* 1.
Question - Required -
Child's name:
* 2.
Question - Required -
Child's grade completed in the 2022/2023 school year:
(Maximum response 255 chars, approx. 5 rows of text)
* 3.
Question - Required -
Street address:
(Maximum response 255 chars, approx. 5 rows of text)
* 4.
Question - Required -
City:
(Maximum response 255 chars, approx. 5 rows of text)
* 5.
Question - Required -
Zip code:
(Maximum response 255 chars, approx. 5 rows of text)
* 6.
Question - Required -
Name of parent/guardian:
(Maximum response 255 chars, approx. 5 rows of text)
* 7.
Question - Required -
Parent/guardian phone number:
* 8.
Question - Required -
Parent/guardian E-mail:
(Maximum response 255 chars, approx. 5 rows of text)
* 9.
Question - Required -
Please list any behavioral, medical, or other special considerations (please type "none" if your child does not have any special considerations):
(Maximum response 255 chars, approx. 5 rows of text)
* 10.
Question - Required -
Please include any other information that
may be helpful:
(Maximum response 255 chars, approx. 5 rows of text)
11.
Question - Not Required -
(Optional) *T-shirt Size*
If purchasing a T-shirt for your child, please indicate size choice below:
* 12.
Question - Required -
The following demographic questions help us track our work toward diversity, equity, and inclusion, and apply for funding to support our work. Your child's information is being used only for overall reporting and will not in any way affect your eligibility for, or participation in, our programs.
What is your child's ethnicity?
Please select response
Hispanic or Latino
Not Hispanic or Latino
Do not wish to provide
* 13.
Question - Required -
Which race does your child primarily identify with?
Please select response
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Do not wish to provide
14.
Question - Not Required -
If registering multiple children, please list their name, age, and any special considerations here:
* 15.
How did you hear about Camp Unleashed?
(Select one of the available choices or enter a different value.)
Question - Required - How did you hear about Camp Unleashed? Click this to indicate that you will select an existing value. Tab to next input."
How did you hear about Camp Unleashed?
Please select response
WHS website
Web search
Email from WHS
Facebook or other social media
MKE with Kids
Milwaukee Moms
Friend or family
WHS Flyer
Other
How did you hear about Camp Unleashed? Click this to indicate that you will enter a new value. Tab to next input."
How did you hear about Camp Unleashed? Provide your answer here
16.
Question - Not Required -
If "Other," please specify: