*
Required
Is your student currently enrolled at Barnhart School?*
Yes
No
Student First Name
*
required
Student Last Name
*
required
School Attending in the Fall 2026
*
required
Phone Number
*
required
Address
*
required
Address 2
City
*
required
State
*
required
Zip
*
required
Mother/Guardian's Name
*
required
Father/Guardian's Name
*
required
Person(s) authorized to pick up your student(s) from Barnhart
*
required
Enroll my student in the following full-week camps
Aloha Summer Camp: June 1st - June 5th - $375
Where the Wild Kids Are Camp: June 8th - June 12th - $375
Enroll my student for daily camps
Mon, June 1
Tues, June 2
Wed, June 3
Thurs, June 4
Fri, June 5
Mon, June8
Tues, June 9
Wed, June 10
Thurs, June 11
Fri, June 12
Do you need childcare?
Yes
No
Select your child care needs
Week 1 (Full week)
Week 2 (Full week)
Mon, June 1
Tues, June 2
Wed, June 3
Thurs, June 4
Fri, June 5
Mon, June8
Tues, June 9
Wed, June 10
Thurs, June 11
Fri, June 12
I understand that full refunds will only be given if Barnhart Cancels camp. No refunds are given for withdrawls*
I understand
Can we use your students emergency contact on file?*
Yes
No
Emergency Contact Name
*
required
Emergency Contact Phone Number
*
required
Student Doctor Name
*
required
Phone Number
*
required
Medical Insurance Company
*
required
Policy Number
*
required
Please list any known allergies or medical problems and any medications your child takes daily
*
required
I understand that the final disposition of an emergency, the judgment of the school authorities, will prevail.
Emergency Contact Name
*
required
Emergency Contact Phone Number
*
required
Parent Signature
*
required
Please send a confirmation email to the address below*: