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Summer School Camp at POP
1
Registration Form
2
Review
3
Receipt
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= Required
Child 1
First Name
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Last Name
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Nickname
Birthdate
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Allergies or special medication
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Child 2
First Name
Last Name
Nickname
Birthdate
Allergies or special medication
Child 3
First Name
Last Name
Nickname
Birthdate
Allergies or special medication
Parent/Guardian 1 Information
First Name
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Last Name
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Address, City, State
Email Address
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Cell Number
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Parent/Guardian 2 Information
First Name
Last Name
Address, City, State (If different from Parent 1)
Email Address
Cell Number
Emergency Information
Who is NOT authorized to pick up your child?
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LOCAL
emergency information other than parent's.
Contact 1
First and Last Name
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Address, City, State
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Phone Number
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Registration Cost
Session 1 "Let's Explore" - August 1-5 Mon-Fri 9-11:30 AM
One Child ($125.00 USD)
Two Children ($250.00 USD)
Three Children ($375.00 USD)
Event Information
8/1/2022 9:00 AM -
8/5/2022 11:30 AM
Contact Information
Marie Strain
952-898-9346
mstrain@popmn.org
