IQhub · 2022 Camp Invention

Contact Information (One child per form)

Child's Name

*

First Name

Last Name

Birth Date

*

(mm/dd/yyyy)

Gender

*

Female

Male

Ethnicity

Grade Fall 2022

*

Name of School Attending in Fall 2022

*

Does your child require an EpiPen?

*

Yes

No

Allergies, prescribed medications, and/or special accommodations

Please call the IQhub at 989-224-3847 a minimum of 2 weeks prior to camp for any 1:1 assistance or medication administration requests.

Alternate Transporation - Name, relationship, phone #

Permission to take/use child's photo (no name) in social media

*

Yes

No

T-Shirt Size

*

Youth Small

Youth Medium

Youth Large

Adult Small

Adult Medium

Adult Large

How did you hear about camp?

*

Parent/Guardian Information

Name

*

First Name

Last Name

Phone

*

Email

*

Verify Email

*

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Pricing & Payment

Camp Times

Drop off 8:15 am to 8:30 am

Camp Time 8:30 am-3:00 pm

Camp Pricing

$80.00 with $10 discount for early registration by May 31st

$90.00 After June 1st

Extended care from 3 pm to 5 pm is an extra $30 for all 3 days

Payment Options

*

Mail form/Pay by Check - (Child's spot is not reserved until check is received)

Credit Card via PayPal

Payment *	Quantity
$80 - Registration Before May 31st
$90 - Registration After June 1st
$30 - 3-5 PM Extended Care for All 3 Days