Registration for Summer Explore! and Common Threads programs for kids.

You will need to complete a separate form for each child you are registering.

Please note program location(s)—we offer programs at Red Run Park, Happel’s Meadow, and Pine Hill Recreation Area.

 

    Parent or Guardian Name (required)

    Email (required)

    Phone (required)

    Address Line 1 (required)

    Address Line 2

    City, State, Zipcode (required)

    Are you a member of The Institute? (required)

    Relationship to Student (required)

    Name of Child (required)

    Birthdate (required)

    Gender (required)

    School (required)

    Entering Grade for Coming School Year (required)

    Allergies (N/A for none) (required)

    Disabilities or Special Needs (N/A for none) (required)

    Medications Child Currently Takes (N/A for none) (required)

    Who else may pick up the child? (required)

    This person's phone (required)

    Backup Emergency Contact (required)

    Phone for Emergency Contact Person (required)

    Select program(s) desired below. Note location: All of these will occur at Pine Hill Recreation Area in Waynesboro, Pa.

    Comments