Register for Summer with Create a Loop

Applicants Name *
Applicants Name
Applicant's Birthdate *
Applicant's Birthdate
Preferred Summer Courses (seats limited) *
Half-Day, 8:30am-9:00 Drop off, 9am-12:00pm Camp
Address *
Address
Parent/Guardian Name *
Parent/Guardian Name
Parent/Guardian Number *
Parent/Guardian Number
Are you applying for a scholarship? *