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ArchiVenture 2019 Registration

A separate entry (registration) is required for each child registered.

Camp schedule: July 22-26, 2019 from 8am - 5pm. Before and after care is not available at this time.

Cost: DISCOUNTED to $100 per child which includes a $25 non-refundable registration fee.

To pay by credit card, click HERE or use the link included in the confirmation email you will receive following submission of the registration form. Cashier’s checks and money orders (ONLY) will be accepted on the participant’s first day of camp. Make cashier’s checks and money orders payable to the Little Phoenixes Foundation.

No cash or personal checks will be accepted.

Registration fee waivers and limited camp scholarships are available. Email Info@LittlePhoenixes.org for eligibility requirements and to apply.

Participant Information
Child's Name: *
Child's Name:
Birthdate: *
Birthdate:
Address: *
Address:
If a resident of the District of Columbia, indicate Ward #. If a resident of Maryland, indicate County.
Any allergies: *
Please note whether the allergy is an ingested or a contact allergy.
Medical Information *
Does your child need to take prescription or over-the-counter medications during camp hours?
List any medications your child will be taking at home during the duration of the camp AND/OR any medication your child will need to take during the camp hours.
Is participant covered under health Insurance? *
Subscriber D.O.B.
Subscriber D.O.B.
Parent / Guardian Information
Parents Name: *
Parents Name:
Work Phone Number: *
Work Phone Number:
Cell Phone Number: *
Cell Phone Number:
Secondary Parent / Guardian Name:
Secondary Parent / Guardian Name:
Work Phone Number:
Work Phone Number:
Cell Phone Number:
Cell Phone Number:
In Case of Emergency
Name of local friend or relative (not living at same address): *
Name of local friend or relative (not living at same address):
Cell Phone Number: *
Cell Phone Number:
Work Phone Number: *
Work Phone Number:
Pick Up Permissions
The Following persons are permitted to pick up my child:
Name 1:
Name 1:
Name 2:
Name 2:
Name 3:
Name 3:
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Copyright © 2019 Little PHOENIXES Foundation, Inc. is a 501(c)(3) non-profit organization.  All rights reserved.