Summer Adventures Registration Form "*" indicates required fields Δ Step 1 of 2 - Registration 50% Name of child* First Last Age*as of June 2026Grade*as of Sept 2026Gender(Optional)This field is hidden when viewing the formExtra Please Register my child for the upcoming Summer Adventures Program with The Phoenix School. No 1 No 2 ROV Construction, Extended Day (Optional) Price: Please Register my child for the upcoming Summer Adventures Program with The Phoenix School. Superhero Science: Full Week, Jun 15 - 19 Superhero Science: Individual Days Maker Missions: Full Week, Jun 22 - 26 Maker Missions: Individual Days Invention Convention: Full Week, Aug 17-21 Invention Convention: Individual Days Water World: Full Week, Aug 24 - 28 Water World: Individual Days Individual DaysDO NOT DELETE - REQUIRED for calculation totals for individual day!!!Extended DaysDO NOT DELETE - REQUIRED for calculation totals for extended day!!!Superhero Science: June 15 - 19, 2026 Price: Superhero Science - Individual Days* Monday 6/15 Tuesday 6/16 Wednesday 6/17 Thursday 6/18 Friday 6/19 This field is hidden when viewing the formN/A - Extended Day (Optional)extended day option 3pm - 5pm - Please note: extended day NOT available for Friday Monday 6/20 Tuesday 6/21 Wednesday 6/22 Thursday 6/23 Maker Missions: June 22 - June 26, 2026 Price: Super Hero Science- Individual Days*ONLY for less-than-full-week enrollment. Monday 6/22 Tuesday 6/23 Wednesday 6/24 Thursday 6/25 Friday 6/26 This field is hidden when viewing the formN/A - Ext Day Selection (Optional)Extended Day option 3pm - 5pm Please note: extended day NOT available for Friday Monday 6/27 Tuesday 6/28 Wednesday 6/29 Thursday 6/30 Invention Convention: August 17-21, 2026 Price: Invention Convention - Individual Days*ONLY for less-than-full-week enrollment. Monday 8/17 Tuesday 8/18 Wednesday 8/19 Thursday 8/20 Friday 8/21 This field is hidden when viewing the formN/A - Ext Day Selection (Optional)Extended Day Option 3pm - 5pm - Please note: extended day NOT available for Friday Monday 8/21 Tuesday 8/22 Wednesday 8/23 Thursday 8/24 This field is hidden when viewing the formN/A - Ext Day Selection (Optional)Extended Day Option 3pm - 5pm Monday 8/24 Tuesday 8/25 Wednesday 8/26 Thursday 8/27 Friday 8/28 Water World: August 24-28, 2026 Price: Nature Agents - Individual Days*ONLY for less-than-full-week enrollment. Monday 8/25 Tuesday 8/26 Wednesday 8/27 Thursday 8/28 Friday 8/29 This field is hidden when viewing the formN/A - Ext Day Selection (Optional)Extended Day 3pm - 5pm - Please note: extended day NOT available for Friday Monday 8/29 Tuesday 8/30 Wednesday 8/31 Thursday 9/1 There are no openings for World Engineers, your child will not be enrolled for any dates in this session. How did you hear about Summer Adventures at The Phoenix School?* Facebook/Social Media Direct Mail Homeschool Group Email From a Friend Other Which friend(s) recommended our program?Would your child like to be a Teen Leader (TL)? Indicate below which sessions they are interested in. Note that there is a separate application process & you will only be billed if applicant is accepted..The Teen Leadership Program is for young people who are too young to have a job, but are interested in spending a week assisting our course teachers in the field, mentoring younger children, helping out with the activities for the day, supervising recess or play at the park. Teen Leaders will be given special assignments by their directing teacher and be responsible for various odd jobs that make the course run smoothly. Interest in science, animals, inventing and building with art materials, and using technology (Mac based) to create presentations — a plus. Teen Leaders should have had previous experience working successfully with younger children, be able to work as a member of a team and have a basic understanding of how children learn through active exploration. 1-2 applicants will be accepted for each course. Please refer to the Teen Leader section on our website for more information. June 15-19 - Superhero Science - TL June 22-26 - Maker Missions - TL August 17-21 - Invention Convention - TL August 24-28 - Water World - TL Other: Please indicateWhat School or Homeschool Groups are you connected with?* Parent's/Guardian's Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Preferred Phone Number*Alternate Phone Number2nd Parent's/Guardian's Name (if applicable) First Last Your Child's Allergies and other Medical Conditions*Please list all allergies, including food, environmental and pharmaceutical. List any medical conditions or limitations. if none, please list "none". T-shirt Size*Youth - SmallYouth- MediumYouth - LargeAdult - SmallAdult - MediumAdult - LargeAdult - X-LargeNote: Since T-shirts must be ordered well in advance, we cannot guarantee your preferred size but if necessary will substitute the best fit from available sizes. I give permission to The Phoenix School to take, use, publish, and reproduce photos, slides, or videos of my child for its records and/or publications.* Yes No Please indicate if we may use your child's photo. The following waiver must be signed to complete registration: Permission is granted for my child to participate in all planned Summer Adventures activities; understanding that competent leadership and supervision will be provided. I understand that programs that do not meet the minimum enrollment may be cancelled or changed I agree to have the medical and emergency forms completed and sent to The Phoenix School by June 10th or by August 12th. I understand that my child may not attend a Summer Adventures program until the medical and emergency forms are received by The Phoenix School. Refunds will not be given for days missed due to lack of properly completed forms. I agree to pay the balance of my child's tuition by June 10th or August 12th. I understand the $50 Registration Fee for each program is non-refundable and that tuition is not refundable for withdrawal, dismissal, failure to attend, or incomplete attendance. To receive a full or partial tuition refund, cancellations must be made on or before June 10th or August 11th. Digital Signature - Permission to participate* Authorization for Medical and/or Surgical Treatment and for Release of Information Every effort is made to contact and inform the parents or guardians in case of a medical emergency, serious injury, or illness when immediate medical or surgical intervention is deemed necessary. On isolated occasions the parents or guardian cannot be reached. Accordingly, they are requested to sign the following statement: In the event of illness or accident involving our/my son/daughter, we/I hereby give permission to The Phoenix School, its officials, and the treating physicians, surgeons, and dentists, to secure and furnish medical, dental, or surgical care and treatment for him/her and to give, administer, and render any treatment or aid, including anesthetics or surgery, as is necessary to protect, preserve, and safeguard the life and health of our/my son/daughter. We/I further authorize The Phoenix School to release information to facilitate the medical or surgical care of our/my son/daughter, as is necessary for the completion of a claim for health insurance. I give permission to the Vacation Adventures instructor to share information relevant to my child’s health condition with appropriate school personnel when needed to meet my/our child’s health and safety need.Digital Signature - Permission to Treat and/or to Release Medical Information as per the above Authorization Form*Total Credit CardCard Details Cardholder Name
