Summer Camp | Garden State Academy

Submitting this form does not guarantee admission. Once the form is completed you will be contacted directly via email from one of our administrators with further instructions on how to confirm your registration.

Camper Information

Camper's First Name

Camper's Last Name

Date of Birth

Grade in September 2022

Does your child have a diagnosis?

Does your child have an IEP?

Please select the weeks your child will be attending:

Week 1: July 5th-8th | Magical Experiment

Week 2: July 11th - 15th | Colorful Rainbow

Week 3: July 18th-22nd | Around the World

Week 4: July 25th-29th | Adventureland

Week 5: August 1st-5th | Wild Safari

Week 6: August 8th-12th | Splish Splash Under the Sea

Week 7: August 15th-19th | GSA Roar

Parent/Guardian #1 Information

First Name

Last Name

Relationship to Camper

Address

City

State

Zip

Home Phone

Cell Phone

Work Phone

Employer

Parent/Guardian #2 Information