Camp Registration

Summer Camp 2026: 5 years old and up 9:00 AM–12:45 PM (August: extended day available until 3:00 PM)

A minimum of 5 kids must sign up for the camp to take place.
Child Name

First NameLast Name
Age
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
To register by day please email bluegiraffedc@gmail.com or call 301-275-6768
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