Select a Program *

Philadelphia, Center City, August 3 - 7, 2019,

Cambridge Innovation Center, August 10 - 14, 2020

Regis College, August 17 - 21, 2020

Child's Name *

First Name

Last Name

Gender *

Male

Female

Birth Date *

MM

DD

YYYY

Parent / Guardian Name *

First Name

Last Name

Cell Phone *

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Work Phone

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Home Phone *

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Does your child have any allergies, food allergies, dietary restrictions, or physical, mental, or psychological conditions requiring medication, treatment, or special treatment or consideration during the program? If yes, please explain (or contact us). *

Yes

No

1) Student and parents agree to abide by rules and regulations set by Directors for health, safety, and welfare of the students. 2) Parents give student permission to participate in all program activities shown on sample and final schedule, special programs, and off-site trips, etc. 3) Parents agree to give the program permission to use student's likeness or image in program publications, web site, social media, and videos. *

Agree

Don't Agree (cancel registration)