so that we are prepared in the unlikely event of an emergency.

Once completed, you may:

✅ Upload a scan or photo of the signed form in the space below
🖨️ Print, sign, and bring it with you on the first day of camp
📧 Email it to: santacruzlearningcenter@gmail.com
📬 Mail it to:
Santa Cruz Learning Center
2560 Soquel Ave, Suite 204
Santa Cruz, CA 95062

Thank you for helping us keep your camper safe and well cared for!
Upload a photo or a scan of your completed emergency form here.

Browse Files
Click on the "Browse Files" button to find and select your form. Cancelof
Anything We Missed?

We want to ensure we have all the information needed to support your child and create a great camp experience.

Is there anything else you’d like to share about this camper, or anything we may have neglected to ask in the registration form

Let us know below.
Don't hesitate to answer informally and freely!
PAYMENT INFORMATION
Name of individual responsible for payment.*

First NameLast Name
Relationship of responsible person to camper.*
Email of responsible party. If this email is already included under parent or guardian information. You may leave this section blank.
example@example.com
Payment Information

Because these camps are small and require advance preparation of materials, full payment is required to reserve a spot.

We are unable to hold spots without payment, as supplies, staffing, and planning are based on confirmed registrations.

Camp Rates:
- Forensics & Physiology (June 15–19, 1–4 PM): $175
- Coastal Crafts & Design (1–4 PM): $275
If you have any questions or need to make arrangements, please don’t hesitate to reach out:
📧 santacruzlearningcenter@gmail.com
📞 (831) 331-5611

Enter your payment amount and the type of payment

USDEnter the total amount for Camp

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

ACH Bank Transfer

Should be Empty:

Teen & Tween Summer Camp Registration Ages 12–16

Parents and Guardians

Camps to choose from

Permissions Section

PAYMENT INFORMATION

Payment Methods