Parents Name *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Child Name *

First Name

Last Name

Child Birthday *

MM

DD

YYYY

Camp Selection

Week 1: 7/8 - 7/12/24: Archery / Robotics

Week 2: 7/15 - 7/19/24: Cooking / Kayaking

Weeks3: 7/22-7/26/24: Data Science / Avation

Week 4: 7/29 - 8/2/24: Hellyer Park Mural

Tell me more... *

San Jose Resident

US Veteran or Active Duty

Other