Summer Camp Registration Form

Note: Please add supply fees to the total if applicable.
Note: Math, Sewing, Fashion Design, DIY crafts and Candles to Scrubs each have an additional $30 supply fee.
Note: The price shown is as estimated by this tool. Please verify the calculation.

If you need beforecare/aftercare click below and pay on the first day of camp, fees are not included above.

Aft/bf care?(separate price)

Registration Form

Registration Code

How did you hear about us

E-Mail

Personal Information

Parent Full Name

Phone #

Alternate Phone #

Address

City

State

Zip Code

Student Information

First Name

Last Name

Grade

Allergies

Emergency Information

Contact Full Name

Emergency Phone #

Payment by check only and must be received to complete registrations.

Make check payable to: Little Einstein Explorers
Mailing address: PO Box 223242, Chantilly, VA 20153-3242.